2022-2023 CHILD CARE TRANSPORTATION ARRANGEMENT FORM

NEEDS TO BE CONSISTENT MONDAY THROUGH FRIDAY

Transportation of open enrolled students becomes the responsibility of the parents; school bus transportation is generally not provided except as appropriately arranged from the homes of the child care providers residing in the attendance area of the school to which the child open enrolls.

Buses will not be rerouted for child care purposes and corner stops are utilized when/where sidewalks are prevalant.

PLEASE ALLOW FOR up to FIVE (5) SCHOOL DAYS TO COMPLETE REQUEST AND YOU WILL BE NOTIFIED VIA EMAIL - THANK YOU.

NOTE: If you are completing this form the week prior or during the first two weeks of school, all requests will filled and completed following Labor Day depending on the volume of last minute requests.

*** Transportation needs to be consistent Monday through Friday ***

Please be sure to list all the information needed to complete the request and that the information is accurate prior to submitting. Thank you.
Today's Date: Today's Date: / MM / DD YYYY
School Year for which you are requesting transportation

School Year for which you are requesting transportation 2022-2023

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
Street Address
PARENT/GUARDIAN NAME PARENT/GUARDIAN NAME First Last
Primary Contact Number Primary Contact Number - ### - ### ####
Parent Email Address
Child Care Provider Information
Arrangements

Arrangements Cancel existing child care ONLY IF A PREVIOUS REQUEST WAS SUBMITTED Before School After School Before and After School using the Same Child Care Address

This form is for arranging an alternate pickup or drop off location. For regular student bussing, it is not required.
Name: Child Care Provider (AM or All Day) Name: Child Care Provider (AM or All Day) First Last
Must be consistent Monday through Friday
Phone: Child Care Provider (AM or all day) Phone: Child Care Provider (AM or all day) - ### - ### ####
Address: Child Care Provider (AM or All Day)
Name: Child Care Provider (PM) Name: Child Care Provider (PM) First Last
Must be consistent Monday through Friday
Phone: Child Care Provider (PM) Phone: Child Care Provider (PM) - ### - ### ####
Address: Child Care Provider (PM)
Comments:
Effective Dates:
From: From: / MM / DD YYYY
To: To: / MM / DD YYYY
I understand that by submitting this form, it is considered to be my electronic signature.

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

2022-2023 CHILD CARE TRANSPORTATION ARRANGEMENT FORM

2022-2023 CHILD CARE TRANSPORTATION ARRANGEMENT FORM

Child Care Provider Information

Effective Dates: