Telecommunication (Cell Phones) & Other Electronic Devices Confiscation and Return Form Grand Prairie High School Grand Prairie High School prohibits the use of telecommunication devices, including cellular phones and pager/beepers, at all school during the instructional school day (7:00 a.m. – 2:45 p.m.) from the morning entry bell to the afternoon dismissal bell. Students are allowed to be in possession of such devices; however, the device shall not be visible and shall remain turned off during the instructional day. Students who violate this policy shall be subject to established disciplinary measures. Students who violate this policy shall have the device confiscated. The assistant principal will determine whether the device, not including cell phones, may be returned to the student at the end of the day. The parent may pick up a confiscated cell phone from the assistant principal’s office for a fee of $15.
Student Name: __________________________ Grade: _____________________________ Date of Infraction: _________________________ Confiscating Teacher: _________________ Item Confiscated: _________________________ Brief description of infraction: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ The above noted device was confiscated from ______________________________________ (Print student’s name)
Student Signature: _________________________
Date: ________________________
The device was turned in to the discipline office by__________________________________ (Print confiscating teacher’s name)
Teacher Signature: _________________________
Date: ________________________
The device was picked up by _________________________________
(student / parent)
(Print name)
Student / Parent Signature: ________________________
Date: ___________________
Administrative Use Only: Warning issued
62
Copy of policy issued
$15 fee issued