DUNDEE-CROWN HIGH SCHOOL

DUNDEE-CROWN HIGH SCHOOL
Be responsible
Be respectful
Be positive
Visit us online at dchs.d300.org
1500 Kings Road
Carpentersville,
Illinois 60110
224-484-5000
Fax: 224-484-5098
Students at District 300 may bring one guest to a social event, provided that the following information is completed and approved by the
Deans' Office prior to purchasing tickets for the event. The guest must be currently enrolled in at least 9th grade and no guest will be
admitted over the age of 20 years old. A photocopy of the guest's high school ID or current state driver's license/state ID care MUST
be attached to this form. This I.D. photo can be faxed to Dundee-Crown High School at 224-484-5098.
Lynn McCarthy
Principal
Jeffrey Herb
Associate Principal,
Operations
Mary Hawley
Associate Principal,
Curriculum & Instruction
Basilio Salazar
Assistant Principal,
Student Services
Janine Glenn
Assistant Principal,
Student Services
Dan Palombit
Dean of Students
Upon entering a District 300 event, students must present a current District 300 ID & ticket. Their guest must also present a ticket
and current photo identification.
Completed guest permission forms are to be turned into the Deans' Office no later than __April 2, 2015___ by 4:00 P.M.
Dundee-Crown Event: Junior-Senior Prom
May 2, 2015
________________________________
DCHS High School Student (Print Name)
___________________________
Student ID Number
As a student at Dundee Crown High School, I understand that all school policies apply to my guest and me during the school-sponsored
activities. I am also aware that once my date/guest and me leave the dance, we will not be allowed re-entry for any reason. I will take
the responsibility to inform my guest and ensure full compliance with school policies. All guests are required to abide by the same rules
as Dundee Crown High School District 300 students. In addition, I agree that the submitted information is truthful and accurate. Forged
and/or dishonest information provided on this form will result in no admittance, removal from the event and/or disciplinary
consequences AND NO REFUND. All students attending the dance are subject to their belongings being searched, their vehicle being
searched and a breathalyzer test.
___________________________________________________
Signature of Dundee Crown High School Student
__________________
Date
As the parent/guardian of the above named Dundee Crown High School Student, I find his/her guest to be a responsible person and I
approve him/her as an acceptable guest for this Dundee-Crown High School activity.
__________________________________________________
Parent/Guardian Signature of Dundee Crown High School Student
__________________
Date
Guest Information & Agreement:
As a guest a Dundee Crown High School, I have been informed and will abide by the policies and procedures of Dundee Crown High
School and District 300. I understand that any violation of the rules and regulations will result in my immediate removal from the
activity and/or District property.
Steve Gertz
Athletic Director
Nicole Woodbury
English & ESL Divisional
In addition, I agree that the submitted information is truthful and accurate. Forged and/or dishonest information provided on this form
will result in no admittance, removal from the event and/or disciplinary consequences AND NO REFUND.
Guest Print Name w/Middle Initial:_______________________________ Age: _____ D.O.B.______
School: __________________________________________________
Home Address: ___________________________________ City/State: ________________________________
Tim Bruell
_______________________________________________
Guest’s Signature
____________
Date
Barbara Sydnor
________________________________________________
Parent’s/Guardian’s Signature of Guest
____________
Date
Science Divisional
Guest High School- Dean Approval
Mathematics Divisional
___________________
Phone # during activity
As the dean/administrator of the guest’s school, I recommend that this student be allowed to participate in this activity.
Gary Glenn
Social Studies Divisional
Brett Gobeli
Special Education
Divisional
______________________________________
Signature of School Dean/Administrator of Guest
______________________
Phone Number
Dundee Crown High School Dean Signature required prior to purchasing tickets.
________________________________________
_________________________
Signature
Date
____________________
Date