Request for Transportation Under Act 372
Dear Parent/Guardian:

According to Pennsylvania Law, Non-Public and Charter school children are entitled to transportation to Non-Public and Charter schools as follows:
  1. A District that provides transportation for resident public school students must also make identical provisions for transporting resident Non-Public and Charter school students according to the Non-Public or Charter school calendar.
  2. Transportation for Non-Public and Charter school students must be provided to and from the Non-Public or Charter school in which the student is enrolled, even if the Non-Public or Charter school is located outside the District, so long as the distance is not more than 10 miles beyond the District boundaries.
  3. A District may transport children who live along hazardous routes even though the children live within walking distance of the Non-Public or Charter school.
Please complete the request form below if you think you are eligible for transportation and desire it for the next school year.

A SEPARATE FORM FOR EACH CHILD MUST BE COMPLETED ANNUALLY FOR CONTINUED TRANSPORTATION SERVICES FOR ALL NON-PUBLIC AND CHARTER SCHOOL STUDENTS.

Please Note: A child must be withdrawn from Public school and officially enrolled in a Non-Public or Charter School for transportation to begin.

Questions? Please contact Nazareth Area School District Transportation Office at (610) 759-1170 x 1177 or email us at Transportation@nazarethasd.org. Thank you.

Sign in to Google to save your progress. Learn more
Email *
First Name of Student *
Last Name of Student: *
Date of Birth: *
Date
School Year Entering: *
Grade Entering: *
Home Address (Street Number and Street Name): *
Home Address City: *
Home Address State: *
Home Address Zip Code: *
Name of Non-Public or Charter School attending: *
The student resides approximately how many miles from the  Non-Public or Charter School they will attend? *
Effective Entrance Date: *
Date
Name of Public School District (in which child resides) *
Please indicate the following (CHECK A or B) *
If transportation IS REQUIRED, please check all that apply: *
Required
If transportation IS REQUIRED, please check all days that apply: *
Required
Parent/Guardian 1 Name  *
Parent/Guardian 1 Cell Phone *
Parent/Guardian 1 Work Phone
Parent/Guardian 1 Email
 *
Parent/Guardian 2 Name
Parent/Guardian 2 Cell Phone
Parent/Guardian 2 Work Phone 
Parent/Guardian 2 Email
Emergency Contact Name 1 (other than parents/guardians):
Emergency Contact 1 Cell Phone:
Emergency Contact Name 2 (other than parents/guardians):
Emergency Contact 2 Cell Phone:
By digitally signing below, I hereby acknowledge that I have completely read and fully understand the Request for Transportation Under Act 372 and affirm the truth of the above listed answers. *
Today's Date: *
Date
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Nazareth Area School District. Report Abuse
Google Forms