Request for New/Changing Transportation

Request for New/Changing Transportation

GENESEE INTERMEDIATE SCHOOL DISTRICT

Transportation Department 2413 West Maple Avenue Flint, MI 48507
Director of Transportation Services, Chad N. Sexton
Transportation Coordinator, Angie Ethridge (810) 591-4579

Dispatchers/RoutersPhone Numbers
Shawna Freeman
Deonna Johnson
Tonya Williams
(810) 591-4518
(810) 591-4915
(810) 591-4919
Date and Time of Application*
Last Name of Student
First Name of Student

Special Education Certification (Per IEPT)*


Additional Special Education Certification (Per IEPT)


Home Address*


Apt.*

City*
State*
Zip*
Birthdate*
Gender*
Student UIC #
Mom Cell
Dad Cell or Home Phone Number (Eg. 810-591-4300)*
Parent or Legal Guardian Last Name*
Parent or Legal Guardian First Name*


School District Child Resides In*

Building Attending*
Room #


If your building isn't listed, type here.

Session AM or PM (if applicable)*
4 or 5 day (if applicable)*


Requested Day Transportation Should Start*

Requester*

 

Requester Title

 

Bus Seat Restraint Requirements (Per IEP)

This section must be completed prior to bus assignment. Failure to do so will delay start date.

Transportation Notes

If there is anything else you need transportation to be aware of, please leave details in the box.



Security Measure