Mark Stern
Principal
30 Robert H Harp Drive
Livingston, NJ 07039
(973) 535-8000
www.livingston .org
PLEASE RETURN THIS FORM NO LATER THAN TUESDAY, JUNE 9TH TO
MRS. FRANCHINO IN THE MAIN OFFICE.
Name of Guest: _____________________________________________________________
Accompanying LHS Student: ___________________________________________________
(LHS Student Name)
Name of Guest’s Parent/Guardian: ______________________________________________
Address: _________________________________________________________________
Emergency Contact Numbers: Home: ___________________ Cell: ___________________
Medical Concerns: ___________________________________________________________

All students are expected to take buses to and from the prom.

Students must arrive at LHS between 5:00 p.m. and 5:15 p.m.

Students will report to the auditorium where they will group together by bus number.

Buses will depart LHS at 6:00 p.m.

Buses will return from the prom to LHS at approximately 11:30 p.m.

All conduct expectations outlined in the LHS Student Handbook are in place while attending the prom. Any individual not meeting those guidelines will be removed from the prom.
____________________________________________________________________________
Signature of Guest’s Parent/Guardian indicating agreement with the above
To the Principal of the Student Guest: The student named above wishes to attend the
Livingston High School Senior Prom at The Royal Manor, Garfield, NJ. on June 11, 2015.
Please indicate your knowledge of same and your approval by signing below.
Principal’s Signature: __________________________________________________________
Principal’s Name (please print): __________________________________________________
Name of School: _______________________________ Phone Number: _______________