Kenosha Unified School District Transportation Request

Kenosha Busing Request
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 11:59p on Tuesday, July 14th. 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 NameLast Name
Birthdate

MonthDayYear
Date
Birthdate
Gender
Ethnicity

Other
School Year
Grade
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Parent/Guardian Information
Name

First NameLast Name
Address (If different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Relationship to student:
Today's Date
Today's Date

MonthDayYear
Date
Should be Empty: