Transportation Arrangements Form
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1TRANSPORTATION ARRANGEMENTS 2014-15
Grades K-5
• For Grades 1-5, please submit this form ONLY if your child will be picked-up or dropped-off at a
location (Childcare Provider, Sitter, at School for Parent Transport) other than your home address,
before or after school, on a permanent weekly basis.
• For K students, all families are to fill out this form, even if your child is traveling by bus to/from home.
• For Grades 2 & 3 at Elmwood School, please also submit this form if your child will attend the
afterschool program at Kidsborough-Elmwood School on a permanent weekly basis.
STUDENT’S NAME:_______________________________2014-15 GRADE:_______
STUDENT’S HOME ADDRESS:___________________________________________
HOME PHONE #:__________________________CELL #______________________
EMAIL:_____________________________________________________________
2014-15 Childcare Transportation Policy Notes
Per Student Transportation Policy (EEA), updated 2/27/14:
For students in grades K-5, no day-to-day bus switching is allowed.
Parent(s)/Guardian(s) may request one additional pick-up location and one additional drop-off location
in addition to their home address. The additional pick-up and drop-off addresses do not need to be the
same and can occur on as many days as necessary.
Transportation to and from childcare locations is permitted under these conditions:
•
The Childcare Provider has contracted with HPS Transportation for the 2014-15 school year to
provide busing service to their place of business
•
A designated sitter location is the residence of a “familial sitter” (family relation)
•
The bus serving the childcare provider has available space
•
The childcare locations are continuous throughout the school year and at an approved bus stop
BUS PICK-UP ADDRESS:
BUS DROP-OFF ADDRESS:
Monday:_______________________________
Monday:___________________________
Tuesday:_______________________________
Tuesdays:__________________________
Wednesday:____________________________
Wednesday:________________________
Thursday:______________________________
Thursday:__________________________
Friday:_________________________________
Friday:_____________________________
Childcare Provider:____________________________ Phone #___________________________
Address:_______________________________________________________________________
For Sitter: Designate family relationship_____________________________________________
Childcare Provider:____________________________ Phone #___________________________
Address:_______________________________________________________________________
Per updated Student Transportation Policy (EEA), I expect that this arrangement will be continuous for
the 2014-15 school year. I understand that in the future, any request for change will be subject to
review and may take up to 2 weeks.
Date:_________________ Parent/Guardian Signature_________________________________________
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