FIELD TRIP TRANSPORTATION REQUEST
School/School District
Requestor Name
First and last name
Requestor Title/Position
Requestor Email
Requestor Email
example@example.com
Requestor Phone number
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Trip Information
Date of Trip
-
Month
-
Day
Year
Date
# of Passengers
Does your trip have multiple stops/pick-up/drop locations? If you answered Yes, please list each stop below. If you have more than 2 stops, please contact our Office for further assistance.
YES
NO
STOP 1 Pick-Up Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
STOP 1 Pick Up Address Arrival Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
STOP 1 Venue/Facility Name
STOP 1 Drop off Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
STOP1 Return Pick Up Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
STOP 2 Pick-Up Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
STOP 2 Pick Up Address Arrival Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
STOP 2 Venue/Facility Name
STOP 2 Drop off Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
STOP 2 Return Pick Up Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Trip Point of Contact Name/Phone
First and last name
If this request is for students, please specify grade level(s)
Pre-School
K
1
2
3
4
5
6
7
8
9
10
11
12
Other
Parking/Special Instructions
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Signature
To provide the best possible service, we request a detailed itinerary listing all loading points and stops with street addresses and any special directions. Please make any changes before this time. Extensions or changes in service during the charter may result in additional charges. A $100 non-refundable deposit per vehicle per day is due upon booking. The remaining balance is due 10 days prior to the day of service. The $100 deposit is non-refundable and is forfeited with cancellation. Cancellations made less than 3 business days prior to the day of service, will incur a charge of 50% of the charter amount, while cancellations made with less than 24 hours notice will incur a 100% charge. All fees must be paid in full prior to the day of service. Trips returning later than the time scheduled on the charter service agreement will incur a fee of $75 per hour, for each additional hour. Your signature above signifies that you have read and agree to the terms and conditions listed on this charter service agreement.
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