SchoolPool Spring 2019 Application
This program is aimed at reducing car trips accessing schools by encouraging students to use public transit. Guardians must fill out this form for their child(ren). Your answers to this survey will not in any way affect your eligibility for the SchoolPool program or any other 511 Contra Costa programs. All answers will remain confidential. Answers to demographic questions are not required.

En Español: https://docs.google.com/forms/d/e/1FAIpQLSfAYWhZHGu996mGxvYgdnFj_ITetEyKW1mVKoIYXpoZ0DjKhQ/viewform

Parent/Guardian Information
Parent First Name *
Your answer
Parent Last Name *
Your answer
Home Address *
We’ll use this address to mail your bus tickets to you
Your answer
Apartment Number
Your answer
City *
Your answer
Zip *
Your answer
Daytime Phone *
Your answer
Email Address *
We’ll use this email to contact you with any questions about your application
Your answer
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