Special Authorization For Joint-Custody Transportation
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12355 Galt St. West
Sherbrooke, Qc J1K 1L1
Tel.: (819) 566-2739
Fax: (819) 566-7612
SPECIAL AUTHORIZATION FOR JOINT-CUSTODY TRANSPORTATION
For JOINT-CUSTODY TRANSPORTATION , the schedule must be regular (i.e.: one week at one residence/one week at the other)
Note that weekend visits are not considered JOINT CUSTODY for transportation purposes.
The Eastern Townships School Board is not obligated to transport a student to more than one address.
Registration for School Year: ________ Attending: _____________________________________________________
Name of Student: _____________________________________________ Grade Level: _______________________
The care of the student listed above is shared equally by both parents (50% of the time with each parent).
We, the undersigned, hereby request school bus transportation as follows:
FATHER:
Please check boxes:
MORNING TRANSPORTATION
AFTERNOON TRANSPORTATION
From:
To:
Address with father ____________________________
Address with father ____________________________
OR
OR
____________________________________________
____________________________________________
Indicate address of reference for transportation purposes
Indicate address of reference for transportation purposes
MOTHER:
Please check boxes:
MORNING TRANSPORTATION
AFTERNOON TRANSPORTATION
From:
To:
Address with mother ___________________________
Address with mother ___________________________
OR
OR
____________________________________________
____________________________________________
Indicate address of reference for transportation purposes
Indicate address of reference for transportation purposes
Please note that the signature of both parents is required when Joint-Custody Transportation is
requested.
_______________
_______________________________________ ____________________________________
Date
Signature of Parent
Telephone number where I can be reached during the day
_______________
_______________________________________ ____________________________________
Date
Signature of Parent
Telephone number where I can be reached during the day
This form must be submitted to the School Principal ANNUALLY whenever transportation is requested in
situations of Joint-Custody. Failure to return this form may result in the suspension of school bus transportation
to one of the two Joint-Custody addresses.
Revised August 2011
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