Form 3545-P - New Registration - Transportation Application Non-Public Schools 2015-16
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1BELLMORE-MERRICK CENTRAL HIGH SCHOOL DISTRICT
3545-P
1260 MEADOWBROOK ROAD
NORTH MERRICK, NEW YORK 11566
NEW REGISTRANT - TRANSPORTATION APPLICATION NON-PUBLIC SCHOOLS
SCHOOL YEAR 2015 - 2016
This form is to be returned to the Bellmore-Merrick Transportation Office, no later than April 1st, 2015.
In accordance with the Education Law of the State of New York, Section 3635, late applications for transportation to non-public
schools, or changes to applications, will not be approved after the April 1st deadline.
Students for whom non-public transportation is requested must be officially registered with the district.
PROOF OF RESIDENCY IS REQUIRED FOR FIRST TIME APPLICANTS ONLY.
Transportation will not be provided on the following days unless the Bellmore-Merrick CHSD is in session: Columbus Day, Veteran’s
Day, Thanksgiving Day, Christmas Day, New Year’s Day, Martin Luther King Day, President’s Day and Memorial Day.
I hereby formally request transportation for the student listed below:
PRINT
STUDENT'S NAME __________________________________________TELEPHONE NO._________________________________
ADDRESS___________________________________________________Nearest Cross St.__________________________________
TOWN______________________________________________________BIRTH DATE____________________________________
School Name _________________________________________________Telephone No. ___________________________________
Street_______________________________________________________Principal_________________________________________
Town_______________________________________________________ Grade Entering ___________________________________
School Hrs. __________________________Present Bus Stop: ________________________________________________________
School of Last Attendance: ___________________________________ City ___________________ State______________________
THERE WILL ONLY BE CORNER BUS STOPS FOR THE 2015-2016 SCHOOL YEAR. THERE WILL BE
NO HOUSE STOPS.
Please indicate if late bus service will be needed. YES_______ NO_______ The Bellmore-Merrick CHSD requires a minimum
of five (5) students attending a non-public school to schedule a late bus. The number of students riding late buses will be
checked periodically. If the average number drops below five the bus will be cancelled with five days notice to students.
You are required to file a new application each year that you request transportation.
______________________________
__________________________________________
Date
Parent/Guardian Signature
Forms should be returned to:
Bellmore-Merrick CHSD
Transportation Office
1260 Meadowbrook Rd.
N. Merrick, NY 11566
*NOTE
: Non-Public school buses are shared by the four elementary districts and the central high school district. Routes are
planned by the bus companies in the most direct and economical manner both to and from school. Routes are not affected by
a student’s district of residence.
Approved: 09/27/2012
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