NOTICE I acknowledge Due to bus space constraints, before filling out this form you must receive approval from Shelby Lillard in the Secondary Campus Main Office.Parent/Guardian Name* First Last Email* Plan Selection (Student 1)1. Student Name* First Last 1. Student Grade*Choose OnePreK3PreK4Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th1. Select AM Plan #*Select OneNot ApplicablePV-A5-5 DayPV-A4-4 DayPV-A3-3 DayPV-A2-2 DayPV-A1-1 DayNLR-A5-5 DayNLR-A4-4 DayNLR-A3-3 DayNLR-A2-2 DayNLR-A1-1 Day1. Select PM Plan #*Select OneNot ApplicablePV-P5-5 DayPV-P4-4 DayPV-P3-3 DayPV-P2-2 DayPV-P1-1 DayNLR-P5-5 DayNLR-P4-4 DayNLR-P3-3 DayNLR-P2-2 DayNLR-P1-1 DayPlan Selection (Student 2)2. Student Name First Last 2. Student Grade*Choose OnePreK3PreK4Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th2. Select AM Plan #Select OneNot ApplicablePV-A5-5 DayPV-A4-4 DayPV-A3-3 DayPV-A2-2 DayPV-A1-1 DayNLR-A5-5 DayNLR-A4-4 DayNLR-A3-3 DayNLR-A2-2 DayNLR-A1-1 Day2. Select PM Plan #Select OneNot ApplicablePV-P5-5 DayPV-P4-4 DayPV-P3-3 DayPV-P2-2 DayPV-P1-1 DayNLR-P5-5 DayNLR-P4-4 DayNLR-P3-3 DayNLR-P2-2 DayNLR-P1-1 DayPlan Selection (Student 3)3. Student Name First Last 3. Student Grade*Choose OnePreK3PreK4Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th3. Select AM Plan #Select OneNot ApplicablePV-A5-5 DayPV-A4-4 DayPV-A3-3 DayPV-A2-2 DayPV-A1-1 DayNLR-A5-5 DayNLR-A4-4 DayNLR-A3-3 DayNLR-A2-2 DayNLR-A1-1 Day3. Select PM Plan #Select OneNot ApplicablePV-P5-5 DayPV-P4-4 DayPV-P3-3 DayPV-P2-2 DayPV-P1-1 DayNLR-P5-5 DayNLR-P4-4 DayNLR-P3-3 DayNLR-P2-2 DayNLR-P1-1 DayPlan Selection (Student 4)4. Student Name First Last 4. Student Grade*Choose OnePreK3PreK4Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12th4. Select AM Plan #Select OneNot ApplicablePV-A5-5 DayPV-A4-4 DayPV-A3-3 DayPV-A2-2 DayPV-A1-1 DayNLR-A5-5 DayNLR-A4-4 DayNLR-A3-3 DayNLR-A2-2 DayNLR-A1-1 Day4. Select PM Plan #Select OneNot ApplicablePV-P5-5 DayPV-P4-4 DayPV-P3-3 DayPV-P2-2 DayPV-P1-1 DayNLR-P5-5 DayNLR-P4-4 DayNLR-P3-3 DayNLR-P2-2 DayNLR-P1-1 DayPaymentI understand that my FACTS account with be drafted for the amount corresponding to the Plan # I have chosen.* I understand and give my permission. Δ