2020-2021 MCCC SHUTTLE REQUEST FORM

to and from Medina Co Career Center & Brunswick HS

Transportation of students in grades 9-12 is the responsibility of the parent. School bus transportation is provided from Brunswick High School leaving at 7:20 AM to Medina County Career Center (MCCC). Afternoon bus transportation from MCCC is scheduled to arrive at Brunswick High School at 2:30 P.M. Parents are required to transport home.

ALL DROP OFFS AND PICK UPS FOR am & pm ARE LOCATED AT THE STADIUM.

MASKS MUST BE WORN AT ALL TIMES AND STUDENTS WILL LOAD BACK TO FRONT AND DISEMBARK FRONT TO BACK WHILE THE COVID-19 PANDEMIC EXISTS.
Date Date * / MM / DD YYYY
School Year for which you are requesting transportation *

School Year for which you are requesting transportation 2020-2021

This form is for arranging an alternate pickup or drop off location. For regular student bussing, it is not required.
STUDENT NAME STUDENT NAME * First Last
Attending School *
Grade *
Program Type- please select one

Program Type- please select one AM PM All Day
PARENT/GUARDIAN NAME PARENT/GUARDIAN NAME * First Last
Primary Contact Number Primary Contact Number * - ### - ### ####
Parent Email Address *
Comments:
Effective Dates:
From: From: * / MM / DD YYYY
To: To: * / MM / DD YYYY
I understand that by submitting this form it considered to be my electronic signature. *

I understand that by submitting this form it considered to be my electronic signature. Yes
Name of Person Completing Form Name of Person Completing Form * First Last