Student Transportation Request Form
Email address *
Student Information
First Name *
Your answer
Last Name *
Your answer
House Number *
Your answer
Street Name *
Your answer
Apartment / Unit Number
Your answer
City *
Your answer
Zip Code *
Your answer
Parent / Guardian Name: *
Your answer
Email Address *
Your answer
Contact Number 123-456-7890 *
Your answer
School *
Grade *
Riders Options
My child will ride: *
If you answered occasionally, please check alternate means of transportation:
Tutoring / Decatur Recreation Options
1. I understand that in order for students to qualify for transportation services their address must be in excess of 1mile or in a defined safety hazard zone from the school in which they are enrolled. *
2. I understand that transportation is provided to and from school in which they are enrolled. *
3. I understand that should an authorized stop not be utilize for 5 consecutive school days, the bus driver will cease stopping until notified by the parent of the student. *
4. I agree that I will review the CSD Code of Conduct with my child. *
5. I agree that the safety of my child while walking to and from school and waiting at the bus stop is my responsibility. *
6. I agree that any change to my child's travel plans must be completed in writing and turned in at least 2 school days before the change is to occur. *
7. I certify that I am the parent/legal guardian of the child listed on this form and that all the information I have provided is true and accurate. I understand that City Schools of Decatur may take steps to verify my address, including home visits, review of public documents and contacting other government agencies, without further notification. *
A copy of your responses will be emailed to the address you provided.
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