Student Transportation Request Form
Email address *
2019-2020
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 *
My child will ride: *
Required
If you answered occasionally, please indicate your child's alternate means of transportation:
If you answered Extended Day Tutoring or Decatur Recreation options, please identify which program:
Consent
1. I understand that in order for students to qualify for transportation services their home address must be in excess of .5 mile or in a defined safety hazard zone from the school in which they are enrolled. *
2. I understand that transportation is only provided to and from the school in which they are enrolled. *
3. I understand that should an authorized stop not be utilized for 5 consecutive school days, the bus driver will cease stopping until the transportation department is notified by the parent of the student. *
4. I agree that I have reviewed 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. *
8. Administrative Transfer Student ( Zone for a different school)
Survey
Would you like to receive route notification, e.g route delays? *
A copy of your responses will be emailed to the address you provided.
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