Pratt USD#382 Bus Rider Information Form
April 24, 2008
| PRATT UNIFIED SCHOOL
DISTRICT BUS RIDER INFORMATION FORM |
-Office Use Only-
Driver: |
||
|---|---|---|---|
If there is existing information below it has been entered from our district database. Please review the existing information, complete any remaining information and return this form to your school.
Last Name (please use legal name):
First Name:
Grade:
Street Address:
City:
State:
Zip Code:
Parent/Guardian Information
[1]Parent/Guardian's Name (last name first):
Address:
Home Phone:
Employer:
Employer Phone Number:
[2]Parent/Guardian's Name (last name first):
Address:
Home Phone:
Employer:
Employer Phone Number:
I do
not want in-town shuttle bus service (please sign form)
I
wish in-town shuttle bus service (complete information below and
sign)
| A.M. | P.M. | ||
|---|---|---|---|
|
|
Southwest Liberty Sacred Heart |
Southwest Liberty Sacred Heart |
Southwest Liberty Sacred Heart Holly & Stout 1200 N. Main Country Club Apts. 6th and Commodore 6th and Thompson 6th and Ninnescah Country Estates Garfield & Starr Iuka & Grant West Blaine (400 Block) Zerger Park (2nd and Thompson) Mound and Logan |
RURAL BUS SERVICE REQUEST
Approximate distance from your home to the school:
We
understand that this is not a contract. Permission for in-town
service may be granted providing there is room on the bus. We also
understand that this privilege may be revoked if:
1. Student is a discipline problem on
the bus.
2. Student is not on time (The bus
driver WILL NOT wait).
I agree with
this form.
I disagree
with this form.
Date:
