Bus Transportation Form
Please fill out the information below. Allow up to three days for our department to process and call you back with your busing information. You will need to provide transportation until you receive your information. If you have any questions or concerns you may contact us @ (330) 477-1300.
Transportation Start Date: (When do you want busing to begin) *
MM
/
DD
/
YYYY
Student Name *
Date of Birth: *
MM
/
DD
/
YYYY
Home Address (include city/state/zip): *
Parent(s)/Guardian Name: *
Home Phone #:
Cell Phone #:
School Attending: *
Student's Grade *
Ride: *
If A.M. pickup is other than the home address fill out information below: (e.g.:daycare/sitter/grandparent)
OTHER PROVIDER'S NAME: (if student is in elementary, the provider must live within the same elementary school boundaries)
PROVIDER'S ADDRESS:
PROVIDER'S CONTACT #:
NOTE: P.M. transportation must be 5 days to same drop off location. If P.M. pickup is other than the home address fill out information below: (e.g.:daycare/sitter/grandparent)
OTHER PROVIDER'S NAME: (if student is in elementary, the provider must live within the same elementary school boundaries)
PROVIDER'S ADDRESS:
PROVIDER CONTACT #:
Comments
Submit
Never submit passwords through Google Forms.
This form was created inside of Perry Local Schools. - Terms of Service - Additional Terms