St Kieran Catholic Primary School eNewsletter

Application for Student Use of a Mobile Phone

This is the online application of the paper version of this form. The full policy can be found below.

Parent/Guardian First Name *

Parent/Guardian Last Name *

Email *

Child's Full Name *

Class *

Student Mobile Phone Number

I wish to apply for permission for my son/daughter to carry a mobile phone on school premises and acknowledge the carrying of a mobile phone is for safety, security or emergency use.

We (parents/guardians) agree to the conditions set down under ‘Conditions of Use’ and understand that violation of the policy may result in loss of privilege to carry a mobile phone at the school.

Please sign *

Write your signature above the line

Office Use Only

Approved

Not Approved

Reason permission not approved

Principal Signature: __________________________________