Paul Laurence Dunbar High School
1600 Man O’ War Boulevard
Lexington, KY 40513
Telephone: 859-381-3546
Fax: 859-381-3560
FALL FORMAL PERMISSION SLIP
Fall 2015
PLD students are eligible to purchase one guest ticket when purchasing their own ticket. A guest is defined as any HIGH
SCHOOL STUDENT not currently attending PLD.
For the event, the fall formal guest must agree to:
 Follow all Fayette County Public Schools and Paul Laurence Dunbar High School rules and regulations
 Arrive at the Fall Formal with the purchaser of his/her ticket
The PLD student who purchases the guest ticket:
 Accepts responsibility for all actions of his/her guest on the night of the Fall Formal
 Agrees to arrive at the same time as his/her guest
Guests without prior approval will not be allowed to attend the Fall Formal. The PLD student and guest must
provide the following information to the main school office by Wednesday, October 21st, 2015. Students whose
guests are not approved to attend the Fall Formal will be notified by October 23rd, 2015.
PLD Student Name: ______________________________________________________________________
Grade Level______________
Parent/Guardian_________________________________
Home Phone________________
Address_______________________________________
________________________________________
Guest Name (must be a current high school student):
_____________________________________________________________________
High School__________________________________ School Phone ________________
Grade Level_______
Principal Name_____________________
Parent/Guardian of Guest___________________________________________________
Address_________________________________________ Phone__________________
We understand that students and their approved guests must follow the guidelines and rules of Fayette County Public Schools and Paul Laurence Dunbar High
School while at the Dunbar Fall Formal. Students or guests not following the rules can be asked to leave the activity without being reimbursed the cost of their
ticket(s).
Signatures:
PLD Student ____________________________________PLD Guardian________________________________________
Guest
______________________________ _________Guest Guardian_______________________________________
--------------------------------------------------------------------------------------------------------------------------------------------------------------------Dunbar Principal Signature_______________________________________________________________Date__________
(Rains, Blackman, Tinsley or Hill)
ADMINISTRATION
Betsy Rains, Principal
Andrea Tinsley, Associate Principal  Tony Blackman, Associate Principal Nancy Hill, Associate Principal
Liz Pelphrey, Academic Dean  Deanna Smith, Head Counselor