CHANGE IN TRANSPORTATION FORM All * areas must be completed. Please save and e-mail as an attachment to:
[email protected] or bring to the school's office. Thank you. School: *
Today's Date: *
Lester Park
Reason: *
New Student(s)
(“X”-choose one)
Change because of Child Care
Other
Moved/Change of Address Previous Transportation Address:
*
(house address)
Name of Student
Grade
*
Student Number
*
Teacher's Name
Your Current Home Address Parent/Guardian
*
E-mail address
*
*
Phone *
Complete both before and after sections with Home Address (if busing), “Parent Transport”, “Walker”, or “KEYZone” Child goes to school from this location (before school): * _____________________________________________ Child goes to this location from school (after school): * _____________________________________________
Goes into effect on: __________________ Comments: __________________________________________________________________________________________________ ____________________________________________________________________________________________________________
Filled out by Transportation Department AM Bus/Run PM Run Effective
Pick-Up Time
From
PM Bus #
To
