Suffern Central School District
Transportation Office SY 2024-2025
45 Mountain Avenue NY State Deadline:
Hillburn, NY 10931 April 1, 2024
transportation@sufferncentral.org
845-357-7783 x11286 fax 845-357-3073
REQUEST FOR TRANSPORTATION TO PRIVATE/PAROCHIAL SCHOOL
TRANSPORTATION REQUEST DEADLINE:
Parents who desire transportation to private/parochial
school next year, 2024 – 25 must submit this form by April 1, 2024
Date
In accordance with the laws of the State of New York, I hereby request transportation for my child to a private
school during the coming school year.
Child’s First Name Last Name
Date of Birth Age Gender: Male Female Home Phone #
Home Address
(Number and Street) (City) (Zip Code)
Mailing Address (if different)_________________________________________________________________________
Mother’s Name Cell # Email
Father’s Name Cell # Email
Emergency Contact Phone # Relationship
Private School To Be Attended School’s Phone #
Private School Address
Grade Child Will Be Entering First Day of School
Does the child currently ride a Suffern CSD bus: Yes No
By electronically signing my name below, I acknowledge and agree that I am the legal parent/guardian of student identified above. I
agree that I will be legally bound, obligated and responsible for this REQUEST FOR TRANSPORTATION TO PRIVATE/PAROCHIAL
SCHOOL form, as if I had submitted it in hard copy form with my handwritten signature.
Signature Printed Name
(Parent/Guardian)
Please note:
1. An individual request must be submitted for each child -
each year transportation is desired. All information requested must be
included.
2. Children not 5 years of age by December 1 are not entitled to transportation during that school year.
3. This form must be received in the Transportation Office of the Suffern Central School District by April 1, or transportation
privileges may be jeopardized for the entire school year.
4. New residents must submit their request(s) within 30 days of moving into the district, provide proof of residency and a copy of child’s
original birth certificate.
5. New enrollee (including siblings or Kindergarteners) requests must include a copy of child’s birth certificate.
If a Request for Private School Transportation is rejected before April 1, any second request must be submitted by April 1.
THIS FORM MUST BE RECEIVED AT THE DISTRICT OFFICE IN HILLBURN BY APRIL 1, 2024
6.
