Mobile Phone Ban Exemption

Mobile Phone Exemption Request Form

* Indicates required field

Parent/Caregiver Name *

First

Last

Student Name *

First

Last

Phone Number *

Email *

Exemption Number *

The device is used to monitor or help manage a health condition The device is a negotiated adjustment to a learning program for a student with disability or learning difficulties The device is used for translation in the classroom by a student with English as an additional language The student has extenuating personal circumstances such as being a parent themselves or a primary carer to younger siblings or an unwell family member

Please provide details to support your exemption request *

Supporting documentation where relevant, such as the student's health care plan and / or learning plan, must accompany your exemption request *

Max file size: 20MB

Submit