Request edit access
2019-20 PCHS Bus Registration Form
Email address *
Parent(s) Name
Your answer
Address
Your answer
Cell phone number for father
Your answer
Cell phone number for mother
Your answer
Student Name
Your answer
Grade
Student Name
Your answer
Grade
Student Name
Your answer
Grade
Public School District that you reside
Special Instructions (based on approval by the Transportation Committee) Pick up address (if not home address listed above):
Your answer
Name and phone number for this address
Your answer
Afternoon Drop-off address (if not home address listed above):
Your answer
Name and phone number for this address
Your answer
Fees (choose those that apply) *part time student rate is for students who ride one way or ride 2 days per week either time or both.
Days Riding (mark all that apply)
PAYMENT - Please make checks payable to PCHS and drop off or mail to PCHS at 300 Eagle Lane Pella, IA 50219
I am aware of the rules for bus conduct that can be found in the Parent Handbook and I will discuss these with my child(ren) before riding the bus the first day of school. My typed signature is my acknowledgement that the above information has been completed accurately to my knowledge.
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Pella Christian High School. Report Abuse - Terms of Service