* SERVICE DESIRED

for 2008/2009 School Year

	Annual Bus Pass ($300)
	Fall Semester Pass ($165)
	Spring Semester Pass ($165)
	Ride Tickets ($40 per book)

( * Denotes mandatory field)

Please note, per Governing Board policy, Transportation services are not available for students attending school on an Intra-District transfer, Administrative Exception or participating in the Choice Program.

Student Bus Pass Application

Grossmont Union High School District
1100 Murray Drive - El Cajon - California - 92020

RIDER INFORMATION

Student #1			Student #2
*Last Name			Last Name
*First Name			First Name
Middle Initial			Middle Initial
*Student ID #			Student ID #
*Grade			Grade

Student #3			Student #4
Last Name			Last Name
First Name			First Name
Middle Initial			Middle Initial
Student ID #			Student ID #
Grade			Grade

HOUSEHOLD INFORMATION

Home Address
*Street Number	*Street name	Apartment #

*City

*State

*Zip Code

*Phone Number

*Parent/Guardian Name

*Email Address

FREE & REDUCED BUS PASS

Qualifying Information
Annual Household Income
Number of Persons Living In Household

By pressing the 'Submit' button, you and all riders agree to all terms and conditions set forth in the School Bus Safety Rules School Safety Rules Link Privacy Policy