Email Address

Today’s Date

Name

Address

Name

Driver Name for this trip

Phone

Number of People Who Will Be in the Bus During Use Number of People Who Will Be in the Bus During Use Up to 17 up to 16 Less than 17

Are Drivers over 25 Are Drivers over 25 Yes No

Date(s) of Requested Use

Date of Bus Return

Type of Licence: You must have D1 Above Type of Licence: You must have D1 Above Category B Category D1 Category D1E

Sorry u can not drive the Bus with that Licence

Do you have Insurance to Drive Bus Do you have Insurance to Drive Bus Yes No

Insurance Cover: You cover the Bus to drive it Insurance Cover: You cover the Bus to drive it Comprehensive Third Party

Are u Able to submit your licence Are u Able to submit your licence Yes No

Are you a church member Are you a church member Yes No

Sorry we are unable to process your Request

Types of member Types of member Pastor Deacons or Deaconesses Workers Member

Agreement: Please download and read the Policy : By Ticking the box below, the Applicant states that he/she (1) has reviewed the Church Bus Policies and Guidelines and agrees to abide by them at all times during bus usage,

Description of Activities

Agreement Agreement Yes No