Transportation - 4K/EC Transportation

Once you know your child's placement, please fill out the form if you require an alternate bus location. Approvals will be determined after your child is placed at a 4K site via an email confirming the request.

Student's Name Student's Name First Last
Student's Residence Address Student's Residence Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
School/Site Attending

School/Site Attending Encompass - AM Session (MORNING PICK UP AND/OR MID-DAY DROP OFF) No afternoon busing available. Fairview Glenbrook - AM Session (NO AFTERNOON BUSING AVAILABLE) Hillcrest - AM Session Hillcrest - PM Session Lannoye EC - Morning Session Lannoye EC - Afternoon Session Shining Stars Hobart - AM Session Peaceful Beginnings - AM Session (MORNING BUSERS ONLY; NO MID-DAY DROP) Peaceful Beginnings - PM Session (MID-DAY PICK UP AND/OR AFTERNOON DROP) Sunnyside - AM Session (MUST BE IN APPROVED AREA FOR AM; CHECK WITH OFFICE) Sunnyside - PM Session (MUST BE IN APPROVED AREA FOR AM; CHECK WITH OFFICE)
Additional Comments
Name of resident at Alternate Location Name of resident at Alternate Location First Last
Relationship

ex: neighbor, friend, relative, in-home daycare provider
Address of Alternate Location Address of Alternate Location
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number for Alternate Resident Phone Number for Alternate Resident - ### - ### ####
Parent / Guardian Name Parent / Guardian Name First Last
Parent / Guardian Phone Number Parent / Guardian Phone Number - ### - ### ####
Emergency Phone Number Emergency Phone Number - ### - ### ####
I understand that as the parent/guardian of this student, I assume responsibility for the student's safety at all times and will not hold Pulaski Community School District responsible for any injury or damage incurred with the use of the alternate bus stop location. The District reserves the right to refuse this special request for bona fide reasons.
Your Email Address
Name Name First Last
Time Time : HH MM AM/PM