2021-2022 SCHOOL YEAR TRANSPORTATION REQUEST
Please complete ONE FORM PER STUDENT for the 2021-2022 school year.
~To be completed for ALL K-12 students requiring transportation.
~GSRP and ECSE student requests go through Model Elementary.
~Please ONLY complete if you are planning to use transportation.
~We are not accepting requests for students with two different stop locations.
~Each student will only be assigned one (1) stop location.
~Students are only permitted to ride the bus to and from their assigned stop location.
You will receive your students busing information before the start of the school year.
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Student Last Name
Student First Name
Model - DO NOT NEED TO COMPLETE FORM. CONTACT MODEL TO REQUEST TRANSPORTATION FOR YOUR MODEL STUDENT
Home Address (will be confirmed with address on file in PowerSchool)
Requested stop address ONLY IF different from home address
Please list the best phone number to be reached at
Please list additional phone number to be reached
I acknowledge I have read and understand the transportation rules and guidelines for the school year. In addition, I acknowledge that failure to follow these rules will result in disciplinary actions up to and including bus privileges being revoked. PARENT SIGNATURE BELOW.
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This form was created inside of Lincoln Consolidated Schools.