Prom Appeal Form

READ CAREFULLY AND FILL THIS OUT COMPLETELY
(Incomplete submissions will not be considered.)

*Your grade level administrator or program administrator will review your appeal
*You will be notified by email of the decision
*No appeal is guaranteed to be approved
*Appeals are reviewed in the order received
*Tickets are first come, first serve

Criteria to attend prom and all related activities:
*Students must have a 2.0 or higher GPA for Semester 1/Quarter 3
*No level 3 or 2F/2G Referrals
*No more than two total Level 1 or 2 Referrals
*Can not be on "No Go/Items Owed" List

Student Name Student Name First Last
Student ID
Must be 6 characters. Currently Entered: 0 characters.
First period teacher name (or first class you have each day)
Student Email (Please use school email, for example 123456@student.pasco.k12.fl.us)
Confirm Student Email (Repeat previous step)
Today's Date Today's Date / MM / DD YYYY
Your Assistant Principal for Your Class or Program

Your Assistant Principal for Your Class or Program 12th Class of 2026 (Martin) 11th Class of 2027 (Lewis) 10th Class of 2028 (Maz) 9th Class of 2029 (King) 9-12th IB (Kledzik)
You are not eligible because: (Check all that apply)

You are not eligible because: (Check all that apply) I have below a 2.0 GPA for Semester 1 Discipline: I have a level 3 or 2F/2G referral Discipline: I have more than 2 referrals I am on the "No Go/Items Owed" List
Administration Use Only (Approved or Denied)

This is the description of your section break.
Approved or Denied/Additional Notes

Prom Appeal Form

Prom Appeal Form

Administration Use Only (Approved or Denied)