Application for Continuing Transportation
DO NOT USE IF REQUESTING TRANSPORTATION FOR THE FIRST TIME! Use only for CONTINUING private and parochial school transportation. For information regarding kindergarten or first time requests, please call Central Registration at (631)471-7861 or visit the Sachem Transportation Office of Central Registration Webpage.
****ONE FORM PER STUDENT****
Student's First Name
Student's Middle Name
Student's Last Name
Alternate Pick up or Drop Off Address (if applicable)
School the student will be attending in September 2019
Grade the student is entering in September 2019
Student Date of Birth
Parent or Guardian Name: (First Name & Last Name)
Home Telephone Number (including area code)
Emergency Telephone Number (including area code)
Work Telephone Number (including area code)
In accordance with the laws of New York State, I hereby formally request transportation for my child to:
Name of School
Harbor Country School
Holy Family Regional School
Laurel Hill School
Our Lady of Mercy
Our Savior New America
Smithtown Christian School
St Anthony's High School
St John the Baptist High School
St Joseph School
St Mary's School
St Patrick's Bayshore
St Patrick's Smithtown
St Philip & James School
The Stony Brook School
Victory Christian Academy
Address of School
School Telephone Number (including area code)
School Hours for September 2019
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree that the information I have provided is accurate and truthful.
If you have any questions in regards to this form, please direct all contact to:
Joseph Cervone, Transportation Supervisor.
Transportation Office 51 School Street Lake Ronkonkoma, NY 11779 (631) 471-1380
A copy of your responses will be emailed to the address you provided.
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