Private School Transportation Request
Submit a request for each child that requires private school transportation.
Student Information
Student Last Name
Your answer
Student First Name
Your answer
Student Date of Birth
MM
/
DD
/
YYYY
Student Grade
Street Address
Your answer
City
Your answer
Parent Information
Home Phone Number
Your answer
Mother's Full Name
First Name Last Name
Your answer
Mother's Cell Phone Number
Your answer
Mother's Email Address
Your answer
Father's Full Name
First Name Last Name
Your answer
Father's Cell Phone Number
Your answer
Father's Email Address
Your answer
Medical Concerns
Emergency Contacts (Other than Parents)
Please include full name, relationship, and phone numbers.
Your answer
Describe any serious medical concerns. If none, state 'NONE'
Your answer
Transportation Details
School Currently Attending
St. Rita & St. Joan Families, changes for this school year: I understand that my student(s) will be part of a transportation hub system both in the morning and afternoon. Meaning, that Kenston Local SD buses will provide transportation and my student will be required to change buses at a central location on Kenston's campus if I choose "Home Service". At which point they will get on a bus that services their school or neighborhood. NDCL & St. Helen Families no changes to your transportation. *
Preferred Morning Pickup Location
Preferred Afternoon Drop-off Location
Alternate Child Care Information
Do your child have alternate child care?
Alternate Child Care Full Name (if applicable)
Your answer
Alternate Child Care Street Address (if applicable)
Street Address, City, ZIP
Your answer
What days of the week does the child go to the alternate child care location?
(if applicable)
Ride Needs / AM or PM, or Both
Ride Frequency - How Many times Per Week?
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