Application

Applications for Graduating Class of 2032 fall season will be accepted beginning 1 February 2024.

Applications for graduating classes, 2029, 2030, and 2031 are accepted at any time.

There is no application fee. If accepted, tuition in the amount of $275 will be due upon acceptance in July.

Thank you for your interest in LRJC.

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Email *
Today's Date *
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Applicant's First Name *
Applicant's Last Name *
Applicant's Preferred Name *
Applicant's Gender *
Applicant's High School Graduation Year *
Applicant's School - Please state the school they will be enrolled in during their time in Cotillion. *
Applicant's Mailing Address *
Applicant's City *
Applicant's Zip Code *
Guardian 1: First and Last name *
Guardian 1: Email Address 
Please list an email address that is checked frequently.
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Guardian 1: Mailing Address *
Guardian 1: Phone Number *
Guardian 1: Relation to Applicant *
Guardian 2: First and Last name *
Guardian 2: Email Address 
Please list an email address that is checked frequently.
 *
Guardian 2: Mailing Address *
Guardian 2: Phone Number *
Guardian 2: Relation to Applicant *
Emergency Contact: First and Last name *
Emergency Contact: Phone Number *
Emergency Contact: Relation to Application *
Applicant is a Legacy -
A legacy is an applicant whose parent or older sibling attended LRJC ALL FOUR YEARS or when an older sibling is reenrolled for the same year the younger sibling is applying for. The parent passes the legacy to the first child, who passes the legacy to the second child, etc.  
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Legacy Information - First and last name *
Legacy Information - Relation to Applicant *
Legacy Information - Years of attendance  *
Legacy Information - Maiden Name *
Please tell us anything about your child that we may need to know to provide the best experience possible; physical differences, needs to keep insulin near, has seizures, etc.
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Waiver and Consent - Sign full name

By submitting this application, I consent to my child participating in Little Rock Junior Cotillion, Inc. (LRJC) dances and other activities and consent to LRJC publishing photographs of my child while participating. LRJC may summon medical or other assistance for my child in an emergency. I acknowledge, agree and consent that LRJC dances and other activities involve physical activity and physical contact with others. I release and hold harmless LRJC and its employees, officers, directors and agents from any responsibility, claim or liability for harm or injury resulting from my child participating in LRJC.

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A copy of your responses will be emailed to the address you provided.
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