In-Person Student Pickup

Berne Union Transportation Department

In-Person Student Pick Up
By filling out and signing this form, you are stating that you the undersigned have picked up the student listed below from the Berne Union Transportation department in person at the specified date and time listed in this form.
Your Name
Full Name
Relationship to Student
Student's Full Name
Today's Date

MonthDayYear
Date
Time of Pickup

Hour Minutes

AM/PM Option
Your Signature
Should be Empty:

Berne Union Transportation Department