East Wilkes High School

Universal Dance Guest Form

This form is for all non-East Wilkes students (high school freshmen to age 20) who wish to attend any Dance, sponsored by East Wilkes High School. This form should be filled out completely and have all signatures and returned to East High three days prior to the dance.

Name of Dance: ______Date of Dance: ______

GUEST INFORMATION (Please print all information clearly)

Name ______

Address______City, St, Zip______

Cell Phone ______Home Phone ______

Parent Name ______Parent Phone # ______

Name of East High Student Escort: ______

GUEST SCHOOL APPROVAL (Please print all information clearly)

School, college or trade school where Guest attends ______

Phone number of School where Guest attends ______

Grade in School (example: Junior) ______(Minimal High School Freshman; maximum under age 21)

The above student at your school wishes to attend a dance sponsored by East Wilkes High School. Please verify that this student is in good standing at your school and would exhibit behavior suitable to represent your school. Please sign this form as an indication that you feel that he/she would have good behavior while not on your school campus.

Principal/ Assistant Principal Name (Printed) ______

Principal/ Assistant Principal Signature ______Date______

GUEST AGREEMENT (Please read carefully)

I the undersigned do promise to follow the dress code of Wilkes County Schools, of which I have read and understand (reference website). While on campus for this dance I will behave in a mature manner and respect those around me. I realize that the East Wilkes High school campus is a tobacco, drug and weapon free facility. I further understand that I am a guest on the East High campus and as such I will show respect to the chaperons, officials and principals in authority for this school activity. I also promise that I am of high school age and to have a good time!

Guest Signature ______Date ______

How to Process: Form may be sent via: text, fax 336-835-9298 or email the teacher in charge

For School Use ONLY School Approval: ______Date: ______