{"id":3361,"date":"2019-12-04T01:57:10","date_gmt":"2019-12-04T01:57:10","guid":{"rendered":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/?page_id=3361"},"modified":"2019-12-04T01:57:10","modified_gmt":"2019-12-04T01:57:10","slug":"mobile-phone-registration-for-students-with-approved-health-care-plans","status":"publish","type":"page","link":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/?page_id=3361","title":{"rendered":"Mobile Phone Registration for students with approved health care plans"},"content":{"rendered":"<form method=\"post\" enctype=\"multipart\/form-data\" id=\"vfbp-form-28\" class=\"vfbp-form\"><div style=\"display:none;\"><label for=\"vfbp-EMAIL-AN8fuQyoDLXem\">If you are human, leave this field blank.<\/label><input size=\"25\" autocomplete=\"off\" type=\"text\" name=\"vfbp-EMAIL-AN8fuQyoDLXem\" value=\"\" id=\"\"><\/div><input type=\"hidden\" name=\"_vfb-timestamp-28\" value=\"1777848426\" id=\"\"><input type=\"hidden\" name=\"_vfb-form-id\" value=\"28\" id=\"\"><div class=\"vfb-form-group vfb-col-8\"><div><h2 class=\"\">Mobile Phone Registration for students with approved health care plans<\/h2><span class=\"vfb-help-block\">Permission for mobile phone use on the school grounds will only be granted to students who already have an approved school health care plan in place.<\/span><\/div><\/div><div class=\"vfb-col-8 vfb-fieldType-heading\" id=\"vfbField842\"><\/div><div class=\"vfb-col-12 vfb-fieldType-name\" id=\"vfbField843\"><div class=\"vfb-form-group\"><label for=\"vfb-field-843\" class=\"vfb-control-label\">Student Name <span class=\"vfb-required-asterisk\">*<\/span><\/label><div class=\"vfb-name-block\"><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-843-first\" class=\"vfb-form-control vfb-namepart-first\" placeholder=\"First\" required=\"required\" type=\"text\" name=\"vfb-field-843[first]\"><\/div><\/div><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-843-last\" class=\"vfb-form-control vfb-namepart-last\" placeholder=\"Last\" required=\"required\" type=\"text\" name=\"vfb-field-843[last]\"><\/div><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-3 vfb-fieldType-select\" id=\"vfbField849\"><label for=\"vfb-field-849\" class=\"vfb-control-label\">Year Group <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-form-group\"><select id=\"vfb-field-849\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" name=\"vfb-field-849\"><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><option value=\"11\">11<\/option><option value=\"12\">12<\/option><\/select><\/div><\/div><\/div><div class=\"vfb-col-3 vfb-fieldType-text\" id=\"vfbField846\"><div class=\"vfb-form-group\"><label for=\"vfb-field-846\" class=\"vfb-control-label\">House Group<\/label><div><input id=\"vfb-field-846\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-846\" value=\"\"><span class=\"vfb-help-block\">(if known)<\/span><\/div><\/div><\/div><div class=\"vfb-col-6 vfb-fieldType-checkbox\" id=\"vfbField847\"><label for=\"vfb-field-847\" class=\"vfb-control-label\">Check if student already has an approved health care plan<\/label><div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-847-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-847\" type=\"checkbox\" name=\"vfb-field-847[0]\" value=\"1\"><\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField848\"><div class=\"vfb-form-group\"><label for=\"vfb-field-848\" class=\"vfb-control-label\">Rationale for student mobile phone use in school<\/label><div><textarea id=\"vfb-field-848\" class=\"vfb-form-control\" placeholder=\"\" rows=\"10\" name=\"vfb-field-848\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-name\" id=\"vfbField852\"><div class=\"vfb-form-group\"><label for=\"vfb-field-852\" class=\"vfb-control-label\">Parent\/Guardian Name <span class=\"vfb-required-asterisk\">*<\/span><\/label><div class=\"vfb-name-block\"><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-852-first\" class=\"vfb-form-control vfb-namepart-first\" placeholder=\"First\" required=\"required\" type=\"text\" name=\"vfb-field-852[first]\"><\/div><\/div><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-852-last\" class=\"vfb-form-control vfb-namepart-last\" placeholder=\"Last\" required=\"required\" type=\"text\" name=\"vfb-field-852[last]\"><\/div><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField850\"><div class=\"vfb-form-group\"><label for=\"vfb-field-850\" class=\"vfb-control-label\">Parent\/Guardian Email <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-850\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"email\" name=\"vfb-field-850\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField853\"><div class=\"vfb-form-group\"><label for=\"vfb-field-853\" class=\"vfb-control-label\">We will contact you after reviewing your submission.<\/label><div class=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-submit\" id=\"vfbField855\"><button id=\"vfb-field-855\" class=\" btn btn-primary\" placeholder=\"\" type=\"submit\" name=\"_vfb-submit\">Submit<\/button><\/div><div class=\"vfb-clearfix\"><\/div><\/form>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/pages\/3361"}],"collection":[{"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3361"}],"version-history":[{"count":2,"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/pages\/3361\/revisions"}],"predecessor-version":[{"id":3366,"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=\/wp\/v2\/pages\/3361\/revisions\/3366"}],"wp:attachment":[{"href":"https:\/\/www.rossmoyneshs.wa.edu.au\/forms\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3361"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}