TRANSPORTATION PLAN FORM

WALTER PANAS WISE PROGRAM

Student’s Name: ______________________________________________________

Internship Site: ______________________________________________________

Site Supervisor: ______________________________________________________

Site Address: ______________________________________________________

Site Telephone #: ______________________________________________________

Dates of Participation: _____________________________________________________

IF YOU ARE DRIVING YOUR OWN CAR:

Parking Permit Number:________________

Make an Model of the Car:__________________________________________________

License Plate Number:_________________________

Other WISE students leaving campus with you:_________________________________

IF NO CAR, MEANS OF TRANSPORTATION:_____________________

What time will you be leaving school?

(Be sure to specify whether it is all days, certain days of the week, or certain letter days.)

___________________________________ __________________

Parent/Guardian Signature Date