Director’s Home

National League of Junior Cotillions
Greater Lee County Chapter

Registration

Welcome to the Greater Lee County Chapter of the National League of Junior Cotillions! We are so pleased you have interest in signing up your student for the 2025 - 2026 cotillion season. Please note that it is very important for you to check the schedule below to ensure you do not have any conflicts for the classes. We work very hard to ensure we have an equal number of ladies and gentlemen for our ball room dancing lessons. Classes will be filled on a first-come, first serve basis and require both payment and a completed registration form for enrollment.

If you have any questions regarding enrollment, payment, or the registration process in general, please feel free to contact me at [email protected] or 334-524-1694.

2025 - 2026 Tentative Class Schedule:

August 24

September 14

October 26

November 2

December 14

January 11

January 25

February 10

February 24

March 1

2025-2026 Student Information

Class Registering For*

First Name*

Last Name*

Preferred Name*

Gender * Male Female

Salutation

Street Address *

City *

State *

Zip *

What school will the student attend in the fall *

What elementary school did the student attend*

Current Grade *

Grade Entering In Fall *

Birth Date (format: 5/13/2011)

Add additional child to this registration »

About the Parents

How did you hear about us?

Parent / Guardian 1 Salutation

Parent / Guardian 1 First Name *

Parent / Guardian 1 Last Name *

Parent / Guardian 1 Email Address *

Parent / Guardian 1 Email Address (Again)*

Parent / Guardian 1 Cell (or Preferred) Phone *

Parent / Guardian 1 Occupation

Parent / Guardian 2 Salutation

Parent / Guardian 2 First Name

Parent / Guardian 2 Last Name

Parent / Guardian 2 Email Address

Parent / Guardian 2 Cell (or Preferred) Phone

Parent / Guardian 2 Occupation

Photo and Video Release*

Please use the checkbox below to grant permission to the National League of Junior Cotillions and National League of Junior Cotillions Greater Lee County Chapter to use photos and/or videos taken at NLJC events for any legal use, including but not limited to newsletters, publicity, and web content, UNLESS I notify the director, Mary Evelyn Jordan, in writing (with instructions and a photo of the child) before classes begin. The National League of Junior Cotillions will not use names or identifying information about students in any publication.

As the parent/guardian, I GIVE permission for images of my child(ren) to be used by The National League of Junior Cotillions in print or electronic materials as indicated above.

As the parent/guardian, I DENY permission for images of my child(ren) to be used by The National League of Junior Cotillions in print or electronic materials as indicated above.

Allergies * I understand the director will not be held responsible with respect to accommodating food-born allergies.

Note to Director

Payments I'll pay with Venmo I'll pay by check

Younger Siblings

We attempt to ensure that younger siblings receive an invitation to participate, once they have reached the appropriate age for cotillion classes. If interested, please provide some information about younger siblings.

Sibling 1 First Name

Sibling 1 Last Name

Birth Date

Year entering fifth grade *

Elementary school child will attend

Sibling 2 First Name

Sibling 2 Last Name

Birth Date

Year entering fifth grade *

Elementary school child will attend

Sibling 3 First Name

Sibling 3 Last Name

Birth Date

Year entering fifth grade *

Elementary school child will attend

Sibling 4 First Name

Sibling 4 Last Name

Birth Date

Year entering fifth grade *

Elementary school child will attend

Please note: If your child has any special dietary restrictions or any conditions that would restrict their ability to participate in cotillion activities, please contact the director with those details.

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Director’s Home

National League of Junior Cotillions
Greater Lee County Chapter

Registration

2025-2026 Student Information

2025-2026 Student #2 Information

2025-2026 Student #3 Information

2025-2026 Student #4 Information

2025-2026 Student #5 Information

2025-2026 Student #6 Information

About the Parents

Younger Siblings