RAVENA-COEYMANS-SELKIRK CENTRAL SCHOOL DISTRICT

  

REQUEST FOR OUT OF DISTRICT TRANSPORTATION

 

 

EDUCATION LAW REQUIRES THIS FORM BE RETURNED PRIOR TO APRIL 1ST, 2010.

 

RETURN TO:   Ravena-Coeymans-Selkirk CSD

                     Transportation Department      

                     2025 SR RT 9W

                     Ravena, New York 12143

 

 

We,                                                                        , residing at                                                                       in the Ravena-Coeymans-Selkirk Central School District, hereby request transportation for our child, residing with us, to and from the school he or she will attend as follows:

(PLEASE USE A SEPARATE SHEET FOR EACH STUDENT.)

 

                                                                                                       

Student’s Last Name                First  Name                                      Age

 

                                                                                                       

Street Address                      P. O. Box #                 City                     Zip Code

 

                                                                                                                            

Date of Birth                                                                     Grade for  2010-2011  School Year

 

                                                                                                                            

Fathers Work #                                 Mothers Work #                                                Home Phone #

 

                                                                                                                            

Parent or Guardian Signature

 

 

 

I hereby certify that the above named child is enrolled in:

 

 

 

                                                                                                                                                           

Name of School for the School Year 2010-2011        School Address                         

 

                                                                                                                                   

 School Start  Date  &  End  Date  for  2010-2011                                    School Hours (arrival & dismissal times)

 

          

                                                                                                       

Principal‘s Signature                                                                       Date                                        School phone #

 

RAVENA COEYMANS SELKIRK CENTRAL SCHOOL

CONFIDENTIAL INFORMATION 2010-2011

 

Private School Students

 

 

 

Please indicate below by marking yes or no on the appropriate line if any of the following apply to your child.  If “yes”, please include an emergency phone number.

 

                   DIABETIC                        

 

                   SEIZURE DISORDER                    

 

                   SEVERE BEE ALLERGY                 

 

                   OTHER                                     

 

 

ADDITIONAL INFORMATION:                                                                         

 

                                                                                                                  

 

 

EMERGENCY PHONE #:                                                                                  

 

CHILD’S NAME:                                                                                            

 

SCHOOL ATTENDING:                                                                                   

 

PARENT/GUARDIAN SIGNATURE:                                                                   

 

If you have any questions, please contact the Transportation Department at 756-5241.

TRANSPORTATION INFORMATION

 

 

STUDENT NAME:                                                                                                    

 

 

HOME ADDRESS:                                                                                                    

 

 

HOME PHONE:                                              DATE OF BIRTH                                  

 

 

DAYS ON AT HOME:         M, T, W, TH, F                 AM

 

DAYS OFF AT HOME:        M, T, W, TH, F                   PM

 

Check here if NO transportation is needed for AM                        PM                        

 

 

SITTER’S NAME:                                                                                                     

 

SITTER’S ADDRESS:                                                                                                          

                                             Street, house # and a brief description

 

SITTER’S PHONE #:                                                                                                

 

 

DAYS ON AT SITTERS:       M, T, W, TH, F                       AM

 

DAYS OFF AT SITTERS:      M, T, W, TH, F                     PM

 

 

IMPORTANT NOTICE FOR PARENTS

 

Please remember that the deadline for transportation requests is April 1, 2010. NYS Education Department states:  “In order to obtain transportation for their children, parents must file requests with the district in which they live by April 1 of the preceding school year or within 30 days of moving into the district.”    In order to prepare and set up routes, we MUST have all applications by that date. 

 

 

If your child does not ride the bus to school in the morning, you must notify the Transportation Department by noon @ 756-5241 if your child will require transportation home.  If no phone call is received, we will assume that transportation is not needed.

When the RCS School District is closed for inclement weather, holidays, vacations or recesses, no transportation will be provided.