Transportation Reimbursement Form - Christopher Columbus Charter School
Dear Parents/Guardians:

The School District of Philadelphia determines eligibility for partial reimbursement of transportation costs to families who are driving students to school in an automobile or van on a daily basis. If you are driving your child to school and wish to be considered for reimbursement, please complete the bottom of this form.

Once the School District has determined that you are eligible to receive transportation reimbursement, a monthly check will be mailed directly to you. Because of this, it is important that you notify us of any address change that may occur through the school year.

The amount of each month’s reimbursement check will be based upon your child’s monthly attendance at CCCS.

If you would like consideration for free transpasses/monthly reimbursement, please submit this form.
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Email *
Please select: *
Student 1 - Last Name *
Student 1 - First Name *
Student 1 Grade *
Student 2 - Last Name
Student 2 - First Name
Student 2 Grade
Clear selection
Student 3 - Last Name
Student 3 - First Name
Student 3 Grade
Clear selection
Student 4 - Last Name
Student 4 - First Name
Student 4 Grade
Clear selection
Student(s) Address *
Is this a new address for this school year? *
Name of person receiving reimbursement *
Adult Contact Phone *
Vehicle Year *
Vehicle Make *
Vehicle Model *
Vin *
Actual Mileage to/from school *
Seat Capacity - not including driver *
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