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Bus Transportation Form
Please include all students in household on this form, unless you have a student in your household that will need to ride a different bus. Please fill out another request for that student.
Will your student(s) be riding an In-Town Bus or Country Bus?
a) Parent/Guardian Name & Phone Number
Ex: Mike Doe - 641-666-3222
Your answer
b) Parent/Guardian Name & Phone Number
Ex: Mike Doe - 641-666-3222
Your answer
Physical Home Address
Ex: 222 B Ave, Oskaloosa, IA
Your answer
Parent/Guardian Email Address
You will receive a confirmation email
Your answer
Student Information
School Building: Elementary School = OES Middle School = OMS High School = OHS
a) Student Name - Student Grade - School Building
Ex: John Doe - KG - OES
Your answer
b) Student Name - Student Grade - School Building
Ex: Sam Doe - 5th - OES
Your answer
c) Student Name - Student Grade - School Building
Ex: Kim Doe - 6th - OMS
Your answer
d) Student Name - Student Grade - School Building
Ex: Tim Doe - 9th - OHS
Your answer
e) Student Name - Student Grade - School Building
Ex: Dave Doe - 12th - OHS
Your answer
If there are any health concerns the driver should be aware of please explain:
Include students name and health concern
Your answer
Will your student(s) be riding to or from a daycare provider?
If Yes, please list: AM/PM, Daycare Provider Name, Address, Phone Number
Ex: PM Only - Sally Smith - 222 B Ave - 641-555-3333
Your answer
In-Town Bus Students Only
Each student is only allowed: (1) AM Bus Stop Location and (1) PM Bus Stop Location. The AM / PM Bus Stop Locations may be different but students can NOT have multiple AM or PM Bus Stops. Students MUST ride 3 days or more a week to be eligible for Bus Transportation.

Example:
ALLOWED = AM Bus Stop Location: 813 N. H St.
PM Bus Stop Location: Jefferson School

NOT ALLOWED = AM Bus Stop Location: Lincoln School & Garfield School (alternate every other week)

AM Bus Stop Location (please choose from above)
Ex: Oskaloosa Street (If AM Bus is not needed type - NONE)
Your answer
PM Bus Stop Location (please choose from above)
Ex: YMCA (If PM Bus is not needed type - NONE)
Your answer
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