Form Jpds Nc PDF Details

Form Jpds Nc is a document used to apply for an unemployment insurance claim. This form can be filled out online or on paper, and it must be submitted within 20 days of the date you become unemployed. In order to qualify for benefits, you must meet certain eligibility criteria. You can find more information about Form Jpds Nc and how to file a claim on our website. We hope this information is helpful, and we wish you the best of luck in your job search.

QuestionAnswer
Form NameForm Jpds Nc
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesJPDS bus enrollment 13 14 jpds nc bus route form

Form Preview Example

JPDS-NC

BUS ENROLLMENT FORM 2013-2014

 

SELECT YOUR ROUTE:

ROUTE #1 ROUTE #2

ROUTE #3 ROUTE #4

SHUTTLE ONLY

***SELECT IF NEEDED:

 

 

 

INTER-CAMPUS SHUTTLE-FREE: TZAFON TO DAROM

AM or PM __DAROM TO TZAFON AM or PM

 

 

(SELECT ONE)

(SELECT ONE)

Parent 1 Name: __________________________________ Parent 2 Name: ___________________________________

Parent 1 Cell Number:____________________________ Parent 2 Cell Number: ______________________________

Cell Phone Company: ____________________________ Cell Phone Company: _____________________________

Parent 1 Email Address:___________________________ Parent 2 Email Address:___________________________

- - - - - - - - -

 

 

 

 

 

 

 

 

 

 

 

 

Parent 1:

 

Text Messages Only

Email Messages Only

Both Types are OK

Parent 2:

 

Text Messages Only

Email Messages Only

Both Types are OK

- - - - - - - - -

 

 

 

 

 

 

 

 

 

AUTHORIZED PICK UP PEOPLE (Non-Shuttle only)

 

Child's Name

 

 

 

Grade____

 

 

 

 

 

 

 

If you are only taking the shuttle, type “None”

 

 

 

 

 

 

1. _________________________________________

 

Child’s Name____________________________________Grade____

 

 

Child’s Name____________________________________Grade____

 

2.__________________________________________

- - - - - - - - -

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AM Bus Stop ____ ___________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. _________________________________________

 

PM Bus Stop ____________________________________________

 

 

 

 

 

Alternate Bus Stop Suggestion:_____________________________________

4. _________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Alternate Bus Stop comments:

 

 

 

 

 

 

 

 

 

- - - - - - - - -

 

 

 

 

 

 

 

 

 

 

 

 

FEES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MINIMUM BUS FEE and

 

 

 

 

 

 

 

 

 

Round Trip

One Way

After PEP ONLY and non PEP Tuesdays

Occasional Rides

 

$750

$520

 

$100

 

 

 

 

$10

 

 

 

 

______ riders x $ _________ =

>Total = $__________<

TOTAL AMOUNT OWED: $ ___________

Select a Payment Option: ___ Check for Total Amount is Being Mailed (Put “Bus” in the Item Line)

___ Add Total Amount to remaining FACTS Balance

___ Charge Total Amount to Credit Card

___ Shuttle – No Charge

- - - - - - - - - - - - - - - - - - - -

2.5% administrative fee will be added

If Credit Card:

 

Name on Card:__________________________________________ Amount to be charged: $ _________+2.5%

Card Number:___________________________________________ Expiration Date:___________________

Signature:______________________________________________________ Date:___________________

By providing your electronic signature (typing your name in the box above), you give JPDS-NC permission to charge your credit card for the total amount indicated plus the 2.5% administrative fee.

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