LIFT Transportation Request Form
2019-2020
Student's Name *
Your answer
Home Address *
Your answer
Phone Number *
Your answer
When he or she attends the LIFT Program, will your child be transported to HOME or to DAYCARE? *
Drop-off Address (if different than home address)
Your answer
Which days of the week will your child require transportation? *
Required
STUDENTS MUST ADHERE TO WEEKLY SCHEDULE. ARRANGEMENTS WILL NOT BE MADE TO ACCOMMODATE RANDOM SCHEDULES.
My digital signature certifies that I am the parent/legal guardian of the above student and authorized to request transportation for my child.
Type your full name below to provide your digital signature. *
Your answer
Date *
MM
/
DD
/
YYYY
Submit
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