Courtesy Ride Form (NLESD)

This form is only to be filled out if you live within or need transportation within the walk zone of a school. If you are moving addresses or require joint custody transportation, please contact your school.

Requested Start Date

District

School

Grade

Student Last Name

Student First Name

OEN

OR

Temporary Student ID

Please indicate AM or PM

BOTH

Requested Pickup Address

Apartment

Number

Street

City

Requested Drop off Address (if different from the pickup address)

Apartment

Number

Street

City

If student is JK/SK, the school must be provided with up to four (4) designate names (Parents can be considered one name)

It is my responsibility to ensure the safety of my child at the bus stop

It is my responsibility to get my child to and from the bus stop

I acknowledge I will be assigned to the closest existing stop only

Courtesy Ride Policy: http://www.buskids.ca/policies/GT-013-Courtesy%20Ride%20Policy.pdf

Submitted by Submission of this document acknowledges that I understand that a courtesy ride, if approved by Student Transportation, is for the current school year ONLY. Courtesy rides may be revoked at any time during the school year and the decision is final. Only one (1) submission per student is allowed.

Last Name

First Name

Courtesy Ride Form (NLESD)

More than one student matches the criteria submitted. Please select the student to use

OR

Requested Pickup Address

Requested Drop off Address (if different from the pickup address)

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