Transportation Program Application

Thank you for your interest in participating in the PHA School Bus Transportation Program. Please complete all sections of this application. Submission of this application does not guarantee placement. Families will be notified of whether they are offered a seat on the bus within two weeks of submitting this application.

Parent/Guardian Name*

Answer required for "Parent/Guardian Name"

Phone*

Number Required

Email*

Answer required for "Email"

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

Student information

Child 1 Name*

Answer required for "Child 1 Name"

Child 1 Grade in 2026-2027*

Answer required for "Child 1 Grade in 2026-2027"

Child 2 Name

Answer required for "Child 2 Name"

Child 2 Grade in 2026-2027

Answer required for "Child 2 Grade in 2026-2027"

Child 3 Name

Answer required for "Child 3 Name"

Child 3 Grade in 2026-2027

Answer required for "Child 3 Grade in 2026-2027"

Is your child(ren) new to PHA?*

Answer required for "Is your child(ren) new to PHA?"

Yes

Emergency Contact Information
Your emergency contacts are authorized to pick up your child from the bus.

Emergency Contact 1 Name*

Answer required for "Emergency Contact 1 Name"

Contact 1 Phone*

Number Required

Emergency Contact 2 Name*

Answer required for "Emergency Contact 2 Name"

Contact 2 Phone*

Number Required

Emergency Contact 3 Name

Answer required for "Emergency Contact 3 Name"

Contact 3 Phone

Answer required for "Contact 3 Phone"

Bus Route & Stop:
Select your route and your stop - REQUIRED

Purple Route: Woburn – Medford – Somerville

Answer required for "Purple Route: Woburn – Medford – Somerville "

Registration Fee
A non-refundable registration fee of $50 per family is required to participate in the School Bus Transportation Program. If you receive an email indicating that your child has been offered a seat on the bus, you have 48 hours to submit payment and secure that seat. Failure to pay by the stated deadline will result in you losing the seat. Payments must be submitted online via credit or debit card, Venmo, ApplePay, or PayPal. The payment link will be provided via email.

I understand that, if I receive a seat on the bus, I must pay a $50 registration fee per student / seat in order to secure said seat. *

Answer required for "I understand that, if I receive a seat on the bus, I must pay a $50 registration fee per student / seat in order to secure said seat. "

Yes

Please fix the highlighted areas below before submitting.

Transportation Program Application