Child Care/Bus Stop Change Request

To determine eligibility for a bus stop change, please consider the following:

Will the student(s) be picked up at the same stop every day (can be different from the afternoon bus stop)?
Will the student(s) be dropped off at the same stop every day (can be different from the morning bus stop)?
Is the daycare provider or alternate site located in the student's assigned school attendance area?

If the answers to all these are yes, complete the form below. If one or more of the answers is no, your child is ineligible for an alternate bus assignment.

This form must be submitted 5 days in advance of any changes.

School Yearrequired

Studentrequired

First Name

Last Name

Schoolrequired

Do you have another student?

Yes

No

Student #2required

First Name

Last Name

Schoolrequired

Do you have a third student?

Yes

No

Student #3required

First Name

Last Name

Schoolrequired

Do you have more students?

Yes

No

Additional Students

HOME - Street Address

HOME - Address City

BUS CHANGE STOP REQUEST

Do you want to request a new PICK-UP LOCATION?

Yes

No

Name

Street Address

City

Phone Number

Do you want to request a new DROP-OFF Location?

Yes

No

Name

Street Address

City

Phone Number

Starting Daterequired

Must contain a date in M/D/YYYY format

Parent/Guardianrequired

First Name

Last Name

Phone Numberrequired

Email Address

Confirmationrequired

By checking this box and typing your name below, you are confirming that the information provided above is accurate and you are the legal guardian of the student(s) listed above.

Electronic Signaturerequired

Date of Signaturerequired

Must contain a date in M/D/YYYY format