Permission Slip to Ride Alternate Bus
10-A
Scofield Magnet Middle School
641 Scofieldtown Road
Stamford, CT 06903
(203) 977-2750/Fax (203) 977-2766
www.magnetmiddle.org
Mr. Scott Clayton
Principal
Ms. Donna Gardner
Assistant Principal
Permission Slip to Ride Alternate Bus
My child (ward) _________________________________has permission to ride home
with _____________________________________ on Bus # ___________ on this date:__________________,
Yes, I have already cleared this with the student’s parent (guardian).
_________________________________
Parent/Guardian - Please Print
_______________________
Phone Number
_________________________________
Parent/Guardian’s Signature
_______________________
Date
_________________________________
Administrator’s Signature and Date
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To the Bus Driver: Yes, ____________________________ has permission to ride home with ___________________________ on Bus # ___________ on this date: __________________.
Thank you,
_______________________________________
Administrator’s Signature and Date
