Request for School Transportation

Grade *

School *

School Year *

Student First Name *

Student Last Name *

Student ID Number *

Student Home Address (childcare address is not permitted) *

New School *

Yes

No

New Address *

Yes

No

Parent/Guardian First Name *

Parent/Guardian Last Name *

Home or Cell Phone Number *

Work Phone Number

Health concern driver should know, such as allergies, diabetes, epilepsy, etc.

The state of Iowa states elementary and middle school students must live over 2 miles, and high school students over 3 miles to qualify for transportation. Paid busing is on a space available basis ONLY. The Transportation Department processes applications for paid busing after all applications for students who meet the transportation eligibility requirements.

Parents are responsible for providing transportation for students attending a school other than the school designated for attendance (boundary school).

Paid busing is offered ONLY if space is available on an existing bus and after meeting the requirements of transporting those students who live beyond the two or three miles required by Iowa School Transportation Code. Paid riders will NOT be added to bus routes the first 14 days of school as required by this code. Plan on providing transportation to your student unless you are notified by the Transportation Dept. your request for paid transportation is approved.

I am requesting paid busing for my child/children and would agree to pay the monthly fee set by the school district. *

Yes

No

District Policy Regarding School Transportation

By typing my name below, I agree that I have read and understand the guidelines and rules for my child’s bus transportion. School buses are equipped with video cameras in accordance with school board policy.

Signature *

NON-DISCRIMINATION STATEMENT:

The Sioux City Community School District offers career and technical programs in the following areas: Business & Marketing, Family & Consumer Science, Health Science, and Industrial Arts, Technology, & PLTW.

The Sioux City Community School District is an equal opportunity/affirmative action employer and does not discriminate on the basis of race, creed, color, sex, sexual orientation, gender identity, genetic information (for employment), national origin, religion, age (for employment), disability, socioeconomic status (for programs), marital status (for programs), or veteran status (for employment) in its educational programs and its employment practices. The District is required by Title IX and 34 CFR Part 106 not to discriminate on the basis of sex in its programs, activities, or employment.

Inquiries or grievances under Section 504 and Title II of the Americans with Disabilities Act may be directed to Dr. Dora Jung, Director of Student Services & Equity Education/Title IX Coordinator at 627 4th Street, Sioux City, IA 51101, (712) 279-6075, jungd@live.siouxcityschools.com. Inquiries about the application of Title IX and its regulations to the District may be referred to the Title IX Coordinator, the Assistant Secretary of the U.S. Department of Education, or both. Please see District Board policies 103 and 504.4 for additional information on available grievance procedures