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Nomination Form
Debutante Nomination Form
Read Before Completing:
A candidate must have attained at least her freshman year in college or the equivalent. She may not be formally engaged at the time of the presentation nor may she be associated with another debutante club prior to The Debutante Club of Mississippi, Inc. (Herein after called DMC) presentation. IMPORTANT: Recommendations must be submitted on these forms only! Additional forms may be picked up from Mary Ellen Dillard. PLEASE DO NOT ATTACH A RESUME or Extra Paper – FILL IN THE BLANKS. If the information is not complete, the prospect will not be considered. If more information beyond the scope of this form is needed, you will be contacted. CONFIDENTIALITY: PLEASE DO NOT PUBLICLY DISCUSS PROSPECTIVE DEBUTANTES. Mothers and sisters SHOULD submit proposals. Additional letters of recommendation are encouraged. NO ONE IS AUTOMATICALLY INVITED. PLEASE RETURN THIS FORM NO LATER THAN January 15, 2026.
PROSPECTIVE DEBUTANTE:
Name
(Required)
Last
First
Middle
Called By
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Age
(Required)
Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
High School Attended
Year Graduated
College Attending
College Sorority:
Mothers, Grandmothers, and Great-Grandmothers that have made debut with DMC in Jackson (name & relation):
Siblings & their ages:
PARENT’S HISTORY:
Full Name means Title, First, Middle/Maiden, and Last
Marital Status
Married
Divorced
Mother's Full Name
Title
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Middle
Last
Maiden Name
Father's Full Name
Title
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Middle
Last
Parent's Address
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Cell Phone
Email
Mother raised in
Father raised in
Length of Parents’ Jackson (or other hometown) Residency:
Parent’s Previous Residency
Length of Residency:
Father’s Occupation:
Mother’s Occupation:
Names of Maternal Grandparents & Residence:
Names of Paternal Grandparents & Residence:
Parents’ Civic Activities:
Prospective Debutante Honors:
(Please list High School & College Honors and Community/Civic Services below)
Please describe your relation to the sponsored lady and length of time you have known her:
How well do you know the Prospective Debutante? Check one of the following:
I know the prospective debutante well, and I am willing to back the recommendation in the strongest possible manner and will furnish other information if desired.
I know little of the prospective debutante but think she is definitely eligible for consideration for membership.
I do not know the prospective debutante but was asked to recommend her. This is a courtesy recommendation only.
Digital Signature
Full Name
Title
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First
Middle
Last
Maiden
Year of Presentation
Address
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Cell Phone
Email