Greensburg Salem High School
Greensburg Salem High School
2015 Prom Ticket Order Form
“Casino Royal”
Please complete all relevant information on this form. This completed form along with the “CONTRACT FOR NON-GREENSBURG SALEM STUDENTS” (if applicable) and payment in the amount of $150/couple or $75/ per single should be placed in the attached envelope and turned in to Mrs. O’Neill in room 373 throughout the day OR to her in the main lobby between 7 a.m. and 7:30 a.m. Applications will be accepted through Wednesday, April 15th, 2015. No applications will be accepted after 3:00 p.m. on Wednesday, April 15th. Cash or checks will be accepted. Make checks payable to GREENSBURG SALEM ACTIVITY FUND-Formal Dance.
SCA is offering a layaway-style purchase. Tickets may be purchased with a $25 down payment per ticket to Mrs. O’Neill and the rest may be paid in small increments until the tickets are paid off. Tickets must be paid in full by April 15th.
Grand March lineup will be determined by order in which applications are received with the exception of class officers, SCA and prom committee officers and chairmen. Those who are purchasing their tickets on the layaway plan will not be added to the Grand March lineup until their tickets are PAID IN FULL.
Please be sure to PRINT your name and the name of your date (the way you want it to appear in the Grand March program) on the envelope. Tickets will be issued to the first student listed on the application, through your first block teacher.
Only one order should be placed per couple. If incomplete orders are submitted, they will be returned to the submitting student and will be renumbered when they are complete.
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PREASE PRINT LEGIBLY, detach and place in envelope
NAME: ______
BLOCK 1 ROOM #_____ BLOCK 1 TEACHER’S NAME______
GRADE: ______
HOME PHONE: ______
NAME OF PARENT/GUARDIAN ______
DATE’S NAME: ______
GSHS STUDENT? YES / NO If Yes, BLOCK 1 ROOM#____
BLOCK 1 TEACHERS NAME______GRADE: ______
If No, SCHOOL GUEST ATTENDS: ______
HOME PHONE: ______
NAME OF PARENT/ GUARDIAN: ______
IF GUEST IS NOT A GSHS STUDENT THEN PLEASE
COMPLETE THE NEXT PAGE AND SUBMITT IT ALONG WITH THIS
FORM AND A PHOTO ID.
Please write down the title and artist of a song you would like to be played at Prom:
Artist:______Song title:______
RULES AND REGULATIONS
FOR THE 2015
JUNIOR/SENIOR PROM
“Casino Royal”
1. Admission is limited to Greensburg Salem seniors, juniors, and guests. Guests are not limited to Greensburg Salem students. Guests may be any current high school student or a high school graduate (must submit proof of graduation) under the age of 21 as of May 8th, 2015. JUNIOR HIGH OR MIDDLE SCHOOL STUDENTS ARE NOT PERMITTED TO ATTEND THE PROM. All school districts and grade levels will be verified. NO EXCEPTIONS WILL BE PERMITTED.
2. All couples must be at the high school auditorium between 3:45 p.m. and 4:00 p.m. YOU MUST BE IN LINE BY 4:00 pm. Please be prompt. The Grand March Ceremony will begin at 4:15 pm. Mrs. O’Neill, Mr. Gazze and other faculty members will be there to line you up for the Grand March. Please cooperate in a quiet, orderly manner.
3. Prom photos will be taken while in line for the grand march.
4. Students must arrange for their own transportation to Stratigos Banquet Center. Directions will be included with your tickets. Students must be at Stratigos by 6:00 pm. Dinner will be served by 6:15 pm. Pre-dinner drinks will be served.
5. ALL School Rules will apply to the prom.
6. If school is in session then ALL STUDENTS must be in school on time the day of the prom.
7. Any student on the Attendance Sanction List on May 7th will not be able to attend the prom and their money will not be refunded. Any senior who does not have a senior project binder graded by their advisor and turned in to Mrs. Nelson or Mrs. Yuhas by April 10th will not be able to attend.
DATE: Friday, May 8th, 2015
TIME: 4 p.m. – 11 p.m.
GRAND MARCH: Grand March will begin promptly at 4:15 p.m. and will be held in the Greensburg Salem High School Auditorium.
PROM: Stratigos Banquet Center, North Huntington, Pa. Dinner will be by buffet.
TRANSPORTATION: ALL students must provide their own transportation to and from the prom site.
TICKET PRICE: Tickets will be $150/ couple and $75/ singles.
GREENSBURG SALEM HIGH SCHOOL
65 MENNEL DRIVE
GREENSBURG, PA 15601
(724) 832 –2960
CONTRACT FOR NON-GREENSBURG SALEM STUDENTS CURRENTLY IN HIGH SCHOOL
OR A GRADUATE
I, ______, (A NON-GREENSBURG SALEM STUDENT) WILL BE ATTENDING THE 2014 GREENSBURG SALEM PROM WITH ______(A CURRENT GREENSBURG SALEM STUDENT). I AGREE TO OBEY ALL OF THE RULES AND REGULATIONS GOVERNING THE PROM SPECIFICALLY AND ALL GENERAL RULES FOR SCHOOL EVENTS AS STATED IN THE GREENSBURG SALEM HIGH SCHOOL STUDENT HANDBOOK.
______
SIGNATURE OF NON–STUDENT SIGNATURE OF GREENSBURG STUDENT
FOR NON – GREENSBURG SALEM ATTENDEES INCLUDING ALUMNI:
CHECK APPROPRIATE ITEM:
______I ATTENDED ______HIGH SCHOOL.
**** (ATTATCH COPY OF DIPLOMA and PHOTO ID) *****
______I CURRENTLY ATTEND ______HIGH SCHOOL.
**** (IF YOU CHECK THIS LINE PLEASE HAVE YOUR CURRENT PRINCIPAL FILL OUT THE INFORMATION
BELOW AND SUBMITT THIS INFO ALONG WITH A PHOTO ID) ****
FOR HIGH SCHOOL PRINCIPAL:
I, ______PRINCIPAL OF ______HIGH SCHOOL,
ACKNOWLEDGE THAT THE STUDENT LISTED ABOVE IS A MEMBER IN
GOOD STANDING OF ______HIGH SCHOOL.
______
PRINCIPAL SIGNATURE