Broward Form

FIELD TRIP REQUEST FORM (Broward)

Instructions: Please complete this form. Your trip is not confirmed until you receive an e-mail confirming your bus (es).

School/Organization (required) Requestor's First Name (required)
Requestor's Last Name (required) Requestor's E-mail (required)
Group/Team (required) Bookkeepers E-mail (required)
Fax No. (required) Phone No.
Number of Buses (required)
(2 per seat = 43 pass.) (3 per seat = 65 pass.)
Date of Trip (required)
Hours Total $
Minimum Charge $204.00 for 4 Hours, Please add more hours as needed.

Pick-Up Location Name and Address
Pick-Up Location Name Address (required)
City (required) State (required)
ZIP (required) Loading Area (required)
Pick-Up Time
(required)
Person Traveling w/ Group
(First Name) (required)
Person Traveling w/ Group
(Last Name) (required)
Contact Person Emergency
Phone No (required)

Destination Location Name and Address
Location Name (required) Address (required)
City (required) State (required)
ZIP (required) Departure Time (required)
Special Instructions

Payment Information
District PO (required)
Enter PO Number:
School Check
Enter School Check:

I'm paying my invoice online with a credit card (required)
If you click YES we will call you to setup payment.
I'm paying my invoice cash:


One day cancellation notice required to avoid minimum payment of $100.00 USD (PER BUS), the cancellations need to be made during business hour from 8:00 AM to 3:00 Pm Monday thru Friday

THE INSTITUTION AND THE PERSON MAKING THE RESERVATION ARE RESPONSIBILE FOR CANCELLATION PAYMENT.

Cancellations must be done via e-mail ONLY. Phone cancellations will not be accepted.

Changes to the reservations must be done via e-mail ONLY.

A charge of 2.5% will be applied to invoices over 30 days old.

Bus (es) must depart destination at the designated time. Late buses are subject to additional costs.


By signing you agree to the Terms & Conditions.
(Please print name in lieu of signature.)

Requestor's Signature:
Signature Date:

Note: Your trip is not confirmed until you receive an e-mail confirming your bus (es).