JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Lane Transit District TouchPass Application
If you want your child to receive a free District-provided LTD pass, you must complete the form below. Please submit one form for each of your middle school children.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Date
*
MM
/
DD
/
YYYY
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student's Grade Level
*
6th Grade
7th Grade
8th Grade
Required
Parent First Name
*
Your answer
Parent Last Name
*
Your answer
I give permission for my child to receive a free LTD TouchPass card. I understand that my child will receive a card which provides free rides on Lane Transit District buses. I certify that I have the authority to provide this consent. (Please type your full name below to show you agree to these terms.)
*
Your answer
Bethel School District will charge a $3.00 replacement fee to replace lost passes.
*
I understand there will be a replacement fee for lost passes.
Required
This program expires in September. If you would like your child to receive a new pass for the next school year, please respond below.
Yes
No
Maybe
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Bethel School District.
Report Abuse
Forms
