Directions:

Start at the rear of the bus and

• Enter "X" to denote an empty seat
• Enter "NoSeat" where no passenger seat exists
• Enter "WC" if there is a Child Safety Restraint System used
• If there are standing passengers, use the approximate row designation annd list at the bottom

	Driver	Front of Bus
Seat	Window	Middle	Aisle	Row	Aisle	Middle	Window
Name				1
Name				2
Name				3
Name				4
Name				5				28 PASS
Name				6
Name				7
Name				8
Name				9
Name				10
Name				11				66 PASS
Name				12				72 PASS
Name				13
Name				14				81 PASS
Rear of Bus

Standing Passengers

Row	Passenger Name

Submitted by

Last Name

First Name

Email

Confidentiality Statement

In accordance with the Personal Information Protection and Electronic Documents Act, Article 29, Paragraph (2), personal information requested in this form will assist in providing transportation services. The information is gathered in accordance with the Education Act S.R.O. 1980, c. 129, s.166 (1).