TRANSPORTED STUDENT FORM
939 - ASELTINE	Created: 05/23/2025

Student Name: MANUYLOV ARTEM	Student ID: 702515	Grade: 4	Ethnic:	Gender: M	Effective Date: 05/26/2025
Resident Address 11846 CYPRESS VALLEY DR		Track T	Program SE	LOS 2	Phone(619) 509-7885
Special Services

1	Trip Name: Route: 1 - AM	Trip ID: N939 1A	Stop Time: 7:34	Days: MTWHF
	Service Address: 11846 CYPRESS VALLEY DR
	Stop Description: CYPRESS VALLEY DR @ PEPPERVIEW TR		Additional Description: (1210A1)
	Enter Service Address Change As Needed

2	Trip Name: Route: 1 - EO	Trip ID: N939 1E	Stop Time: 13:48	Days: H
	Service Address: 11846 CYPRESS VALLEY DR
	Stop Description: CYPRESS VALLEY DR @ PEPPERVIEW TR		Additional Description: (1210A1)
	Enter Service Address Change As Needed

3	Trip Name: Route: 1 - PM	Trip ID: N939 1P	Stop Time: 15:48	Days: MTWF
	Service Address: 11846 CYPRESS VALLEY DR
	Stop Description: CYPRESS VALLEY DR @ PEPPERVIEW TR		Additional Description: (1210A1)
	Enter Service Address Change As Needed

4	Trip Name:	Trip ID:	Stop Time:	Days:
	Service Address:
	Stop Description:		Additional Description:
	Enter Service Address Change As Needed

SCHOOL USE ONLY (Only if Service Change Needed)
Date Submitted:	____/____/____	Recommended Stop: Existing New
Submitted By:	_________________	General Comments:
Requested Effective Date:	____/____/____	Drop fromTransportation          Change: 1 2 3 4