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* 1. School Student(s) Will Be Attending

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* 2. Parent/Guardian Name

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* 3. Parent/Guardian Email Address

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* 4. Parent/Guardian Phone Number

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* 5. Full Address (including town) 

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* 6. Student Name(s) and Grade Level(s) in School

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* 7. Interested in...Walking? Biking? Either?

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* 8. Which days of the week?

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* 9. Before school? After school? Both?

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* 10. Do you have availability to volunteer? If so, which days and times?

Note: Parent/guardian volunteers play a huge role in the success of Walking and Biking School Buses!

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* 11. Please share any additional information with us!

Thank you for filling out our Walking and Biking School Bus Interest Form. If any other families who live nearby express similar interests as you, we will be in contact!

We are here to help! Contact us with any questions or suggestions.
April Bril // abril@uerpc.org // 563-419-6224
Ashley Christensen // achristensen@uerpc.org // 563-419-6112
Upper Explorerland Regional Planning Commission
Safe Routes to School

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