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Series - 707.4P - Student Transportation Fee-For-Service Registration

 

In accordance with District Policy 707, Student Transportation, students enrolled in their attendance area school and living or attending daycare outside of the areas eligible for transportation may pay an annual fee     for bus service to and/or from their attendance area school. Students who live within non-busing areas but are eligible for transportation due to hazardous crossing restrictions will continue to receive transportation at no charge. Fee-for-service transportation is not available for open-enrolled or intradistrict transfer students.

Parents/guardians applying for the transportation fee-for-service option must register each child receiving transportation services. Registration may be submitted in the following ways:

  • Online with a credit card payment;
  • By mail with this form and a check, or
  • In person with this form and a check or cash.  Mail or deliver your payment to: District 196 Transportation Dept., 15180 Canada Ave., Rosemount, MN 55068

SCHOOL YEAR FEE OPTIONS (check only one):         

Submitted between June 1 and July 31(discounted)       Submitted August 1 and later        

__$275 per student                                                                      __$300 per student

__$550 max per family                                                                  __$600 max per family

__$138 per student eligible for reduced-price school meals*              __$150 per student eligible for reduced-price school meals*  

__$276 max per family eligible for reduced-price school meals*        __$300 max per family eligible for reduced-price school meals*

__$69 per student eligible for free school meals*                                 __$75 per student eligible for free school meals*

__$138 max per family eligible for free school meals*                           __$150 max per family eligible for free school meals*

*You have my permission to verify free or reduced-price school meal status.

 REGISTRATION:

Student                                                                                                                                                                      

                                    last name     first name        middle initial    grade    ID#

Home address                                                                                                                                    

                              address                              city                                           zip code

Parent/Guardian                                                                                                                        

                             last name                      first                                          middle initial

Phone number                                                                                                                                                                                    home                            work                                         cell

Complete information below for any deviations in transportation to and/or from home each dayAlternate address/Daycare provider information:

                                                                                                                                               

last name                                              first name                                 phone

                                                                                                                                               

address                                                 city                                           zip code      

 

School attending                                                                                                                                                      

Frequency information:

Home Address

To School        ___M___T___W___TH___F                   From School  ___M___T___W___TH___F

Alternate Address/Daycare

To School        ___M___T___W___TH___F                   From School  ___M___T___W___TH___F

I understand it is my responsibility to bring my child to and from the bus stop designated for the location(s) noted above. I understand the school district’s responsibility will be to transport my child to and/or from school from the bus stop designated for these location(s).

Parent/Guardian signature                                                                      Date                               

Procedures/707.4P/5-13-19

Transportation Dept. use only:  online payment_________ck#__________cash__________rec’d date_________rec’d by