Text Box: Jefferson Bus Service

Jefferson Bus Service

Transportation Registration Form  2007—2008 School Year

 

Parent or Guardian Information

 

             Are you new to the Jefferson School District?       Yes   No  

 

Please indicate the days of the

week your student will be in day

care and if we are to pick them

up at day care and/or drop them

off at day care.  For days not

marked, we will assume the

home address.

Jefferson Bus Service will treat all of the above information as Personal and Confidential

And will use it only to help us schedule transportation or in the event of an emergency.

Jefferson Bus Service may also us audio/video recording equipment on any or all of our

vehicles in order to monitor and maintain discipline of both passengers and drivers.

 

 

Student Information

First Name:  Last Name:

Home Address:

City:  State:  ZIP:

Home Phone:  Work Phone:

Email:

Secondary Contact Person:

Secondary Contact Phone: 

 

Baby Sitter / Day Care Information

Name:

Address:

City:  State:  ZIP:

Phone:

Monday

 

AM

PM

Tuesday

 

AM

PM

Wednesday

 

AM

PM

Thursday

 

AM

PM

Friday

 

AM

PM

First Name

Last Name

School

Grade