2017-2018 Nominations

Email Address *

Please use an email that you check at least once a week. However, avoid using a Comporium account because Comporium blocks MailChimp emails.

Alternate Email Address (for Comporium users)

If you use Comporium, please provide another email.

Indicate Chapter Location *

Please Select OneGaston County, North CarolinaLancaster County, South CarolinaYork County, South Carolia

Please Select which location is best for your nomination.

Participant's First Name *

Participant's Preferred Name

Participant's Last Name *

Participant's Gender *

LadyGentleman

The participant will be in... *

Please indicate which grade the participant will enter in August 2017.

The participant attends... *

Please indicate which school the participant will attend in August 2017.

Mailing Address *

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

All Classic Cotillion, LLC correspondence will be mailed to this address.

Home Telephone Number *

( ) -

If the participant does not have a home number, please use (555) 555-5555.

Title

This title will be used when addressing envelopes for the formal invitation.

Parent's First Name *

The formal invitation will be addressed to this person.

Parent's Last Name *

Contact Number *

( ) -

Please include a cell or work number for the participant's parent. This will be used to return telephone calls ONLY. If you do not wish to do so, use (555) 555-5555.

Sibling Information *

Please list the first and last names of all siblings and include the grade they will enter in Aug 2017. Please type "none" if there are no siblings.

Nominated by

Please leave your name so that we may thank you. NOTE: We do not mind if you nominate your own child.

York County AND Gaston County's CLASSIC COTILLION, LLC 2017-2018 Nominations

York County AND Gaston County's
CLASSIC COTILLION, LLC
2017-2018 Nominations