Busing Form

Please complete the form below. Required fields marked with an asterisk *

Today's Date*

Answer Required

Please use this form to indicate that your student lives outside the city of Ipswich, and that you wish to have the bus transport them to and/or from school.

Student's Names and Grades (Please list students and grades):*

Answer Required

Parent/Guardian Contact Information

First Name*

Answer Required

Last Name

Answer Required

Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Mobile Phone*

Number Required

Mobile Phone*

Number Required

Home Phone*

Number Required

Work Phone*

Number Required

Location of Pickup:*

Answer Required

Location of Drop-off:*

Answer Required

Alternate Emergency Contact (List name, address and phone number)*

Answer Required

For Ipswich Public School Use Only:

Answer Required

Request Approved

Request Denied

Denied for the following reason:

____ Not along the public school route

____ Not of age for public school transportation

Please note:

13-29-1.2 Transportation for non-public school students - Conditions. School districts may provide transportation to nonpublic school students if no additional public funds are expended to provide the transportation. No school district, however, is required under this section to provide transportation to nonpublic school students. This section does not affect the transportation of any eligible student pursuant to an individualized education plan. Source: SL 2003, ch 102

Ipswich Public School does not provide busing for preschool students.

Please fix the highlighted areas below before submitting.

Busing Form