Non-Primary Transportation Request

Out of Area Safe Location Request
FormTitle
This form is to request transportation services to a Safe Haven location. The location of the Safe Haven must be a current registered stop or collection point where services occur most school days and can be reasonably accommodated on the existing bus service. The schedule must be consistent and predictable. Alterations to the route will not be approved.

Requestor
Student Name*
Student ID Number*
Acquired from the School
Primary Address*
Requestor Email Address*
example@example.com
Parent Name*
Requestor Contact Number*
Please enter a valid phone number.
School Attending*
School Form
Grade*
Grade Form
Transportation Start Date*

MonthDayYear
Date
Host Family Information
Host Name*

First NameLast Name
Host Email*
example@example.com
I understand that this form must be completed and submitted annually. I understand that transportation will no longer be provided for my child/children if there is no longer available capacity on the bus, if the alternate stop location is no longer a registered stop or the host family no longer permits the service to their residence. I understand that approval for this service may be rescinded by Prairie Spirit School Division at any time.
Signature of Parent Guardian*

Clear
Date

MonthDayYear
Date

Please allow up to seven (7) business days to process and possibly longer in August, September & October. Delays will occur if information is not legible and/or incomplete.
Should be Empty:

Out of Area Safe Location Request