This form must be completed and approved by the employee’s supervisor and the Assistant Superintendent for Business before a cell phone may be issued. Once approvals are obtained, the employee must complete and submit the Cell Phone Agreement Form before the phone will be issued.
Employee’s Name: ______________________________________________________
Title: _________________________________________________________________
Primary Work Location: __________________________________________________
Please describe why this position requires that a cell phone be issued (it is recommended that the employee refer to the Board of Education Cell Phone Policy):
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.
Anticipated amount of use (daily, occasionally, only in emergency situations, etc.):
__________________________________________________________________________________________________________________________________
Employee’s Signature: ______________________________________________________ Date: _______
Supervisor’s Signature: ______________________________________________________ Date: _______
Approved by Assistant Superintendent for Business: ________
Date: _______
Adopted: May 22, 2006