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S, OR the address of the child's before and after school day care provider. Name of Student: _____________________________________ Last Name __________________ School ___________________________ Grade __________ First Name ________ Middle Student ID ____________________ _____ My student will require transportation and lives more than 1½ miles from his/her school, or meets the D300 criteria for transportation eligibility. _____ My student will NOT require transportation to/from school, I .

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