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Date *
MM
/
DD
/
YYYY
Student Last Name *
Student First Name *
School *
Grade *
Parent / Guardian Name *
Street Address *
Phone *
Have you moved? *
Last year's bus stop? (Type N/A if this does not apply) *
Additional Information?
Please Read
I have received, read and understand the Transportation Safety plan for Lincoln Unified School District. I understand transportation will only transport my child to his/her designated bus stop. I understand my student must present a valid bus pass each trip. FAILURE TO DO SO MAY CAUSE REFUSAL OF TRANSPORTATION TO THE STUDENT. Parents are advised that the district does not supervise bus stops. I understand the replacement fee for a lost or damaged bus pass is $8.
Parent / Guardian Signature (Please type your name below) *
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