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707.5.2P - Transportation for Students in Daycare or to an Alternate Address

707.5.2P - Transportation for Students in Daycare or to an Alternate Address

Adopted: July 1979
Revised: September 2014


Download 707.5.2P - Transportation for Students in Daycare or to an Alternate Address

PARENT/GUARDIAN:  This form must be completed for any move to daycare or change of daycare location by a resident or non-resident elementary school student within the attendance area of the school the student currently attends.  (Non-resident elementary school students must already have approved Procedure 502.4.4P, Student Transfers:  Daycare for Students in Grades K-5, on file in the district for the school year in question.)  This form may also be used for students in grades 6-8 if requesting an alternate address within attendance area of the school boundaries.



last name             first name                                 middle initial                                     grade

Home address                                                                                                                      

                       # and street name                                 city                                           zip code

Parent(s) or Guardians(s)                                                                                                      

                                        last name                           first name                                       middle initial


home phone                                    work phone                                                 cell phone                                                      

Daycare provider                                                                                                                  

               last name                           first name                                    daycare phone

Daycare provider address                                                                                                      

                                                   # and street name                  city                                                                                  zip code

School attending                                                                 School year                                

Transportation Information:                          Start Date:                                                    

Daycare or Alternate Address:                       No Transportation: (circle) daycare transports, SACC, walker

To School:     ____M____T____W____TH____F      To School:                      ____M____T____W____TH____F

From School:____M____T____W____TH____F       From School:   ____M____T____W____TH____F


To School:     ____M____T____W____TH____F

From School: ____M____T____W____TH____F

I understand it is my responsibility to transport my child from home to daycare or an alternate address and from daycare or an alternate address to home, and that it is the school district’s responsibility to transport my child to and from the designated bus stop for the daycare or alternate address.

School/transportation must be notified of any change in this information during the current school year. This information will remain active for the entire time the student attends the school listed above or until the information is changed by the parent.

Parent/Guardian signature                                                                           date                                        


RETURN TO: Student’s elementary school/middle school