SCHOOL BUS REQUEST FORM

SCHOOL BUS REQUEST FORM

Bus Capacity: Elementary - 84 Students Middle School - 72 Students High School - 60 Students

DATE OF REQUEST

DATE OF TRIP

Requisition Number:

Transportation Use Only

SCHOOL/DEPARTMENT REQUESTING BUS

NAME OF PERSON REQUESTING BUS

PHONE NUMBER/EXT AUTHORIZING SIGNATURE

GROUP OR CLASS REQUESTING TRIP

PROGRAM - FUNCTION - LOCATION - OBJECT

Account Number:

Trips must have a valid account number or billing information before they will be scheduled.

TRIP INFORMATION

# OF

# OF

STUDENTS ADULTS

WILL THERE BE WHEELCHAIRS?

YES

NO

SCHOOL OR ALTERNATE PICK-UP LOCATION

# OF WHEELCHAIRS

TIME TO TIME TO

PICK-UP AT DROP OFF AT

SCHOOL

SCHOOL

WILL THE GROUP NEED STORAGE?

YES

NO

SPECIAL INSTRUCTIONS:

DESTINATION(S)

DATE FORM RECEIVED TRIP #

FOR TRANSPORTATION DEPARTMENT USE ONLY:

TRIP HOURS

$

TOTAL AMOUNT DUE

TRIP MILES

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