Bus Route Notification

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Bus Route Notification

Date: __________________ Select one: Elmbrook /Menomonee Falls/ Pewaukee Student Name: _______________________________ Grade/Teacher: _______________________________ has permission to ride the bus with ____________________________ today only. (Student Name)

Route #: _____________ Emergency Contact Name: ____________________________________________ Phone (please list two): ________________________ & ________________________

Parent Signature: _________________________________________

Teacher/Staff Approval: ____________________________________