Director’s Home

National League of Junior Cotillions
Fairfax & Arlington Chapters High School Cotillion

Registration

2020-2021 registration for Fairfax & Arlington Chapters High School Cotillion

High School program tuition is $450.

Due to COVID-19 the 2020-2021 season will not begin until March.

To register for 6th-8th grade classes in the Fairfax and Arlington Chapters please see our list of classes and locations here.

TUITION PAYMENT

Tuition is due in full by the first day of class.

You can choose to pay online or by check.

To pay online select 'Pay with PayPal' with registration. You may choose to pay full tuition upfront or to make two payments of 50% tuition each. A small 3.15% processing fee will be added to your online payment.

To pay by check, select 'Pay with check' at the end of registration. Mail a minimum $50 tuition deposit to The Ann Group, LLC, 9712 Schmidt Drive, Burke, Virginia 22015.

Please put student's full name and grade on the memo line.

NLJC has 'no refund' policy except in the case of extraordinary circumstances such as extreme illness or moving out of the area.

ENROLLMENT CONFIRMATION

Enrollment confirmation and class information are all sent through email. Please make sure your email address is correct.

If you have any questions about registration or program information please contact us at:

703-569-6721 or send an email to [email protected]

2020-2021 Student Information

Class Registering For*

First Name*

Last Name*

Preferred Name*

Gender * Male Female

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 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 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 Fairfax & Arlington Chapters High School Cotillion 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, Ann Achiu, 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.

Refund * There will be no refunds given except in the case of extraordinary circumstances such as moving or illness in fairness to the students who are on the waiting list.

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 PayPal* I'll pay by check

*an online handling fee of 3.25% will be added to PayPal payments.

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
Fairfax & Arlington Chapters High School Cotillion

Registration

2020-2021 registration for Fairfax & Arlington Chapters High School Cotillion

TUITION PAYMENT

ENROLLMENT CONFIRMATION

2020-2021 Student Information

2020-2021 Student #2 Information

2020-2021 Student #3 Information

2020-2021 Student #4 Information

2020-2021 Student #5 Information

2020-2021 Student #6 Information

About the Parents

Younger Siblings