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Title One Schools: Ditch Safety Pass Request Form

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Applicant Information
Please provide your full name; first and last
Please provide your position at your school
Please provide the name of your school
Use postal abbreviation.
Total Students
Provide total number of students at the school receiving swim passes
Please provide passes to students who will take advantage of a free pool day this summer. If sending the passes home in the students backpack, please inform the parents of the free swim pass.
Quantity of Passes

Please provide a count of how many passes you will need for your school.

There is a maximum of 500 per school. Please use your total number of students as a guide for calculating the amount of passes desired. Keep in mind, these are one time use passes.
Please pick up passes from the Parks and Recreation Admin office located at 1801 4th St NW - Building A, Albuquerque, NM 87102. If you are unable to pick up your requested passes we can mail them. Please indicate below: