ABRSD Elementary One Day Pass Request

This form must be completed and submitted before 2:00 pm the day before for which the change is effective, otherwise the student will be dismissed according to his/her usual dismissal procedure. For example, if the bus pass is for Tuesday, September 22, this form must be submitted by 2:00 pm on Monday, September 21.
If you are unsure of the bus number needed for this pass, please look up the address here: http://www.infofinderi.com/tfi/address.aspx?cid=ARS5OMB7LJU3 and return to this form.

Today's Date

Student Name

This is a required question

Teacher Name - Room Number:

This is a required question

Date of Bus Pass:

Student will Ride on Bus Number:

This is a required question

To Existing Bus Stop Location:

This is a required question

Receiving Adult Name:

The student will be in the care of this person.

This is a required question

Receiving Adult Phone Number:

Phone number of person student will be in the care of.

This is a required question

Name of Parent/Guardian Requesting Bus Pass:

This is a required question

Phone number of Parent/Guardian Requesting Bus Pass:

This is a required question

You must select "yes" to electronically sign this request

This is a required question