Newton South High School Class of 2012

Prom Information

Date: June 5, 2012 Time: 7:00 pm- 11:00 pm Location: Skywalk Observatory 800 Boylston Street, Prudential Tower Boston, MA 02199 Cost: $100 In order to attend, all forms attached to this must be presented when purchasing tickets. These forms include: Student Information Form, Menu Choice Form, Guest Information Form, and Financial Aid Form. Please fill out all forms that apply. Checks must be made payable to NSHS Class of 2012 with Prom 2012 in the memo line.

Student and Guest Information

Due Tuesday, April 23
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Student Information
Student Name: _______________________________ ___________________ House: Cutler, Goldrick, Goodwin, Wheeler Emergency Contact Information: Name: __________________________________ Relationship:__________________________ Cell Number: __________________________ ______________________ Home Number: Homeroom:

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Guest Information
Guest Name: _________________________________ Age: _________

Newton South Student? yes/ no (if your guest is not a South student, please fill out the form on page 5)

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Payment Information
Please check one of the following types of payment: ________ cash ________check if paying with a check, please provide the check number check #_________________

Newton South High School Prom 2012

Menu Choice
Due Tuesday, April 23

Appetizer
Salad with Fresh Breads Chopped Salad with Feta, Olives, Cucumber, Tomatoes Italian Herb Dressing

Main Entre
(circle one of the following) Choice 1: Herb Roasted Lemon Chicken with roasted potato and vegetable or Choice 2: Vegetarian Lasagna Marinara with fresh vegetables

Dessert
Marbled Cheesecake with Strawberries Sauce Freshly brewed coffee or assorted teas

Circle all that apply: Kosher Vegan Gluten-free Other (please specify): _____________________ Guest Meal (circle one): Choice 1 Choice 2

FINANCIAL AID FOR THE JUNIOR SEMI AND SENIOR PROM The junior and senior class officers at Newton South believe that no Newton South student should be denied participation in a class event because of his/her inability to pay for the event. Therefore, the class offers financial aid for the junior semi-formal and senior prom. If a student is granted financial aid, 50% of the cost of his/her ticket will be subsidized by the class. (Students receiving financial aid should expect to cover the other 50% of the cost of their tickets and should expect to pay FULL PRICE for their guests tickets.) APPLICATION & SELECTION PROCESS Application forms are available through the class advisors, class officers and the house offices. Students should submit their completed applications to their housemaster. The deadline for applications for the junior semi-formal is April 13, 2012. The deadline for applications for the senior prom is May 11, 2012. The application consists of two parts: 1) a personal/contact information form; 2) a statement of financial need. The Newton South Leadership Team will review all applications. The number of awards in any given year may vary and will depend on the resources available to the sponsoring class. Students will be notified by their housemaster if they are awarded financial aid for the junior semi-formal or senior prom. Students may only apply for financial aid for their own classs events. Application for Financial Aid for the Junior Semi-Formal and Senior Prom Check one: _____ I am applying for financial aid for the junior semi-formal. _____ I am applying for financial aid for the senior prom. Name: __________________________ Counselor:__________________________ House: __________________________ Advisory: _____________ With whom you currently live (name and relationship)? ___________________________ Parent/Guardian Phone Number: _________________________ Have you ever been eligible to receive free or reduced lunch? ____ free ____ reduced

On the back of this page, please explain the nature of your financial need. Outline any circumstances that would help the Newton South Leadership Team better understand your eligibility for assistance (for example: single-parent home, number of siblings, medical expenses, etc.).

Senior Prom/ Junior Semi-Formal Guest Form Each student may bring one guest to the junior semi or senior prom. If that guest is not a Newton South student in the appropriate grade (i.e. a senior for the prom or a junior for the semi), the student must fill out this form and get all the necessary signatures PRIOR to purchasing the guests ticket. Please note that this form must be accompanied by a photocopy of the guests drivers license, school ID, or another photo ID. All Newton South students are responsible for the behavior of their guests. Guests are responsible for following all Newton Public Schools codes of conduct as outlined in the Newton Public Schools Students Rights and Responsibilities Handbook. Newton South reserves the right to refuse any guest from attending a school event. By signing below, I certify that I have read and agree to the above. ______________________________ Student Signature ______________________________ Guest Signature

Check one:

_____ Junior Semi ______ Senior Prom Advisory: ________________ Counselor: ___________________

Name: ______________________________ House: ______________________________

Housemaster Signature: _____________________________ Guests Information Name: ______________________________________ School s/he attends: ________________________ Guests Asst. Principal/Housemaster/Dean of Students Name: _________________________________ Age: __________

Phone: __________________

Guests Emergency Contact Name: _________________________________ Phone: ________________________ Relationship to Guest: ___________________________ 5