Date Request

Received__________

Shelbyville Central Schools

Change of Transportation Form

 Shelbyville Central Schools is committed to safe transportation. In order to ensure that your child is transported to an alternate address or childcare provider, we request that you complete the form below. This form needs to be turned in the Friday prior to the day/week of transportation changes. This allows the office staff to communicate the changes to teachers and the transportation department.

Student Information

Student’s Full Name______________________________________

Teacher’s Name_________________________________________

Date(s) of transportation changes and alternate location and address

Parent/Guardian’s Full Name______________________________