Alternate Address or Daycare Request Registration

Required

If your child will require transportation to/from an alternate address (i.e. daycare), please submit this form. Please allow 3-5 business days for any changes to occur.

Any student registered for a bus who does not ride for 10 consecutive school days (2 weeks) will have their stop removed from routing. A 24 hour notice is required to reassign the stop.

You will be able to access your student’s bus information through Tyler’s Versatrans e-Link. An e-mail will go out to all registered riders in mid-August with detailed information. Please provide a current e-mail address to ensure you receive notifications.

This form is due by June 15

One student per form please

What School Year is this for?

Student Namerequired

First Name

Middle (optional)

Last Name

When Student Will RiderequiredChoose all that apply

Choose all that apply

Street Addressrequired

Apt. #

Cityrequired

Staterequired

Ziprequired

Home Phone Numberrequired

XXX-XXX-XXXX

Graderequired

Parent/Guardian Namerequired

First Name

Last Name

Parent/Guardian Daytime Contact Numberrequired

XXX-XXX-XXXX

Parent/Guardian Cell Number

XXX-XXX-XXXX

Parent/Guardian Email Addressrequired

Does your child need to be picked up or dropped off at an alternate location such as Daycare?required

Yes, my child needs an alternate location for pick-up and/or drop-off.

Fill out this form ONLY IF your student will be transported to/from a place other than home.

Student Will Be Picked Up AtChoose one

Home

Daycare/Alternate

Choose one

Student Will Be Dropped Off AtChoose one

Home

Daycare/Alternate

Choose one

Daycare/Alternate Street Address

Daycare/Alternate City

Daycare/Alternate State

Daycare/Alternate Zip

Daycare/Alternate Contact Name

First Name

Last Name

Daycare/Alternate Contact Phone Number

XXX-XXX-XXXX

Comments/Concerns/Questions?

Parent/Guardian E-Signaturerequired

First Name

Last Name

Date

Must contain a date in M/D/YYYY format