Prince George's County Department of Parks and Recreation
 > Xtreme Teens > Hot Happenings > Programs > Teen Cotillion > Teen Cotillion Participant Application

Teen Cotillion Participant Application

Only 20 female and 20 male applicants will be selected to participate in the Teen Cotillion. All applicants must be residents of Prince George’s County, Maryland, and be between the ages of 15 and 18 years old. 

Deadline is Sunday, November 12, 2017. 

Participants must be able and willing to meet the following with or without accommodation: 

  • Participate in a 16-week program and participate in the 2018 Cotillion Culmination Ceremony
  • Practices Thursdays
  • Learn and perform with a partner, simple to moderate dance routines.
  • Listen respectfully in a classroom setting for approximately one hour/week.
  • Follow directions given by the Teen Cotillion staff
  • Stay with the group while on site and on outings

A non-refundable $100.00 fee for participation is due by January 6, 2018.

For additional information, please call the Special Programs Division at 301-446-3400 or email pgxtremeteens@pgparks.com

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Teen Applicant Information
Full Name
Email
 
Date of Birth
Pick date
School
Grade
How do you identify
Deb (wear formal gown & dance with father figure)
Beau (wear formal tux/suit & dance with mother figure)
Home Address (Street Address, City, State, Zip Code)
Home Phone Number
 
Cell Phone Number
 
What Community Center are you involved with?
Are you involved in the Xtreme Teens Program?
Yes
No
Parent/Guardian Information
Name
Address
Daytime Phone Number
 
Cell Phone Number
 
Email
 
Will you need assistance finding a dance partner for the Parent/Guardian dance routine?
Yes
No
Biographic Profile (175 WORDS MAXIMUM.) Write in your own words a biography about yourself. Be sure to proofread; applications will be judged on the following criteria: grammar/spelling, completion of responses, and comprehension of responses.
Create a biographic profile of yourself incorporating your interests. (i.e. extracurricular activities, favorite school subjects, volunteer experience, awards, and future career plans, etc.) Don't forget to proofread!
Write down a phrase, quote or message that is no more than 2 sentences, which greatly inspires you. Please explain why it inspires you.
Think of a person who has had a positive influence in your life. Name that person and the qualities they possess you would like to develop in your own life.
Please list the extra-curricular activities you participate in during the school year.
Could your involvement in these activities hinder your participation in the Cotillion?
Yes
No