Kenosha Unified School District Transportation Request

Pupil Transportation Request

Kenosha Unified School District No. 1
Dear Parent/Guardian:

If your Upper Campus student (Grades 6-12) will need bus service for the SJCA school year, please fill out the entire form below no later than August 6th. You will be informed sometime in August, if your student qualifies for bus service (either a school bus route or a city bus pass).

Please fill out one form for each student attending the Upper Campus.

Note: You need to live 2 or more miles from the Upper Campus (2401 69th Street) and must live within the KUSD Bus District - East of I-94
Student Name *

First Name Last Name
Birthdate *

Month Day Year
Date
Birthdate
Gender

Male Female
Ethnicity *

American Indian/Alaskan Native Asian Black Hispanic White
School Year
Grade *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Parent/Guardian Information
Name *

First Name Last Name
Address (If different than above)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Relationship to student: *
Today's Date
Today's Date *

Month Day Year
Date
Should be Empty: