2027 COTILLION APPLICATION FORM

2027 COTILLION ONLINE APPLICATION

Application for 2026-2027 Cotillion
- Participant Name
  
  First NameMiddle NameLast Name
- Gender
- Birth Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearEnter birth date in MM-DD-YYYY format
- Mailing Address
  
  Street Address
  
  Street Address Line 2 or P.O. Box
  
  CityState / Province
  
  Postal / Zip Code
- Home Phone (including area code)
  Please enter a valid home phone number with area codeFormat: (000) 000-0000.
- Mobile Phone (including area code)
  Please enter a valid cell phone number with area codeFormat: (000) 000-0000.
- Email
  example@example.com
- SSN (Last four digits)
  Last 4 digits ONLY
- High School
- High School Cumulative GPA
- College/University You Plan to Attend
- Intended Major/Area of Concentration
- Hobbies/Talents/Sports
- Church Name or Affiliation
  Enter "N/A" if not applicable
- T-Shirt SIze
  Please give unisex t-shirt size
- Mother/Guardian Name
  
  First NameLast Name
- Mother's Phone Number (cell preferred)
  Please enter a valid phone number with area code.Format: (000) 000-0000.
- Mother's Email
  example@example.com
- Father/Guardian Name
  
  First NameLast Name
- Father's Phone Number (cell preferred)
  Please enter a valid phone number with area code.Format: (000) 000-0000.
- Father's Email
  example@example.com
- Female Presenter is Mother/Guardian named in Parents/Guardian Section and will also serve as participant's Waltz Partner (if applicable):
- Male Presenter is Father/Guardian named in Parents/Guardian Section and will serve as participant's Waltz Partner (if applicable):
- Alternate Presenter First and Last Name and Relationship (if applicable)
  
  Presenter First and Last NamePresenter Relationship to Participant
- Alternate Presenter Phone Number (if applicable)
  Please enter a valid phone number including area codeFormat: (000) 000-0000.
- Alternate Presenter Email (if applicable)
  example@example.com
- NOTE: Waltz Partner MUST be 21 years of age or older.
- Waltz Partner First and Last Name and Relationship (if applicable)
  
  Waltz Partner First and Last NameWaltz Partner Relationship to Participant
- Waltz Partner Phone Number (if applicable)
  Please enter a valid phone number including area codeFormat: (000) 000-0000.
- Waltz Partner Email (if applicable)
  example@example.com
- Cotillion applicants must provide the following documents with the Cotillion application:
  - Official High School Transcript
  - Two (2) signed letters of recommendation.(NOTE: One must be from a teacher or academic official.).
  - Headshot Photograph
- UPLOAD DOCUMENTS HERE:
  
  pdf, doc, docx, jpg, jpeg, png
  Cancelof
- FEMALE PARTICIPANT FEE - An inital payment of $300 must be submitted with this application.
  
  MALE PARTICIPANT FEE - An inital payment of $225 must be submitted with this application.
- Cotillion Fee Payment Amount ($300-female or $225-male)
  
  prevnext( X )
  USDWrite in the dollar amount of your payment above: $300 for female participants or $225 for male participants. In the notes section within PayPal, please include participant's name.
- Pay with PayPal
  
  Choose from one of the PayPal options to make your payment.
- Should be Empty:

2027 COTILLION ONLINE APPLICATION

Cotillion Fee Payment Amount ($300-female or $225-male)*

Pay with PayPal

Cotillion Fee Payment Amount ($300-female or $225-male)