Robert E. Lee High School
FAIRFAX COUNTY PUBLIC SCHOOLS
6540 Franconia Road
Springfield, VA 22150
Phone (703) 924-8300
Event: Senior Prom, Friday, June 5, 2015 8:00pm – Midnight
Prom will be hosted at the Marriott Fairview Park, 3111 Fairview Park Drive, Falls Church.
Robert E. Lee High School Student Sponsoring Guest:
Name: __________________________________________________________________
Address: ________________________________________________________________
Parent/Guardian: _________________________________________________________
Phone: ________________________________________________________________
AS A STUDENT OF ROBERT E. LEE HIGH SCHOOL, I UNDERSTAND THAT MY GUEST AND I WILL BE HELD ACCOUNTABLE
AND RESPONSIBLE FOR COMPLYING WITH THE CODE OF CONDUCT AS SET FORTH BY FAIRFAX COUNTY PUBLIC
SCHOOLS.
Signature of Robert E. Lee High School Student Host __________________________________________________________
Guest Information:
Name: __________________________________________________________________
Address: ________________________________________________________________
Parent/Guardian: _________________________________________________________
Phone: _________________________________________________________________
School/Place of Employment: _______________________________________________
I UNDERSTAND THAT MY ROBERT E. LEE HIGH SCHOOL HOST AND I WILL BE HELD ACCOUNTABLE AND RESPONSIBLE
FOR COMPLYING WITH THE CODE OF CONDUCT AS SET FORTH BY FAIRFAX COUNTY PUBLIC SCHOOLS. I UNDERSTAND
THAT ONCE I LEAVE THE PROM FOR ANY REASON, I WILL NOT BE READMITTED.
Guest Signature ___________________________________________________________
To be filled out by the guest’s Principal:
______ I recommend this student to be approved as a guest at the function listed above. He/she is a student in good standing.
______ I recommend this student NOT be approved as a guest at the function above because he/she has been involved in disciplinary
actions and/or is not a student in good standing.
Print Principal’s Name _________________________________________
Principal Signature ___________________________________________
Note: If you are not a high school student, please provide your university or place of employment and bring a photo ID. While
no principal’s signature is required, guests who are not in high school must still complete all of the above contact information
with signature. No guests aged 21 or over are allowed.
****THIS FORM must be completed prior to purchasing a ticket and can be turned in at time of ticket purchase, or it
can be faxed to 703-924-8397, ATTN: Sabrina Kessenich.****
Questions? Contact Senior Class Sponsor Sabrina Kessenich - sdkessenich@fcps.edu.