West Clermont School District Childcare Daycare Transportation Form

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Partners in Education
Mike Jones - General Manager Petermann
Robin McCabe- Administrative Assistant
4342 Glen Estes-Withamsville Rd. Cincinnati, OH 45245
 
Phone: 752-4020
Fax: 752-2376
 
 
CHILDCARE/DAYCARE TRANSPORTATION FORM 
Purpose: Requesting a change in my child/children’s bus stop location for the purpose of using a 
childcare/daycare provider. 
Guidelines: 
1. Students must be picked up and/or dropped off at the same bus stop on a regular schedule for the 
entire year.  Parents may request service for AM, PM or both. 
2. Childcare/Daycare must be located on an existing transportation route. The Transportation 
Department will not be able to create new routes, bus stops or connections between schools to 
accommodate childcare/daycare provider. 
3. One (1) bus stop change per school year may be requested. 
4. Childcare/Daycare transportation requests must be made each school year.   
 
Home ‐ Regular Pick Up / Drop Off 
Parent Name   ____________________________________________________________________ 
Address           ____________________________________________________________________ 
Home #           ______________________Work # _________________Cell # __________________            
Child’s Name   __________________________________ DoB_________School ____________Grade________ 
Child’s Name   __________________________________ DoB_________School ____________Grade________ 
Child’s Name  __________________________________ DoB_________School ____________Grade________ 
 
Childcare/Daycare Provider – Pick Up / Drop Off 
Childcare/Daycare Provider Name    __________________________________________________________ 
Address          _____________________________________________________________________ 
Home #          _______________________________ Cell #     ______________________________ 
 
I understand and agree with the guidelines as stated above and give permission for my child to transport to the above 
named childcare/daycare provider.   
_______________________________________________ 
 
 
 
_______________ 
 
 
Parent Signature 
 
 
 
 
 
 
 
Date 
EMAIL (), MAIL, OR FAX THIS FORM TO:  TRANSPORTATION SUPERVISOR 
The Transportation Department will need several days to make the change and will notify you once approved
 
 
Office Use Only:
Original Bus # ___________ Original Bus Stop Location   _______________________________________________ 
 
 
 
New Bus Stop Location   ________________________________________
The Transportation office will contact you about details.
4342 Glen Este-Withamsville Road, Cincinnati, Ohio 45245 (513) 752-4020
and

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