North Star High School Dance Permission Form For guest of LNS student HOMECOMING October 21, 2011 • • • •
Guest must be in high school or under the age of 20, and the guest must complete Box A If guest is a high school student, an administrator from his/her school must complete Box B and fax signed form to LNS (402-436-1054). Form must be turned in to the LNS office by Wednesday, October 19, 2011. Guest must follow all LNS rules and dress code
LNS student name: ___________________________________________ Grade:________ Box A- completed by guest Name:________________________________________________Age:_____DOB:______________ Home address:___________________________________________________________________ City:____________________________ Parent/guardian: _______________________________________________________________________________________
Box B- completed by Administrator of guest’s home high school Name of High School:__________________________________________School phone:______________ Is the above named student currently in good standing? YES
NO
Do you recommend he/she be admitted to the LNS Homecoming dance?
YES
NO
School Administrator Signature and Title: ________________________________________________________________________________ Please print here: _________________________________________________________________________________
GUEST MUST PRESENT A VALID DRIVERS LICENSE OR SCHOOL PHOTO ID AT THE DOOR THE NIGHT OF THE EVENT I, ____________________________(guest), agree to obey all rules and regulations set forth by North Star High School concerning student attendance at extracurricular events. Signed (guest):_________________________________________________Date:____________
This form will not be accepted at the door the night of the dance.