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Transportation Request
INSTRUCTIONS: To be completed by parent/guardian and returned to the school administration office. Please allow for a delay of five business days (or 10 business days in September) from date of receipt for the requested change to come into effect.
District
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Conseil scolaire public du Nord-Est de l'Ontario
District School Board Ontario North East
Northeastern Catholic District School Board
School
Grade
Student Last Name
Student First Name
Gender
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F
M
N
S
X
Birth Date
Student ID
Alternate ID
More than one student matches the criteria submitted. Please select the student to use
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Section I – Request Type
Medical
Hazard
Out of Bounds
Out of District
More secure bus stop
Courtesy seating
Other (specify below)
Start Date
Section II – Reason for Request
Section III – Student Information
Home Address:
House/Apt. number
Street name
Suffix
City/Town
Postal/Zip Code
Telephone (home)
Telephone (mother / guardian)
Telephone (father / guardian)
Morning Pickup Address:
Same as home address (see above)
If address is different, please complete the section below:
House/Apt. number
Street name
Suffix
City/Town
Postal/Zip Code
Contact name
Contact Phone
Contact Phone (alternate)
Afternoon Drop-off Address:
Same as home address (see above)
If address is different, please complete the section below:
House/Apt. number
Street name
Suffix
City/Town
Postal/Zip Code
Contact name
Contact Phone
Contact Phone (alternate)
Submitted by
I acknowledge that transportation procedures will apply.
Last Name
First Name
Email
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