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 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 NameLast Name
Birthdate*

MonthDayYear
Date
Birthdate*
Gender*

MaleFemale
Ethnicity*

American Indian/Alaskan NativeAsianBlackHispanicWhite
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: