WDHS Student Prom Permission Slip 16-17
**Every student attending the Prom must access and submit an online electronically signed permission slip by April 24th, prior to notification for ticket purchase and pick up!**
Untitled Title
Please read and sign the following:
To ensure that the Prom is a positive and enjoyable experience for all in attendance, we ask that you please read and adhere to the rules and expectations below:

- The use and/or possession of a controlled dangerous substance and/or Alcoholic Beverage is STRICTLY FORBIDDEN. All students attending the prom will be subject to alcohol screening with the passive alcohol sensor prior to entering Auletto’s. Anyone suspected of being under the influence will be referred to the Administrator(s) present and will be referred to the police. Parents will be notified immediately. There will be NO SMOKING inside or outside of Auletto’s Ballroom.
- Any student who has accumulated 8 or more discipline points at the time of the Prom will NOT be permitted to attend the Prom.
- Club dancing or suggestive dancing is not permitted at the Prom.
- Any student who has violated the Drug/Alcohol policy during the year may not be permitted to attend the Prom.
- Improper behavior will result in automatic expulsion from the Prom and place your attendance at future school functions in jeopardy. Your parents will be notified immediately and must come to pick you up.
- Once you are inside of Auletto’s, you may only go to your vehicle if you are escorted by a chaperone. This trip must be absolutely necessary. NO EXCEPTIONS!
- ALL STUDENTS ARE REQUIRED TO STAY AT THE PROM UNTIL 10:15 PM!

First Name
Your answer
Last Name
Your answer
School
If you choose "Other," please type the name of the school you attend or the school from which you graduated.
NOTE FOR OUT OF DISTRICT STUDENTS
Out of district students must print the permission form (https://goo.gl/lrr10G), have it completed by their principal, and return it to the WDHS Attendance Office ALONG WITH A COPY OF THEIR PHOTO ID. You may either return the form and copy of the ID in person, via email to cbell@wdeptford.k12.nj.us, or fax at 856-845-5774.
Grade
Student ID Number
(West Deptford students only)
Your answer
Student Signature
Please type your full name. By entering your name in the box, you indicate that you have read and understand the rules and regulations and agree to comply with said rules and regulations and will meet all financial obligations.
Your answer
Parent/Guardian Signature
Please type your full name. By entering your name in the box, you indicate that you have read and understand the rules and regulations and agree to comply with said rules and regulations and will meet all financial obligations.
Your answer
Parent/Guardian Phone Number
Your answer
First Name of Person Attending Prom with You
Your answer
Last Name of Person Attending Prom with You
Your answer
School Your Date Attends
Your answer
Date's Grade
Date's Age
(Out of district students only)
Your answer
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