Privilege Appeal Form for Prom 2026

This form will be sent to your class administrator for review.

Student Name Student Name First Last
Student Number
Must be a number less than or equal to 999999.
Class

Class IB (Mrs. Marriott) Class of 2026 (Mr. Batchelor) Class of 2027 (Mr. Hostetler)
Email- Must use school email address

Confirm Email Address

If you want email confirmation from administrator.
Mark if you are new to LOLHS

Mark if you are new to LOLHS I am a new student
You are not on track or You did NOT qualify to purchase a Prom tickets because: (Check all that apply)

You are not on track or You did NOT qualify to purchase a Prom tickets because: (Check all that apply) Credits: I am behind in credits GPA: I am below a 2.00 Discipline: I earned three level 2 referrals or one level 3 referral Attendance: Below 90% attendance in periods attended (excused or unexcused) Tardies- Above 20 Unexcused Tardies IB Students Only: Off track with IB Diploma Other Other
If you are not on track due to credits, describe what specific actions you have taken to recover this credit/credits?

If you are not on track due to credits, describe what specific actions you have taken to recover this credit/credits? I passing all of my classes with a C or higher during 3rd quarter I am on the 18 credit plan and not behind I am attending extended day to make up credits. I am on track with my credit recovery class I finished an online class in addition to my 6 period day. Other (fill in below) Other (fill in below)
If you are not on track due to attendance, you may earn back your privileges one time each year AFTER you have completed one of the following.
Example: if you missed 5 periods of school you have 1 day to make up.

If you are not on track due to attendance, you may earn back your privileges one time each year AFTER you have completed one of the following.
Example: if you missed 5 periods of school you have 1 day to make up. 2 hours of academic work after school for each block of 5 over 30 periods Other