COLLEGE BUS SERVICE
APPLICATION FORM
STUDENT INFORMATION
Student Name
*
First Name
Surname
Age
*
Please Select
5
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Grade
*
Please Select
P
K
1
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How many other children would you like to add to the form?
*
Please Select
One
Two
Three
No other children to add
Student Name (2)
*
First Name
Surname
Age (2)
*
Please Select
5
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Grade (2)
*
Please Select
P
K
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Student Name (3)
*
First Name
Surname
Age (3)
*
Please Select
5
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Grade (3)
*
Please Select
P
K
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Student Name (4)
*
First Name
Surname
Age (4)
*
Please Select
5
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18
Grade (4)
*
Please Select
P
K
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PARENT INFORMATION
Parent Name
Given Name
Family Name
Email
example@example.com
Telephone (mobile)
Telephone (home)
Telephone (work)
Street/ PO Box
Suburb
State
Postcode
Country
BUS INFORMATION
Preferred Bus Stop (see timetable)
Commencement date of bus service:
-
Month
-
Day
Year
Date
Other comments
CONDITIONS - Students are to be at the bus stop 10 minutes before the scheduled time. Children are to wear the seatbelt at all times. I understand the above conditions and give permission for my child/children to utilise the direct bus service until we inform the College otherwise. I understand that we will be billed for the year
I agree and understand.
Signature
Date
*
/
Day
/
Month
Year
Date
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