RED CEDAR ACADEMY


CELL PHONE PERMISSION FORM


I,_______________, understand that under school policy, I am not permitted to bring my cell phone to school. However, due to the extenuating circumstance listed below, the Principal may allow me this privilege. If I am permitted to bring my cell phone to school, I understand that I must turn my cell phone into my homeroom teacher (Mr. Paul or Ms. Robbi)
every morning and pick it up from him/her every afternoon. I also understand that this privilege may be terminated at any time if complications arise.

The reason I would need to have my cell phone at school:
____________________________________________________________________________________________________________________________________________________________

Student’s Signature:______________Date:_________
Parent’s Signature:_______________Date:_________
Teacher’s Signature:_____________Date:_________
Principal’s Signature:_____________Date:_________