*2019-2020* Imagine School - Chancellor Campus Bus Sign Up Form
*Transportation will be granted on a first come first served basis. Please do not submit more than one request per student unless your address has changed. In many cases, application dates are used to determine priority and the most recent application date overwrites all previous entries.
Email address *
School Year *
Please select the school year that you are requesting transportation.
Parent or Legal Guardian Full Name *
Your answer
Student's First Name *
Please enter the student's legal first name (no nicknames).
Your answer
Student's Middle Initial (INITIAL ONLY)
Your answer
Student's Last Name *
Please enter the student's legal last name.
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's School Name *
Student's School Grade *
Please enter the student's grade level that will correspond to the school year selected above.
Student's Home Street Address (Primary) *
Please enter only the house # and street name only. DO NOT USE ANY PUNCTUATION.
Your answer
Student's Apartment or Unit #
Please enter the unit #.
Your answer
Student's Home City (Primary) *
Please enter the city of residence name.
Your answer
Student's Home Zip Code *
Please enter the zip code.
Your answer
Parent or Guardian's Main Phone Number *
Your answer
Parent or Guardian's Alternate Phone Number 1
Your answer
Parent or Guardian's Alternate Phone Number 2
Your answer
Request Type *
Sibling Enrollment Status *
Will any siblings attend the same school? Please note a separate form must be submitted for each student that needs transportation.
Sibling Names
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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