Monroe-Woodbury Transportation Dept.
27 Mine Road, Monroe, NY 10950
Phone: 460-6010 Fax 460-6040
2020-2021 SCHOOL YEAR
REQUEST FOR A BUS STOP CHANGE
Any request for a school bus stop change must be made in writing. Reason(s) leading to your request must be included. Please
give specific details and explanations. You will receive confirmation that your request has been received, and notification of the
decision will be made to the applicant within 30 business days of the initial request. You will need to complete a form for each
individual student, if more than one request is being made. (Do NOT use this form for babysitter bus stop information; that is a
different form.)
Student’s Name: ______________________________________________________________________
(please enter student’s name)
Student’s Address: ______________________________________________________ ______________
(please enter student’s address, street and town)
Student’s Assigned Bus Number: _________________________________________________ ________
(please enter student’s assigned bus number)
Student’s Assigned Bus Stop Location: _________________________________ ____________________
(please enter student’s assigned bus stop location)
Student’s School: ______________________________________________________ ________________
(please enter student’s school)
Requested New Stop Location: __________________________________________________________
(please enter requested new stop location)
Reason for this request to change the bus stop:
(please enter reason for this request to change the bus stop)
Name of Parent/Guardian: ____________________________________ __________________________
(please enter parent or guardian name)
Contact Phone Number: __________________ Contact eMail Address: _________________________
(please enter contact phone number) (please enter email address)
TO SUBMIT: Print, scan and email to transportation@mw.k12.ny.us OR print and fax to 845-460-6040
For office use only:
Findings: _____________________________________________ Date Stamp:
Date Parent/Guardian Contacted: __________________
Dispatch Comments: _________________________
___________________________________________
