Specialized Transportation - St. Luke School

Specialized Transportation Application - St. Luke School
Applications take up to 3 school days to be processed. Check the parent portal after 1:30 pm on the 3rd school day https://regina.firststudentinc.com/ for the stop information.

Transportation@rcsd.ca or 306-791-7214
STUDENT INFORMATION
First Name of Student*
Last Name of Student*
Requested Start Date of Transportation*

YearMonthDay
Date
Student Date of Birth*

YearMonthDay
Date
Student ID#:*
Grade:*
Home School:*
Program:*

IntegrationNo Integration
PARENT/GUARDIAN/ALTERNATE ADDRESS INFORMATION
Parent/Guardian #1:*

First NameLast Name
Parent/Guardian #1 Email*
example@example.com
Parent/Guardian Home Address #1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian #1 Primary Phone Number*

Area CodePhone Number
Parent/Guardian #1 Secondary Phone Number

Area CodePhone Number
Parent/Guardian #2:

First NameLast Name
Parent/Guardian #2 Email
example@example.com
Parent/Guardian#2 Primary Phone Number

Area CodePhone Number
Parent/Guardian#2 Secondary Phone Number (if different than above)

Area CodePhone Number
Parent/Guardian #2 Home Address - If different than Parent #1 Above.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
My child requires two pickup and drop off addresses. I understand a schedule is required to accommodate this, and requests must be approved by the transportation officer. Complete Alternate information below if this applies to your student.

YesNo
ALTERNATE CONTACT: (This is for alternate pickup and drop-off contact).

First NameLast Name
ALTERNATE Address:

This is the alternate pickup and drop off address for the student.

Street Address Line 2

CityState / Province

Postal / Zip Code
Alternate Primary Phone Number

Area CodePhone Number
SCHEDULE

A schedule must be provided.
Pickup (please choose from dropdown)
Alternate Pickup (please choose from dropdown)
PICKUP SCHEDULE:

MONTUESWEDTHURFRI
ALTERNATE PICKUP SCHEDULE:

MONTUESWEDTHURFRI
DROP-OFF SCHEDULE - Please check day of week for drop-off below. Use alternate address drop-off where applicable.
Drop Off (please choose from dropdown)
Alternate Drop Off (please choose from dropdown)
DROP-OFF SCHEDULE:

MONTUESWEDTHURFRI
ALTERNATE DROP-OFF SCHEDULE

MONTUESWEDTHURFRI
SPECIAL INSTRUCTIONS:
PERMISSIONS - Please included medical concerns, use of booster seats and type (parent provided) and any other information you feel is important):
Please check the Parent Portal after three schools days at regina.firststudentinc.com
Should be Empty:

Specialized Transportation Application - St. Luke School

STUDENT INFORMATION

PARENT/GUARDIAN/ALTERNATE ADDRESS INFORMATION

SCHEDULE