2020-2021 Transportation Request Form
Dear Parent or Guardian:

Each year, a NEW transportation request form must be completed for EACH student. Even if you have a student who doesn't need transportation, please complete the form and indicate the reason for our records. We work hard to account for every student so that no student is missed during the planning process.

All transportation requests should be returned by May 27th as we will begin planning for the 2020-2021 school year at that time. If you have any questions or concerns, please feel free to contact me at 419-736-3305 or bberry@blrv.org.

Thank you for providing this necessary information.

Bruce Berry, Transportation Director
Email address *
BLACK RIVER LOCAL SCHOOL DISTRICT - SULLIVAN, OHIO Transportation Office: 419-736-3305
Student's First Name: *
Student's Middle Initial:
Student's Last Name: *
Grade when school resumes: *
School of Attendance: *
Home Address: *
City, State, Zip: *
Parent/Guardian Name and Relationship to Child: *
Home Phone: *
Parent/Guardian Email: *
Emergency Phone Contact Name & Phone Number *
List any medical alerts that our drivers should know about in order to best care for your child:
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