Student’s Name: _______________________________________
Grade: _____
Period: ______
Permission Slip for Class Related Cell Phone Use
With so much innovative technology available and utilized in the world today, I feel it is important to integrate
what I can into my classes to help prepare students for their futures. During the course of the school year I will
be implementing some newer methods of instruction and assessment, some of which will entail student use of
cell phones for purposes such as recording speaking assessments, text message reminders of important class
information (tests, quizzes, projects etc.) and other classroom activities.
In order to apply this new technology; students will need to have access and authorization to use a cell phone. I
am sending this permission slip to verify that your son/daughter has permission to use his/her cell phone for the sole classroom
purposes explained below. If your son/daughter does not have access to a cell phone during
the school day, I will have mine available for use, if permission is granted by you. I look forward to educating your son/daughter this
year and implementing some exciting new strategies for instruction!
Sincerely,
Mrs. Nancy Patterson
Garfield Middle School
Computer Applications Teacher
1. CELL PHONE USE AUTHORIZATION – Activities and Assessments (Please read all options below, use a checkmark to indicate
your decision and sign at the bottom.)
______ Option 1: I give my child permission to use his/her cell phone for Computer Applications classroom assessments and activities.
______ Option 2: I give my child permission to use the teacher’s phone for Computer Applications classroom assessments and activities.
______ Option 3: I do not give my child permission to use his/her cell phone for Computer Applications classroom assessments and activities.
2. CELL PHONE USE AUTHORIZATION – Texting Messages of Important Classroom Information; Internet Data Use; Taking
Photographs & Videos for classroom use only. (Please read all options below, use a checkmark & sign your initials to indicate
your decision(s) and sign at the bottom.)
(__)______ I give ___________________________________ permission to send and receive text messages for classroom
activities. In addition it is okay for him/her to receive general text messages to his/her cell phone about important class
information such as reminders for tests, quizzes and other assignments for this year. (**Students would only receive or send a
maximum of approximately 10-12 text messages per month.)
(__)______ I give ____________________________________ permission to use his/her cell phone’s Internet Data Use by
sending and receiving email messages & searching the Internet for classroom activities.
(__)______ I give ____________________________________ permission to use his/her cell phone to take photographs & videos
for classroom activities.
(__)______I do not wish for my son/daughter to receive any text messages about Important Class Information; use his/her
Internet data package; and/or use his/her cell phone to take photographs & videos for classroom activities .
** I will not hold the Lakewood City School district, the Computer Applications teacher or Garfield Middle School liable for any
phone charges incurred through calls or the sending/ receiving of text messages for the specific classroom purposes listed above.
I also understand that a text message may not necessarily be sent for every important event, assessment or classroom activity.
________________________________________
(______)______________________
Parent/Guardian Signature
My Child’s Cell Phone Number
_______________
Date
PARENT PERMISSION FORM FOR:
USE OF PERSONAL DIGITAL DEVICES IN THE CLASSROOM
(EXAMPLES: DIGITAL CAMERAS, ITOUCH, IPOD, iPad, LAPTOP, & CELL PHONES)
From time to time we take pictures & videos during computer class activities to use in our computer class
projects. The problem is that we only have 2 classroom digital cameras for 25 to 30 students to use.
Therefore, with your permission your child can bring in their own digital device from home to use in our
classroom as long as the following rules are followed:
Rules for using Personal Digital Devices in the Classroom
1. Your child is responsible for their Digital Device! The Lakewood City School District and its Staff
Members are not responsible in any way for the digital camera that your child brings to school. The
Lakewood City School District will not pay for or replace any camera that is lost, broken or stolen.
2. The digital device needs to come to school empty (with no photographs and/or videos stored on its or
its memory card). And the digital device needs to go back home empty (with no photographs/videos
stored on the memory card). Absolutely no photographs or videos taken at school can be taken home
and used for personal use at home or online.
3. Students can use their digital devices for school projects ONLY. (Example: No texting or sending
photographs, etc… to their friends or family for personal use during class or throughout the school
day.)
4. You need to bring your digital device’s USB cord or card reader, so you can get the photographs &
videos that you have taken at school off the camera during class. *You might, also, want to bring
extra batteries or chargers.
5. When at school, the digital device needs to be kept in the student’s locker and brought only to Mrs.
Patterson’s Computer Class.
6. Photographs & Videos can not be taken in any other class or on school property without prior
permission from Mrs. Patterson.
I grant my child permission to bring their personal digital device from home to use in Mrs. Patterson’s
Computer Class for classroom projects. We, also, understand and will follow the above rules for using our
personal digital devices in the classroom. Students who do not abide by these terms and conditions will
lose their opportunity to take part in these projects & will face consequenses per the student handbook.
Date Signed: ___________ Date(s) digital device will be at school: ______________(Q1) (Q2) (Q3) (Q4)
Type & Produce Name of Device(s): ________________________________________________________
Child’s Name (PLEASE PRINT): ________________________________________Grade:___ Period: ___
Child’s Signature: ______________________________________________________________________
Parent/Guardian’s Name (PLEASE PRINT): _______________________________________________
Parent/Guardian’s Signature: ___________________________________________________________
*(Please return this permission slip to Mrs. Patterson)