Junior/Senior Prom – Guest Form
Saturday, April 26, 2014
8:00 PM – 12:00 AM
The Longhouse
All prom guests who are NOT CURRENTLY ENROLLED at Walkertown High
School must complete this form. The form must be returned to Mrs. Johnson at Walkertown
High School between March 5, 2014 and March 28, 2014. Approval will be given by the
administrative team at Walkertown. All deadlines are strict and all decisions are final.
You may only purchase a ticket for your guest after permission has been granted.
Guest of: ________________________________________________________
Walkertown Student’s Name
Guest Information:
Name: ___________________________________________________ (Please use full, legal name)
Home Address: ___________________________________________________________
Phone___________________________________________________________
Date of Birth: _________________________________
All guests should be under the age of 21. (DOB should be after April 26, 1993)
Please check and complete ONE of the following sections.
Currently enrolled in high school at: ________________________________________
Please have an Administrator at your high school complete the section below:
I verify that ____________________________is a student in good standing at
Guest’s Name
___________________________ High School.
Administrator’s Signature___________________________________Date:_________
Name of Employer or College_____________________________________________
If the guest is not enrolled in high school, for any reason, the parents of the WHS student
are required to provide permission as well.
I , ___________________, give permission for my child, _______________________, to
Parent/Guardian
Walkertown Student
invite _____________________________to the Walkertown High School Prom. I am
Name of Guest
aware that the Winston-Salem Forsyth County School’s discipline policy will be enforced
during this school-sanctioned event.
Parent Signature_______________________ Guest Signature________________________
Administrator: _____________________
Date: ________
Approved
Denied