Transportation Application

Transportation Application

Apply for one or more students below. Phone numbers in xxx-xxx-xxxx format. Do not submit a form for a student more than once for this enrollment period. Please contact Kendall Johnson to make changes. Phone: 816-412-5994

Request for:


Student 1. First Name  Last   Expected Grade

Student 2. First Name  Last   Expected Grade

Student 3. First Name  Last   Expected Grade

Student 4. First Name  Last   Expected Grade


Home AddressTransportation Address (if different from Home)
Street Address* Street Address
City* City
State* State
Zip* Zip

**Note:  If the home address on the transportation request form does not match the address the UA has on file for your student, you must submit two (2) documents proving residency in the Kansas City, MO school district (visit and click "Enrollment" for a list of approved documents). Please contact Kellie Brady at with questions.  Transportation requests may not be processed until after residency documents have been verified.

Change request will not be processed until all required residency information is submitted and approved by the registrar - Kellie Brady.

Parent First Name Emergency Contact 

Contact Information

Parent Last Name(must be someone other than the parent listed on this form)
Primary Phone  
Alternative Phone Emergency Contact #
Email Address (*Transportation assignments will be sent by email only.)


Parental Acknowledgement - You must read and agree to each statement below to apply for Transportation.

I agree as parent/guardian to assume full responsibility for my student’s conduct on the bus and agree that my student, as a passenger, will abide by all safety rules. I understand that my student’s failure to comply with safety rules may result in suspension of bus riding privileges.   I have read and understand this information.

I understand (if a parent of a kindergarten student) that he/she must be met by a parent/guardian or other adult when dropped off in the afternoon (with exception of those kindergarten students approved for a sibling escort). If not, he/she will be returned to the school and I will be responsible for having him/her picked up.   I have read and understand this information.

I understand that I may request—in writing—that an older sibling (grades 6-12 only) be allowed to escort my kindergarten student off the bus. NOTE: Older sibling MUST be a student at University Academy.   I have read and understand this information.

To grant permission for the older sibling to escort your kindergartner, enter the older sibling's name here: 

I understand that if my kindergarten student is returned to University Academy more than two times due to my failure to meet or have another adult meet the student at the bus stop during afternoon drop off, I will be assessed a fee of $10.00 per every five (5) minutes that my students waits at the school to be picked up.   I have read and understand this information.

I understand that I must submit a written request if my student needs to ride a bus route to/from school other than the route he/she is assigned. I understand that students will be denied ability to board an unassigned bus route without prior approval.   I have read and understand this information.

I understand that should my student damage the bus, I may be requested to pay restitution.   I have read and understand this information.

Missouri State Statute 569.155 states that “a person commits the crime of trespass of a school bus if he knowingly and unlawfully enters any part of or unlawfully operates a school bus.” I understand that boarding the bus to address the driver or other students is considered trespassing and violation of this statute will result in the suspension of my student’s bus riding privileges for a period of time deemed appropriate by school officials.   I have read and understand this information.

All UA students receiving TWO (2) bus discipline referrals may lose bus-riding privileges for up to 30 school days at the discretion of school administration. Any student that receives a THIRD (3rd) bus suspension will lose bus riding privileges for the remainder of the school year, no exceptions.   I have read and understand this information.

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