<p> CISD EMPLOYEE CHILD TRANSPORTATION REQUEST FORM</p><p>As an employee of Channelview I.S.D., I am requesting permission for my child or legal ward to be allowed to ride a bus other than their regularly assigned bus to and/or from school as indicated below. Should any changes occur, I understand that it is my responsibility to notify the Transportation Department immediately to request amendments to this schedule.</p><p>Employee’s Name: ______Phone: ______</p><p>Employee’s Address: ______</p><p>Employee’s Work Location: ______</p><p>Employee’s Cell Phone or Pager #: ______</p><p>Emergency Contact Person: ______</p><p>Emergency Contact Person’s Phone #: ______</p><p>Child’s Name: ______</p><p>Employee’s Relationship to Student: ______</p><p>Grade: ______Age: ______Sex: ______</p><p>Campus Attending: ______</p><p>Loading Location: ______</p><p>Drop off Location: ______</p><p>Time of A.M. Loading: ______Bus #: ______</p><p>Time of Midday Loading: ______Bus #: ______</p><p>Time of P.M. Loading: ______Bus #: ______</p><p>Time of Extended Day Loading: ______Bus #: ______</p><p>Please circle the days and times that Transportation is requested:</p><p>Monday: A.M. MIDDAY P.M. Ext. Day Tuesday: A.M. MIDDAY P.M. Ext. Day</p><p>Wednesday: A.M. MIDDAY P.M. Ext. Day Thursday: A.M. MIDDAY P.M. Ext. Day</p><p>Friday: A.M. MIDDAY P.M. Ext. Day</p><p>Employee’s Signature: ______Date: ______</p><p>Principal’s Signature: ______Date: ______</p><p>Approved by Coordinator of Transportation: ______Date: ______</p>