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6900 S OBT, Orlando, FL 32809
safe@rideuptransport.com
+1 (689) 346- 8300
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Transportation Details
Please provide the transportation schedule you are requesting for your student.
Requested Start Date:
*
Days Transportation Is Needed
*
Monday
Tuesday
Wednesday
Thursday
Friday
Transportation Type
*
Round Trip – Morning & Afternoon
Morning Only – Home to School
Afternoon Only – School to Home
Address: School Transportation
Morning Pickup Time:
*
School Dismissal Time
*
Student Information
Please provide information about the student who will be receiving transportation services.
Student Name:
*
First
Last
Grade Level
*
Select Grade Level
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Does the student require a wheelchair-accessible vehicle?
*
Yes
No
Pickup Information
Please provide the student’s home address for transportation services.
Home Address:
*
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
School Information
Please provide the student’s school information and location.
School Name:
*
School Address:
*
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Home-to-School Distance (Miles)
Automatically calculated driving distance between the student’s home and school.
Parent / Guardian Information
Please provide the contact information for the parent or legal guardian responsible for this transportation request.
Parent / Guardian Name:
*
First
Last
Relationship to Student
*
Select Relationship
Parent / Guardian
Grandparent
Sibling
Relative
Family Friend
Other
Primary Phone:
*
Email
*
Additional Information
Please provide any additional information that may help us safely coordinate the student’s transportation.
Special Transportation Instructions
Please include any pickup/drop-off instructions, gate codes, authorized pickup information, mobility needs, or other important details.
Estimated Weekly Rate ($)
Reservation Request Acknowledgment
*
I have reviewed and agree to the Estimated Weekly Rate shown above. I understand that submitting this request does not guarantee transportation availability or reserve a seat. RideUP Transport will review my request and contact me to confirm availability. If a seat is available, payment for the first week will be required before the requested service start date to secure transportation.
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