2022-2023 CAR RIDERS ONLY FORM - No Bussing Needed

The purpose of this form is to help the schools and transportation be aware of whether or not your child is in need of bus transportation. By filling out this form, you are indicating that your child does NOT need bussing to and/or from school. We appreciate your help in identifying this information.
Today's Date: Today's Date: / MM / DD YYYY
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
Car Arrangements

Car Arrangements Before and After School Car Rider Before School Car Rider ONLY After School Car Rider ONLY Bus Rider

This form is for arranging an alternate pickup or drop off location. For regular student bussing, it is not required.
Comments:
Effective Dates:
From: From: / MM / DD YYYY

Start date must be between 8/22/2022 (first day for students grades 1-12) and 5/25/2023 (last day of school for all students)
To: To: / MM / DD YYYY

Date entered must be before or on the last day of school for students: 5/25/2023
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