Special Education Transportation & Emergency Information

Transportation to be provided by

Bus AMBus PMParent Transport

If you live within the service area of your school of attendance would you like to utilize a Basic Education bus?

Student Name

First NameLast Name

Student ID

DOB

Date

Home Address

Street Address

Street Address Line 2

CityState

Zip Code

Home Phone

Please enter a valid phone number.

Email Address

example@example.com

School

Grade

Parent/Guardian (First & Last Name)

Alt. Phone#

Please enter a valid phone number.

Parent/Guardian (First & Last Name)

Alt. Phone#

Please enter a valid phone number.

List people below who are able to receive your child if you are not available (Must have a Valid ID)

Name

Phone Number

Please enter a valid phone number.

Name

Phone Number

Please enter a valid phone number.

Only one stop location is allowed for the AM and only one stop location is allowed for the PM. If your child will be picked up dropped off at a day care or any other address, please fill out the following information