DUNDEE-CROWN HIGH SCHOOL
DUNDEE-CROWN HIGH SCHOOL Be responsible Be respectful Be positive Visit us online at dchs.d300.org 1500 Kings Road Carpentersville, Illinois 60110 224-484-5000 Fax: 224-484-5098 Students at District 300 may bring one guest to a social event, provided that the following information is completed and approved by the Deans' Office prior to purchasing tickets for the event. The guest must be currently enrolled in at least 9th grade and no guest will be admitted over the age of 20 years old. A photocopy of the guest's high school ID or current state driver's license/state ID care MUST be attached to this form. This I.D. photo can be faxed to Dundee-Crown High School at 224-484-5098. Lynn McCarthy Principal Jeffrey Herb Associate Principal, Operations Mary Hawley Associate Principal, Curriculum & Instruction Basilio Salazar Assistant Principal, Student Services Janine Glenn Assistant Principal, Student Services Dan Palombit Dean of Students Upon entering a District 300 event, students must present a current District 300 ID & ticket. Their guest must also present a ticket and current photo identification. Completed guest permission forms are to be turned into the Deans' Office no later than __April 2, 2015___ by 4:00 P.M. Dundee-Crown Event: Junior-Senior Prom May 2, 2015 ________________________________ DCHS High School Student (Print Name) ___________________________ Student ID Number As a student at Dundee Crown High School, I understand that all school policies apply to my guest and me during the school-sponsored activities. I am also aware that once my date/guest and me leave the dance, we will not be allowed re-entry for any reason. I will take the responsibility to inform my guest and ensure full compliance with school policies. All guests are required to abide by the same rules as Dundee Crown High School District 300 students. In addition, I agree that the submitted information is truthful and accurate. Forged and/or dishonest information provided on this form will result in no admittance, removal from the event and/or disciplinary consequences AND NO REFUND. All students attending the dance are subject to their belongings being searched, their vehicle being searched and a breathalyzer test. ___________________________________________________ Signature of Dundee Crown High School Student __________________ Date As the parent/guardian of the above named Dundee Crown High School Student, I find his/her guest to be a responsible person and I approve him/her as an acceptable guest for this Dundee-Crown High School activity. __________________________________________________ Parent/Guardian Signature of Dundee Crown High School Student __________________ Date Guest Information & Agreement: As a guest a Dundee Crown High School, I have been informed and will abide by the policies and procedures of Dundee Crown High School and District 300. I understand that any violation of the rules and regulations will result in my immediate removal from the activity and/or District property. Steve Gertz Athletic Director Nicole Woodbury English & ESL Divisional In addition, I agree that the submitted information is truthful and accurate. Forged and/or dishonest information provided on this form will result in no admittance, removal from the event and/or disciplinary consequences AND NO REFUND. Guest Print Name w/Middle Initial:_______________________________ Age: _____ D.O.B.______ School: __________________________________________________ Home Address: ___________________________________ City/State: ________________________________ Tim Bruell _______________________________________________ Guest’s Signature ____________ Date Barbara Sydnor ________________________________________________ Parent’s/Guardian’s Signature of Guest ____________ Date Science Divisional Guest High School- Dean Approval Mathematics Divisional ___________________ Phone # during activity As the dean/administrator of the guest’s school, I recommend that this student be allowed to participate in this activity. Gary Glenn Social Studies Divisional Brett Gobeli Special Education Divisional ______________________________________ Signature of School Dean/Administrator of Guest ______________________ Phone Number Dundee Crown High School Dean Signature required prior to purchasing tickets. ________________________________________ _________________________ Signature Date ____________________ Date
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