Series 707.7.2P - Request to Ride Existing Buses for Interdistrict Transfer Students
Adopted: December 1991
Revised: October 2015
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
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parent/guardian name (last, first, middle initial) |
telephone number ( ) |
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parent/guardian address (residence)
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city |
zip code
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resident district of student |
city |
resident district number
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student name (last, first, middle initial) birth date _____ _____ _____
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sex M ❏ F ❏ |
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student address (if different from parent/guardian) |
city |
zip code
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previous school attended
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grade attended
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requested District 196 school
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grade attending
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student will use bus: to school only ❏ from school only ❏ both ❏ |
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bus stop location (specify address of stop at which you wish student to be picked up and dropped off)
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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
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OFFICE USE ONLY |
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date received: |
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new student: new ❏ existing ❏ |
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student ID: |
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date sent to transportation: |
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last school attended: |
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requested start date: |
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Return to:
Independent School District 196
Coordinator of Transportation
15180 Canada Ave.
Rosemount, MN 55068
Procedures/707.7.2P/10-12-15