1st Student Name *

First Name

Last Name

Date of birth *

MM

DD

YYYY

Foster Child / Homeless *

Check the applicable box

Foster Child

Homeless

N/A

2nd Student Name

First Name

Last Name

Date of birth

MM

DD

YYYY

Foster Child / Homeless

Check the applicable box

Foster Child

Homeless

N/A

3rd Student Name

First Name

Last Name

Date of birth

MM

DD

YYYY

Foster Child / Homeless

Check the applicable box

Foster Child

Homeless

N/A

4th Student Name

First Name

Last Name

Date of birth

MM

DD

YYYY

Foster Child / Homeless

Check the applicable box

Foster Child

Homeless

N/A

Home Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Do ANY household members (including yourself) currently participate in one of the following assistance programs? *

CalFresh

Calworks

FDPIR

N/A

Parent/ Guardian *

First Name

Last Name

OTHER HOUSEHOLD MEMBER (all household members must be listed)

First Name

Last Name

OTHER HOUSEHOLD MEMBER (all household members must be listed)

First Name

Last Name

OTHER HOUSEHOLD MEMBER (all household members must be listed)

First Name

Last Name

Bus Rider Rules *

The West County Transportation Agency has adopted rules and regulations in conjunction with your local school district to assist students in understanding their responsibilities while riding buses of the Agency. These rules will assure safe and proper travel to and from school and are to be observed while waiting at bus stops, riding the bus home and to school, or on field trips. The following list of student actions, while not being exhaustive, constitute violations of the established rules and regulations: 1. Abrasive body contact (slapping, hitting, poking , shoving, pulling hair, etc.) 2. Fighting on the bus or at a bus stop. 3. Using other than the student’s regularly designated stop. 4. Crossing the road without the driver’s escort or getting off the bus and crossing without permission. 5. Using profane language or obscene gestures. 6. Unauthorized exits (from emergency doors, windows, etc.) 7. Putting any part of the body out of the bus window at any time. 8. Any movement out of the seats while the bus is in motion. 9. Riding the bus after being denied the riding privilege. 10. Legs, feet and objects obstructing the aisle or facing to the rear in the seats. 11. Creating excessive noise. 12. Any improper bus stop procedures. (Not lining up, rock throwing, playing in the street, any property damage at the bus stop, etc.) 13. Unauthorized opening, closing, or tampering of any kind with the bus doors, windows or exits. 14. Lighting of matches, cigarettes , e-cigarettes, vaping or smoking of any kind. 15. Throwing any objects in or out of the bus or throwing objects at the bus. 16. Any type of damage or defacing of the bus. 17. Littering of any kind. 18. Transporting live animals, reptiles, or insects in the bus. 19. Eating, drinking or chewing tobacco or gum on the bus. 20. Disrespect to the driver. 21. Transporting of any object the driver feels is unsafe. 22. Giving improper identification when requested by the driver 23. Tampering with the radio or bus controls. 24. Failure to obey the driver. 25. Failure to remain quiet at all railroad crossings. 26. Endangering the life or limb of other people. 27. Other unauthorized or unsafe actions. Authority of the bus driver as explained in Section 14263 of Title 5 of the California Administrative Code states that: a) Pupils transported in a school bus shall be under the authority of and responsible directly to the driver of the bus, and the driver shall be held responsible for the orderly conduct of the pupils while they are on the bus or being escorted across a street, highway, or road. Continued disorderly conduct or persistent refusal to submit to the authority of the driver shall be sufficient reason for a pupil to be denied transportation. A bus driver shall not require any pupil to leave the bus enroute between home and school or other destinations.

I Have Read & Understand The Rules For Riding The Bus.