antioch community high school (achs)

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Guest forms will NOT be accepted without copies of your guest's state issued ID! Date Received ________

WARREN TOWNSHIP HIGH SCHOOL (WTHS) GUEST APPLICATION FORM 2015

Approval List _________

A student requesting to bring a date who is not a Warren Township High School student must have this form completed before a ticket can be purchased. It requires the signature of a dean or administrator of the guest’s school and of a Warren Township High School’s dean. Once approved, you will receive a letter from Ms. Lobitz with the ID number of your guest so you can purchase a ticket online. The minimum grade level for all guests is ninth grade; the maximum age is 20.

PROM DEADLINES – NO EXCEPTIONS

These dates must be adhered to in order to bring a guest to prom. The Dean's Office will not accept applications after these dates:

Guest Form to Dean dead line: April 2, 2015

Date of ticket purchase: April 6-10, 2015 (Mon-Fri)

Approved guest names will be entered into the POS system prior to purchase. Tickets may not be purchased for a guest who does not exist in the system at the time of purchase. Forms turned in late may not be approved in time for the start of ticket sales. Do not wait until the last minute.

_________________________________________ Name of WTHS Student (Please print)

Date ______________

_________________________________________ Email address of WTHS Student (Please Print Clearly)

You will receive an email from Ms. Lobitz after April 2nd with purchase instructions if your guest is approved. As a WTHS student, I understand that all school rules apply at school functions, and I will take responsibility to inform my date of these rules. __________________________________________ Signature of WTHS Student

Date _____________

As the parent/guardian of the above WTHS student, I find his/her date to be a responsible person, and I recommend his/her date as an acceptable guest for this WTHS activity. __________________________________________ Signature of Parent/Guardian of WTHS student

Date _____________

***Guest Information – A copy of a STATE ISSUED PHOTO ID is required with this application*** Name

__________________________________

Date of Birth

__________________________________

Address

__________________________________

Phone #

__________________________________

School Guest Attends/Attended

_______________________ School

Emergency Contact

_________________________________

Emergency Contact Phone Number

_________________________________

Signature of Guest

_________________________________

Signature of Guest’s Parent/Guardian

_________________________________

WTHS ALUMNI? ______________

__________________ City

_____ State

Guest forms will NOT be accepted without copies of your guest's state issued ID!

____ Year

Guest forms will NOT be accepted without copies of your guest's state issued ID!

AS THE DEAN/ADMINISTRATOR OF THE SCHOOL, I RECOMMEND THAT THIS STUDENT BE ALLOWED TO PARTICIPATE IN THIS ACTIVITY.

________________________________________ Signature of School Dean/Administrator of Guest

____________ Phone #

Date _____________

IF NOT A STUDENT, LIST EMPLOYER ______________________________________ Company Name

__________________________________ Supervisor’s Name (Print)

______________________________________ Signature of Supervisor/Title

Phone # ____________________

IF YOU ARE UNEMPLOYED, A CHARACTER WITNESSES’ NAME AND PHONE NUMBER MUST BE GIVEN. THIS CAN BE A FORMER EMPLOYER, FORMER TEACHER, PASTOR, ETC. _____________________________________ Character Witness (Print) _____________________________________ Signature of Character Witness/Title

Phone # ______________________

WARREN TOWNSHIP HIGH SCHOOL DEAN APPROVAL ____________________________________ Signature of WTHS Dean

Date _____________

This section to be completed when turning guest forms in to the Activity Director. I acknowledge that by bringing a non- WTHS guest to Prom that I fully understand the following requirements: a) To offset the cost of additional security, guest tickets will be increased by $20.00. Guests are required to ride the school- sponsored coach bus to and from Prom and guests MUST attend Prom with the student who purchased the ticket. b) Guest forms will be checked to be certain the guest is in good standing at their home school and/or in good standing with local authorizes. c) If it is determined that a guest is not in good standing or if any of the above information is determined to be false, I agree to forfeit my guest ticket. d) Guest tickets are NOT transferable. The guest I bring to the dance will be the guest I have submitted for approval. Any attempt to bring another person will result in forfeiture of ticket. e) All WTHS students bringing outside guests will be required to leave their WTHS ID with school administration upon entering the dance. All guests will be required to leave their state-issued photo ID with school administration upon entering the dance. Both IDs will be kept together and may be picked up upon exiting the dance. Failure to bring proper identification will result in non-admittance to the dance. No refunds will be given.

_____________________________ ________ ___________________________________ ________ Student Signature Date Non-WTHS Guest Signature Date WTHS ADMIN APPROVAL IS REQUIRED IN ORDER TO PURCHASE A GUEST TICKET! Guest forms will NOT be accepted without copies of your guest's state issued ID!