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Central Primary School
Student Transportation
Information Sheet
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Student's Full Name:
Student's HOME ADDRESS:
Date of Birth:
Race:
Gender:
Grade:
Teacher:
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Please specify the morning and afternoon addresses for your child.
Please check your child’s mode of transportation and circle the route time(s).
If your child’s pick up and/or drop off is different from the home address please name the
daycare, babysitter and/or other:
Afternoon Address (if different from morning address):
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Same
Afternoon
Morning
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Same
Afternoon
Morning
Same
Other Comments:
Student Health / Medical Concerns for the Driver:
Parent/Guardian:
Home Phone #
Cell Phone #
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Work Phone #
Parent/Guardian:
Home Phone #
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Cell Phone #
Work Phone #
Parent/Guardian's Signature
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For Office Use Only
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PM
Car Tag#
AM
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Today's Date
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Submit
Print
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Morning
Afternoon
K
1
2
3
4
5
Selection
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