Roy J. Wasson Academic Campus School Bus Application

1.	Student Last Name*

2.	Student First Name*

3.	Student ID# (if known)

4.	Are you a new or returning student?*
	Are you a new or returning student?* New Student Returning Student

5.	If you are a new student, what time will you (a) arrive at and (b) leave school?

6.	If you are a returning student, did you ride a school bus during the 2021-2022 school year?*
	--Please Select--Yes No

7.	If you did not ride a school bus during the 2021-2022 school year, which bus location would you prefer to be picked up from and dropped back off to?

8.	Which days of the week will you be riding the bus?* Select at least 1.
	Monday    Tuesday    Wednesday    Thursday    Friday

9.	School you are/will be attending at the Roy J. Wasson Academic Campus* Select at least 1 and no more than 3.
	Achieve Online    Bijou    Career Pathways    Digital    Odyssey ECCO    Commuting from RJWAC to attend classes at PIKES PEAK COMMUNITY COLLEGE    Other, please specify

10.	Grade will you be in for the 2022-2023 school year?*

11.	Parent/Guardian Last Name*

12.	Parent/Guardian First Name*

13.	What is your home address? Please include street & house number (example: 123 School Rd)*

14.	What is the zip code to your home address?*

15.	Parent/Guardian email address*

16.	Parent/Guardian home phone number*

17.	Parent/Guardian emergency contact phone number*

18.	What is the nearest D11 school to your home address?*

19.	By submitting this application, I agree to comply with all school bus safety rules and regulations. Any student involved in misconduct on the bus or at the bus stop is subject to removal from all District 11 buses for the remainder of the school year with no further eligibility for transportation privileges.*
	I AGREE    I DO NOT AGREE