WESTBROOK SCHOOL TRANSPORTATION DEPARTMENT Office Use Only

Canal Congin Saccarappa

STUDENT TRANSPORTATION REGISTRATION FORM

• The Transportation Department requires that ALL students complete this form. All lines must be filled in or “N/A” should be used if necessary and returned to the Transportation Department as soon as possible for processing purposes.

Grade _______

Student ID # _____________

Date Transp. Starts: _________________

Student’s Last Name __________________________________ First Name____________________________ Home Address ________________________________ City _________________________ Zip Code________ Student’s DOB ________________Medical/Health Issue__________________________________________ Home Phone # _____________ Emergency Phone # _________________ Cell # _____________________ Parent/Guardian Name _____________________________ Day Care Provider: ______________________ Day Care Address__________________________________ Day Care Phone # ________________________ Parents may designate 2 pick-up/drop-off locations for the school year. Please state on the chart below what pickup/drop-off locations are needed per day. If your schedule should change, please make arrangements to pick-up or drop-off your child. Monday AM ____________ PM

•

____________ PM

____________

Pick-up • • •

Tuesday AM

____________

Wednesday AM

Thursday AM

_____________

________

_____________

PM

PM

PM

________

_____________

_____________

Friday AM

and Drop Off Students are expected to be outside 10 minutes prior to the expected arrival of the school bus. A parent/guardian’s presence is required for a child to be dropped off. Written requests will be submitted to the building principal from any parent/guardian requesting an alternative location or other means of transportation. If student is absent from the bus stop 3 days in succession the bus will not return until notified by the parent/guardian. “One Promise: “The best education for all for life.”