Rolesville High School
Valentine’s Dance guest Form
You must complete this form prior to purchasing a ticket for a guest who is not a student at Rolesville High School. Your guest must be enrolled in the ninth grade or higher at a public, private or a homeschool (one that is recognized by theNorth Carolina Division of Non-Public Education (DNPE) high school. If your guest is not a high school student, he/she must either be a college/university student or gainfully employed. A current copy of the guest’s driver’s license or school ID must be attached. You must submit this form to Rolesville High School for prior approval. Please complete and submit this form two days prior to purchasing your ticket. The latest date for the submission of this form is Thursday, February 2nd, 2016 at 2:30 pm. Please submit form to Mr. Smetana (4803).
RHS Student’s Information (Please Print)
Name____________Grade______
Guest Information (Please Print)
Name ______
Home Address ______
City ______State ______Zip ______
Date of Birth ______Age ______(Not older than 20 years of age) NC Driver’s License #______
Status (check one): high school student college student active military gainfully employed
Based on his/her current status, complete the following as it applies to your guest (select one):
Current high school/college/university attending: ______
Place of current employment: ______
Current branch of service: ______
Phone numbers based on the information above that has been provided by your guest:
(______)______
Work/School/Branch
(______)______(______) ______
Home Mobile
Statement of Guest’s Character
Statement of character: by school Principal/Assistant Principal (if guest attends high school), Professor or Dean (if college), Employer (if guest is presently employed), Commanding Officer (if guest is in the military), Community Contact (if guest is home schooled). Character statements by relatives or parents of the RHS student or his/her guest will not be accepted. (Attach additional sheet, if necessary.)
______
______
______
______
Signature of Person Making Statement of Character Print Name
______(______) ______
Title Daytime Phone Number
Please Note:
· You must agree to the published dress code standards and the WCPSS Code of Conduct found in the current WCPSS Student/Parent Handbook and your date must enter the venue with you
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