Center Point ISD

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ELEMENTARY Bus Rider Form - Electronic Submission

A copy of this form will be sent to the Elementary Office as well as the Transportation Director and Support Services Secretary. Please ensure your contact information is correct so we can contact you for clarification as necessary.

Please complete one form for all of the Elementary (PK-5) students in your household, for Secondary students (6-12) utilize the Secondary Bus Rider Form – Electronic.

Elementary Students Bus Riders Only

Date of Form Submission:

Number of ELEMENTARY Students included on this form:

Reaquired field: 1

Reaquired field: 2

Reaquired field: 3

Reaquired field: Other

Student 1 Name

Student 1 Grade

Student 2 Name

Student 2 Grade

Student 3 Name

Student 3 Grade

Parent/Guardian phone number

Parent/Guardian phone number (Additional Space)

Parent/Guardian Email Address

Reaquired field: Physical Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Do you live within 2 miles of the school?

How will your child(ren) primarily get to/from school? (Please check ALL that apply)

Reaquired field: AM Bus

Reaquired field: PM Bus

Reaquired field: AM Walk/Ride Bike

Reaquired field: PM Walk/Ride Bike

Reaquired field: AM Parent Transport

Reaquired field: PM Parent Transport

Reaquired field: CPISD After School Care

Reaquired field: Other

Will the child(ren) be picked up and dropped off at the same location?

Address for Bus PICK-UP if different than physical address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Address for Bus DROP OFF if different than physical address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

If there is more than 3 elementary students included on this form, use the space below to add names and grades.

Email a copy to

optional

Required Fields

ELEMENTARY Bus Rider Form - Electronic Submission

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