STEO EmergencySTBusing

District

School

Grade

Student Last Name

Student First Name

Gender

Birth Date

Student ID

Alternate ID

Section A

Emergency Bus Seat (2 Days or Less)

Short Term Alternative Busing (2 Weeks or Less)

Start Date

End Date

Last Name

First Name

Home Phone

Work Phone

Cell Phone

911 Address

Number

Street

City

Postal Code

Apartment:

If the student will be riding with another student please name the student here

Bus Route Number

Approval of Principal or Vice-Principal

For same day Emergency Busing: give a hard copy to the driver

Submitted by

Last Name

First Name