Off-Campus Lunch Pass Application  
It is important that parents and students understand the expectations and rules governing off-campus lunch privileges.  Your digital signature will indicate that you have reviewed and discussed these regulations and are fully aware of the liability associated with this privilege.  Only Seniors and Juniors are eligible for an Off-Campus Lunch Pass.
Parent/Guardian should complete the questions below
Important to understand: Students who have a free 6th & 7th period may leave campus at the conclusion of 5th period.  A Lunch Pass is NOT required in this situation, but students must always have a current copy of their schedule.
There is a $10 charge for a Lunch Pass without an ASB Card
Student Last *
Student First Name *
Grade *
Parent/Guardian Name *
Parent/Guardian Home Phone Number *
Parent/Guardian Cell Phone Number
Parent/Guardian Work Phone Number *
Student Cell Phone Number *
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