Dear Parents/Guardians,
We are asking that you fill out this form if your child/children needs to be dropped off/picked up this school year. This is not to be filled out for occassional bus stop changes!! This is for every parent that wants their child to be transported back and forth to school on Florence County School Bus. We ask that you fill out one form per stop per child. We are doing this to improve the efficiency of our transportation routes.
Name of student that needs to be picked up or dropped off at a stop other than the student's home address.
*
First Name
Last Name
Stop Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
School Student Attends
*
Please Select
Florence Elementary School
Florence MS/HS
Students Current Grade
*
Please Select
4K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Stop Description
*
Grandparents house, Daycare, ect.
Phone Number
*
Please enter a valid phone number of a person that we can contact at this address if necessary.
If student will ride the bus to this stop more than one day in a week which days will they ride the bus to this stop?
Monday
Tuesday
Wednesday
Thursday
Friday
Stop Time
*
AM Stop Only
PM Stop Only
Both AM& PM Stops
Email
*
please enter your email address and you will be emailed a copy of this form for verification
Signature
*
DateTime
Submit
Should be Empty: