Palisades Charter High School

Transportation Bus Request

Dear Parents/Guardians,


Please complete the Transportation Request Form below if you are interested in transportation to or from campus. Completion of the Transportation Request Form does not guarantee transportation for your student. It is for geographic location data purposes only. Once the data has been gathered, you will be contacted by the Operations Department and given the opportunity sign your student up for the PCHS transportation program.

 

If you have questions, please contact Susan Darvish in the Transportation Office at (310) 230-6631 or sdarvish@palihigh.org.

 

Mandatory fields marked *

 

If you need to Make a Transportation Payment, start here.

 

TRANSPORTATION REQUEST FORM

Parent Name*:
Student Name*:
Student Grade* (as of September 2012):

 

Address*:

City*:

Home Telephone #*:
Parent's Cell or Emergency Telephone #*:
Parent's Email Address:
By default, the Parent/guardian's email will be the primary way of contact.
If the parent/guardian does not have an email, the student's email will be used.
Student's Email Address:
* required fields

 

Palisades Charter High School      15777 Bowdoin Street, Pacific Palisades, CA 90272      Tel: (310) 230-6623      Fax: (310) 454-6076      info@palihigh.org


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