Cellular Device Medical Exemption Request Form
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Required
Name of Parent
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required
First Name
Last Name
Name of Student
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required
First Name
Last Name
TCA Campus of Student
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required
Central Elementary
East Elementary
North Elementary
Junior High
High School
College Pathways
Cottage School Program
Parent's Email Address
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required
Medical reason student requires access to a cell phone during school hours. (A recommendation from a medical health professional does not automatically guarantee approval by administration.)
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required
Please send any medical documentation to ktagliere@asd20.org
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