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SAN RAMON VALLEY UNIFIED SCHOOL DISTRICT

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SAN RAMON VALLEY UNIFIED SCHOOL DISTRICT Powered By Docstoc
					                                            DOUGHERTY VALLEY HIGH SCHOOL
                                             10550 Albion Road, San Ramon, CA 94582
                                               (925) 479-6400 * FAX (925) 479-6597

    DOUGHERTY VALLEY HIGH SCHOOL - GUEST PASS DANCE AGREEMENT
                                                               Homecoming Dance
                                                                October 22, 2011
                                                               7:00pm – 10:00pm
                                                                   Main Gym
    IMPORTANT YOU MUST COMPLETE THIS FORM ONLY IF YOU ARE BRINGING A NON - DVHS GUEST:

         A.       Students may only bring 1 guest.
         B.       Form must be completed and returned in order to purchase dance tickets. Student ID’s must be present when
                  purchasing tickets.
         C.       ID cards must be presented at the door in order to enter the dance. Students not in school must present a driver’s license
                  and or ID card.
         D.       All school rules apply to this dance.
         E.       Signatures below hold the individuals responsible and accountable for their actions. School rules violated by
                  students may result in disciplinary action.

DVHS STUDENT

DVHS student purchasing ticket (please print)______________________________________________Ticket purchaser’s grade_____


DVHS parent/guardian signature and evening telephone number____________________________________________________

GUEST STUDENT - (ATTENDS ANOTHER HIGH SCHOOL OR IS OUT OF SCHOOL AND UNDER 21 YEARS OF AGE)

Your guest’s name (please print)_____________________________________________Home telephone (______)__________________

Home address___________________________________________________________ City ___________________________________

Signature of guest’s parent/guardian________________________________________ Name of guest’s high school ________________

Guest students who do not attend a high school and are under the age of 21 must give a photo copy of their Identification/Drivers
License when tickets are purchased.

GUEST SCHOOL SIGNATURE

    Yes, this student is in good standing at our high school

Guest school’s telephone (______)_____________________

Guest’s school administrator signature and title________________________________
(please attach a business card)




     SCHOOL ADMINISTRATOR BUSINESS CARD




                                                 Purchase Tickets from DVHS Bookkeeper

				
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posted:10/2/2011
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