Forms CLASS CourtesySeatRequestV5

A courtesy seat MAY be approved if the following conditions are met:

That available space exists on an existing bus route.
That the requested bus services the school the student attends.
THAT THE STUDENT USES AN EXISTING STOP LOCATION. AN ADDITIONAL STOP CAN BE ADDED IF IT IS ON THE EXISTING PATH OF THE ROUTE AND IF IT IS OUTSIDE OF THE WALK BOUNDARY OF THE SCHOOL.
That there is no additional cost to the board.
That the change is not for a temporary situation.
That the student's pick up and/or drop off point(s) is consistent every school day.

District

School

Grade

Student Last Name

Student First Name

Student ID

Requested AM Location

Requested PM Location

Start Date

End Date

Reason for request

Childcare

Outside of attendance area

Within walk boundary of the school

Other (max 600 characters)

Submitted by

Chatham Kent Lambton Administrative School Services ("CLASS") acts on behalf of your school board and contracts transportation service providers to arrange transportation to and from school for eligible students. The personal information you provide on this form will be shared with the relevant staff of CLASS, school board and transportation provider for the purpose of providing appropriate and safe transportation. The information collected is treated as described in our privacy policy and in accordance with applicable laws.

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).

Please check the items before submitting the form
By checking this box, I indicate that I understand and agree that this application is not for a guaranteed seat and, if awarded to the applicant, is subject to terms and conditions administered by the Student Transportation Services of the Chatham-Kent Lambton Administrative School Services. I also give consent for Chatham-Kent Lambton Administrative School Services to communicate with me regarding courtesy seating via the email address that I have provided on this application.
By checking this box, I understand that this request is consistent EVERY school day.
All school buses operated on CLASS routes are equipped with an Audio-Video Surveillance System. Acceptance and use of transportation services implies the consent of parents/guardians for the recording of data and use of the audio-video surveillance system as outlined in the Video Surveillance on School Buses Procedure (STS-PR-021-2004). This procedure is located at http://www.schoolbusinfo.com/policies.asp.

Last Name

First Name

Forms CLASS CourtesySeatRequestV5

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

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