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Bus Use Policy and Request
Policy & Safety Rules

Bus Trip Request Form:

1.
*

Trip Destination:

2.
*

Date(s):

3.
*

Church Group:

4.
*

Purpose of Trip:

5.
*

Estimated Mileage:

6.
*

Driver(s):

7.
*

Driver's DL#:

8.
*

Driver's Date of Birth:

9.
*

Cell Phone #(s):

10.
*

Emergency Contact Phone #:

THE FOLLOWING FOR BUS COORDINATOR ONLY

11.

Approved Drivers

Yes   No
12.

Bus Use Approved

Yes   No
13.

Signed:

14.

Gas Tank Full?

Yes   No
15.

Vehicle returned in proper condition (bus clean)?

Yes   No
16.

Damage?

Yes   No
17.

Comments:

* Enter Your Email Address:

Type in the text that you see above:

  

Bethel Christian Reformed Church
341 South Main
Sioux Center, IA 51250
Phone: 712-722-3101
Fax: 712-722-3081
office@bethelsc.org

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