More information request

Request More Information about BRJC Programs

Please indicate below the programs that you would like to receive more information.

* Indicates required field

Child's Name *

First

Last

Name Called *

Gender *

School Name and Grade Attending in the Fall *

BRJC Legacy of (Full Name) and Legacy Years *

Please select programs you are interested in: *

Junior Cotillion for 6th Graders Junior Cotillion for 7th Graders Junior Cotillion for 8th Graders Junior Cotillion for 9th Graders College Prep Etiquette-(9th-12th graders) Doll and Me Girls Tea Party GO! Girls Only Etiquette Events

Mother / Custodial Parent 1 *

First

Last

Select Title *

Cell Number *

Email *

Father / Custodial Parent 2 *

First

Last

Select Title *

Cell Number *

Email *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Comment *

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