Chartered Shuttle Service Request Form

Chartered Shuttle Service Request Form
For instructions, visit Chartered Shuttle Services.
Requester Information
Department or Organization*
Name*

First NameLast Name
Email*
example@example.com
Phone (Work)*
Please enter a valid phone number.
Phone (Mobile)*
Please enter a valid phone number.
Billing Information
$97.98/hour. Billable hours begin with a minimum 30-minute pre-trip vehicle inspection and end when driver returns to First Transit. Charter must be reserved for a minimum of 4 hours. A 48 hour cancellation notice is required to avoid charges. In the case of a less than 48 hour cancellation, a minimum of 1 hour will be charged. Rates are subject to change.

Banner Org manager's approval is required. Approval may be emailed to Nina Cote at coten1@southernct.edu.
Banner Org #1*
Amount*
Banner Org #2
Amount
Banner Org #3
Amount
Anticipated Cost Not to Exceed
Minimum cost is $391.92 (4 hours @ $97.98/hr)
Charter Information
Charter Name*
Date Charter Needed*

MonthDayYear
Date
Two types of buses are available:
- Bus A can accommodate 20 passengers or 16 passengers + 2 wheelchair passengers.
- Bus B can accommodate 8 passengers or 6 passengers + 2 wheelchair passengers.
Number of A Buses
Number of B Buses
Pickup Location*
Start Time*

Hour Minutes

AM/PM Option
Destination*
End Time*

Hour Minutes

AM/PM Option
Additional Information and Instructions
Should be Empty:

Requester Information