MICA CSE Transportation Request Form

Please note that this request form is ONLY to be used by CSE Student Leaders for trips related to club activities and campus events, which MUST be processed and approved by the Center for Student Engagement. All other Transportation Requests should be submitted directly to Tranportation Services.

In order to request a van, shuttle, or school/coach bus, student organizations MUST submit this form a minimum of 30 days prior the date that is being requested.

The Center for Student Engagement (CSE) will review your request and verify that you have adequate funding. CSE will sign and submit your request to Transportation Services for scheduling if approved.

Please note the following about Transportation Requests:

You must include complete addresses, locations, and times. The Price Chart Below shows the different costs for reserving MICA Shuttle Buses. Your MICA department will be charged per the requested MICA vehicle, and vehicles may make multiple runs if the locations are near one other.
For safety reasons, all transportation that MICA provides outside of the Baltimore Beltway (I-695) will be limited to the use of the 25-passenger bus only, pending availability. Trips inside the Beltway may be accommodated by any of our shuttles, pending availability. All transportation needs outside of the Baltimore-Washington Metropolitan area (to places such as PA., DE., VA., etc) will require the use of a bus or coach of an independent contractor, as MICA shuttles cannot travel outside a one-hour travel time range or fifty miles distance. For any trips that require the use of an independent transportation service, your department will be charged the contractor's full fee instead of MICA's flat rate.
Toll roads will not be used. Drivers do not carry cash + shuttles are not equipped with EZ Pass. If a trip organizer want to access a toll road, or one cannot be avoided, trip organizer must supply cash at the time of toll.
To ensure the timeliness and accuracy of your trip, we ask that specific directions be provided to the driver for each trip. One recommendation to provide this information is to print directions from Google Maps.
Please review the trip charge and cancellation policy: All cancellations must be made in writing at least two business days in advance, and will not be accepted over the phone. You may email cancellation notices to transportation@mica.edu. All improper cancellations will result in paying the full price for the requested services.
All requests are processed on a first-come/first-served basis. Once received from CSE, Transportation Services will contact you regarding confirmation or to make adjustments.

Which group is completing this form?*

Which Student Organization is making this request?*

Requested by*

First NameLast Name

Requested by calculation for form so there isn't a space

Requested by:*

Your Full Name

MICA E-mail:*

Your MICA Email Address

Phone Number:*

Your Phone Number

Today's Date:*

Date of Request:*

When do you need a shuttle?

Alternate Date:*

If a shuttle is not available on that date, do you have an alternative?

Department:*

Department Account Code*

Student Organizations should use Department Code: PG51007 Student Organizations /// MICA Program Board should use Department Code: PG10007 Student Programming

Dept. Account Code form calculations / email populates automatically

CSE Staff Signature*

Contact Person on Shuttle Bus:*

Contact Phone Number:*

Contact Email*

This person will receive a scheduling confirmation, if the request is approved.

Number of Passengers:*

Departure Time:*

Departure Time*

Hour Minutes

AM/PM Option

Departure Location (include address, if off-campus):*

Destination (include address, if off-campus):*

Pick-Up Location (include address, if off-campus):*

Time of Pick-up:*

Time of Pick Up*

Hour Minutes

AM/PM Option

Estimated Return Time to MICA (if applicable)

Hour Minutes

AM/PM Option

Estimated Return Time to MICA (if applicable):

Review of Schedule

If you are requesting multiple stops for the shuttle bus, please add bullet points to this schedule, and indicate all of your requested stops. If your schedule requires more than five lines of text in the field below, please attach a full schedule.

Bus Schedule*

If your schedule requires more than five lines of text in the field above, please attach a full schedule.

Any Special Requests? (Multiple stops, two runs with one van, requesting two buses, etc.)

What program/project/activity is this for?*

Attachment (if applicable)

If needed, attach a detailed shuttle schedule, directions, etc.