TRANSPORTATION REQUEST FORM

AVON LAKE CITY SCHOOLS

In order for your child to be picked up/dropped off at a residence other than where they reside, this form must be completed and returned to the Transportation Dept either via email (sue.cole@alcsoh.org) or via USPS at 33480 Pin Oak Parkway, Avon Lake, OH 44012.

Reason for request (select one): Childcare:   Shared Parenting:  

  STUDENT(S) NAME
  SCHOOL
  GRADE
  HOME ADDRESS
  HOME PHONE
  PARENT/GUARDIAN NAME
  WORK PHONE
  CELL PHONE
  PARENT/GUARDIAN NAME
  WORK PHONE
  CELL PHONE

I would like my student(s) transported to the following location.

NAME 
PHONE 
ADDRESS 

(Private daycare provider must reside in student's elementary school district.)

WHEN WILL YOUR CHILD REQUIRE TRANSPORTATION?

  Before School Only   After School Only   Before and After School

Date requested to begin: 

PARENT/GUARDIAN SIGNATURE 

For Office Use Only

Date Request Received 
APPROVED TO BEGIN 
AM BUS# 
PM BUS# 
  1. All requests must be received two weeks before the start of school. Any requests received after the stated timeframe may not be approved until the second week of school.
  2. Requests will be handled in the order received and will only be granted if there is room on the bus.
  3. Please list licensed daycare provider (ex: Goddard School, Good Kids,Kindercare, etc.) that student(s) will attend. Daycare at a residence must be within the student(s) elementary district.
  4. Student(s) cannot have more than one afternoon stop. (ie: home 2 days and daycare 3 days).
  5. A bus pass issued by the building principal will be issued for emergency requests only.
  6. Five days' notice should be given for requests/changes.

2.2.2021