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Series 707.7.2P - Request to Ride Existing Buses for Interdistrict Transfer Students

 

If requested by the parent, guardian or adult student, a transfer student may ride a District 196 school bus as long as the following conditions are present:

  • There is an existing bus route directly to or from the school of attendance;
  • The student must be picked up and dropped off at an existing bus stop;

If any of the above conditions change, permission to ride a school bus may be revoked.

Date of application                                        Transportation start date                    

parent/guardian name (last, first, middle initial)

telephone number

(       )

parent/guardian address (residence)

 

city

zip code

 

resident district of student

city

resident district number

 

student name (last, first, middle initial)          birth date                                                                                   _____      _____     _____

                                                                                             

sex

M ❏        F ❏

student address (if different from parent/guardian)

city

zip code

 

 

previous school attended

 

grade attended

 

requested District 196 school

 

grade attending

 

student will use bus:

to school only ❏          from school only ❏                   both  ❏

bus stop location (specify address of stop at which you wish student to be picked up and dropped off)

 

         

As a parent/guardian, or adult student, I agree that I am responsible to provide for my child's (or my own) safety while going to and from the District 196 bus stop prior to boarding and after disembarking from the bus.  Administrative Regulation 707.2AR, section 4, Guidelines for Classification and Services for Hazardous Crossing, does not apply to travel to and/or from the designated bus stop.

This agreement will remain in effect for the entire period of time that the student is at the school and bus stop noted above.

_______________________________________                              ___________________________

signature of parent/guardian/adult student                                      date

 

OFFICE USE ONLY

date received:

 

new student:     

new ❏      existing ❏

student ID:

 

date sent to transportation:

 

last school attended:

 

requested start date:

 

         

 

 

 

 

 

 

 

Return to:
Independent School District 196

Coordinator of Transportation

15180 Canada Ave.

Rosemount, MN  55068

Procedures/707.7.2P/10-12-15