Transportation Registration

Transportation Registration

IMPORTANT: Please call a Girls Inc. of Fort Smith Representative before filling out this form. We have to be sure that the school you are requesting pick-up from and the route it is on has availability.
To register for after-school transportation, all girls must have a current Girls, Inc. annual membership. If needed, you can complete membership registration here. All services and any outstanding balances must be paid in full before the transportation start date.

Transportation Registration Deadlines

First Quarter
(August - October)
Fees due upon signing up for transportation at school year beginning

Second Quarter
(November - January 15)
Fees due on November 1

Third Quarter
(January 15 - March 15)
Fees due on January 15

Fourth Quarter
(March 16 - End of School Year)
Fees due March 16

Please Note: Late fees of $5 per week will be required beginning 10 days after the due date. These fees will need to be paid in order to continue service.
Student Information
Student Name*

First NameLast Name
School Child Will Need Transportation From to After School Program*
Primary Guardian Information
Primary Guardian's Name*

First NameLast Name
Primary Guardian's Email*
example@example.com
Primary Guardian's Number*
Please enter a valid phone number.
Emergency Contact Info
Emergency Contact Name*

First NameLast Name
Emergency Contact Email*
example@example.com
Emergency Contact Number*
Please enter a valid phone number.
In keeping with policies and procedures, it is critical for you to review the following information. Check the box next to each policy to indicate your willingness to participate in the program and adhere to the guidelines.*

Before submitting this form online and making a payment, I have called and spoke with a Girls Inc. of Fort Smith representative to assure that there is no Wait List for the school pick-up van which I am requesting.If my child(ren) does not need to be picked up from the designated school due to illness, after school appointment or other activity; I will notify Girls Inc, by 2:00 p.m. go that particular day. If I fail to notify Girls Inc. of my child's absence from the transportation program on three occasions, I understand that my child will be suspended from the transportation program until the next program season begins.I am aware that the complete transportation cost amount is $200.00 and can be paid in full or can be paid out in payments on scheduled payment dates. Each payment installment is $50.00. The following dates are when transportation payments are due these dates will also be sent with your confirmation email upon completion of this form: • First Quarter: August - October (due upon sign up at beginning of school year) • Second Quarter: Nov 1 - Jan 15 (due on Nov 1) • Third Quarter: Jan 15 - March 15 (due on Jan 15) • Fourth Quarter: March 16 - End of School Year (due March 16)I am aware that late fees of $5 per week will accumulate if my payments are more than 10 days past due.I understand that, at each school, a designated pick-up site will be determined. If my child is not present at the time of pick-up, she will not be transported to Girls Inc. I understand that Girls Inc. is not responsible for transporting my child if she misses the van. The van driver is instructed to call roll and wait no longer than three minutes for children.I agree, if my child no longer needs transportation services, to notify Girls Inc. as soon as possible other wise I will still be responsible for the cost of transportation.I agree that, for safety reasons, my child must adhere to the following transportation rules: • Sit perpendicular in seats • Wear seat belts • No yelling and shouting listen to staff member operating or riding in the van • Throw away trash before getting on van • No open snacks, food or drinks in the vanI will inform my child's school of her transportation arrangements with Girls Inc. so that they can aid in directing her to the designated wait area for van pick up.
Electronic Signature: by signing below, you agree that you've read over all policies and agree to continue to payment options. Please note, that no registration is complete without speaking to a Girls Inc. representative first about availability of school pick-up or without payment.*

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Transportation Program Fees

All program fees are non-refundable and must be paid in full at the time of registration. Enrollment may be limited. Registrations will be taken in the order received.
The Transportation Program fees are 50.00 per quarter. You may add multiple quarters to your cart as needed to cover your student's attendance.

Please Note: Late fees of $5 per week will be required beginning 10 days after the due date. These fees will need to be paid in order to continue service.
Pay Now*
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Girls, Inc. Transportation Program Fees (Quarter 1)August thru October
$50.00



Girls, Inc. Transportation Program Fees (Quarter 2)November 1st thru January 15th
$50.00



Girls, Inc. Transportation Program Fees (Quarter 3)January 16th thru March 15th
$50.00



Girls, Inc. Transportation Program Fees (Quarter 4)March 16th thru May
$50.00



Girls, Inc. Transportation Program Fees (All 4 Quarters)August thru May
$200.00



Late Payment Fee$5 per week after 10 days past due date
$5.00 Quantity



Total

$0.00
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Transportation Registration

Transportation Registration Deadlines

Student Information

Primary Guardian Information

Emergency Contact Info

Transportation Program Fees