Student Transportation Request

Client Information

We just need a little info about who is requesting the student transportation.

Client Admin Name

Organization Name

Phone

Student Information

Tell us about the student you'd like us to begin transporting.

Student First Name

Student Last Name

Student Middle Name

Date of Birth

Gender

School Grade

Select all that apply. If other disabilities, please describe below.

Other Disabilities

Population Type

GenEd Foster Care MKV SpEd

Student Addresses

Morning Pick-up Address

Unit # (Pick-up)

Afternoon Drop-off Address

Unit # (Drop-off)

Additional Drop-off Instructions

Guardian Contact Information

Parent/Guardian

Phone

Parent/Guardian (optional)

Phone

Parent/Guardian (optional)

Phone

Transportation Information

Give us some information about the logistics of this request. The confirmed start date will be provided by the ADROIT team once this request has been submitted.

Service Start Date

Service End Date

Select all that apply. If other, please describe below.

Other Transportation Needs

Type of Vehicle

Monitor/Aide Addresses

(if school provides aide)

Optional: Expand and enter any school aide information.

Outbound Ride

Return Ride

School Site Information

School/Place Name

School/Place Address

Morning and Afternoon Pick-up/Drop-off Instructions at the school site

Class/Teacher Contact

Optional: Expand and enter any desired teacher contact information.

Bell Schedules

The times entered will be the driver arrival time at the school in the morning and driver arrival in the afternoon.

Outbound Bell Time

Monday

Tuesday

Wednesday

Thursday

Friday

Return Bell Time

Monday

Tuesday

Wednesday

Thursday

Friday

Health Concerns and Comments

Please upload the student's school calendar below

By submitting this application, you confirm that the information provided is accurate and acknowledge that you have read, understand, and agree to the ADROIT Partner Agreement and Privacy Policy.