Scottsbluff Public Schools

Every Child, Every Day

Transportation Contract for Parents of Bus Student

Please fill out a separate contract for each student.

This request is for *
 New Student  
 Exisiting Student  
 Change Bus Transportation Address  
 Bus Service Declined  
School *
Grade *
Transportation Requirement *
 Both To and From School 
 To School Only 
 Home From School Only 
Requested Start Date *

MM
/
DD
/
YYYY
Student Name *
Prefix
First *
Last *
Suffix
MI
Middle
Parent/Guardian Name *
Prefix
First *
Last *
Suffix
MI
Middle
Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Email *
Primary Contact Phone *

###
-
###
-
####
Secondary Contact Phone

###
-
###
-
####
Special Accommodations (subject to verification)
 Wheelchair Lift 
 Other (please specify) 
Special Instructions/Comments

Safe Pupil Transportation Plan

I have read and agree to the terms stated in the Scottsbluff Pubic Schools Safe Pupil Transportation Plan *
 I agree 
Student Signature
Parent Signature
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