Date of Request: 

Boiling Springs High School

Person making request:

Departure Date: Departure Time:

The bus will arrive approximately 15 minutes early to allow for loading.

Return Date: Return Time:

Destination:

Estimated Number of Students: Number of Adults:

Driver to be obtained by transportation:Yes No

Driver supplied by requestor:

Driver's Name: License Number:

The driver must be properly licensed to drive the vehicle requested and have the proper documents on file with the transportation office.

Principal's Signature:__________________________________________________

The following equipment will be sent or available as requested:

______Buses and Drivers

______Buses available for pickup by your driver

______Suburban type vehicles for which you must supply properly licensed drivers.

Transportation Official_________________________Date:__________________