Transportation Request for Change

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IN ORDER TO MAINTAIN SAFETY AND PROPER BUS LOADS, ONE PICK UP LOCATION AND ONE DROP OFF LOCATION IS PERMITTED AND IT WILL REMAIN THE SAME FOR EVERY DAY OF THE WEEK. THE ONLY EXCEPTION IS FOR DOCUMENTED SPLIT CUSTODY CASES IF BOTH PARENTS RESIDE IN THE DISTRICT. YOU MUST PROVIDE THE DISTRICT WITH A SCHEDULE.

Student Name *

Grade *

Reason for Change Request *

New Home Address

New Babysitter/Alternate Address

To request busing (I am currently transporting my child or my child is returning from cyber)

To change pick up and/or drop off location

Required

Current Home Address *

NEW Home Address and Phone Number

Babysitter/Alternate Name

Babysitter/Alternate Address and Phone Number

Morning pick up location *

Home address

Babysitter/Alternate address

Afternoon drop off location *

Home address

Babysitter/Alternate address

Additional comments

Requested Beginning Date *

YYYY

Parent/Guardian Signature (Phone number and/or email address where we can contact you. *

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