Senior Form

Student's Legal Name
A high school diploma is a legal document and thus a student's legal name must be printed on the diploma.

Please type below where indicated, the legal name as it appears on the birth certificate of the graduating senior.

First name, middle name (no initials), and last name - using the correct spacing.

Legal name as it appears on the graduating senior's birth certificate:
First Name*
Middle Name*

(if none then type "no middle name")
Last Name*
Cap and Gown Information
Cap and gown sizing is determined by height and weight. Please fill in the fields below accordingly.
Height (inches)*
Weight (pounds)*
Leaving Campus During Lunch
We extend a privilege to responsible seniors to leave the school campus during lunchtime. Students who leave must provide their own transportation, follow the rules for off-campus lunch, and return on time for their Block 3 class. Each day that a senior wishes to go out to lunch, he or she must sign out personally with the monitor in the cafeteria on a special form and sign back in personally prior to the beginning of Block 3. Students who do not follow the rules for off-campus lunch will lose this privilege initially for a minimum of three days.

This privilege is reserved for seniors who meet the following conditions:
1. Arrive at school on time in the morning and are seldom late to class.
2. Comply with general school rules.
3. Agree that school activities, meetings, and lunch assignments always take precedence over off-campus lunch.
4. Have paid their $50 parking fee.
5. Agree to follow the rules for off-campus lunch.
6. Have no unserved detentions.
Rules for Off-Campus Lunch:
1. Sign out and in personally each time with the monitor in the cafeteria.
2. Sign in prior to and return on time for Block 3 class.
3. Underclass persons and seniors without permission may not leave the campus.
4. The use of drugs or alcohol will jeopardize this privilege for all seniors.
5. Drive slowly on campus - 10 mph maximum, be extremely careful of students walking or eating in the parking lot, and follow all approved traffic patterns, and exit via the rear driveway only.
6. Not take ineligible student to lunch.
Off-campus lunch privilege may commence on Tuesday, September 6, only if this form is signed and returned to the Deans’ Office and approved by the dean.
Student Acknowledgement*
- I agree to the above Rules for Off-Campus Lunch. If I do not meet these stated conditions, I realize this priviledge will be forfeited. I realize that off-campus lunch can be suspended at the discretion of the administration for poor weather conditions or other circumstances that can arise.
- I do not agree to the above Rules for Off-Campus Lunch or do not wish to leave the ECHS campus during lunch.
Student Signature*
Parent Acknowledgement*
- I have read the above agreement. I agree to allow my son/daughter to leave the ECHS campus during lunch time and will not hold Eastern Christian School Association responsible for accidents or injury that may occur during the time my son/daughter is off campus during lunch.
- I do not agree to allow my son/daughter to leave the ECHS campus during lunch time.
I agree to allow my senior to ride with another student.*
- Yes
- No
I agree to allow my senior to take senior passengers out to lunch.*
- Yes
- No
Parent Signature*

Senior Form

Student's Legal Name

Cap and Gown Information

Leaving Campus During Lunch