LMUSD Transportation Request
Submit this completed form at least 10 days prior to the date requested
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School Site *
Name of Trip *
Specify sport, field trip etc..
School Group
FFA, Gate, Grade Etc..
Date of Departure *
When do you want to go?
MM
/
DD
/
YYYY
Destination *
Address, Site or Drop Off Location BE SPECIFIC, i.e. Chico State Farm, Main campus etc.
Date of Return *
MM
/
DD
/
YYYY
Total Number of Passengers *
Students, Teachers, Parents
Distance One Way (close approximation) *
All overnight trips, and trips outside the Butte, Glenn, Tehama and Shasta County area require Board approval. Board approval requests must be received by the District Office at least 8 calendar days prior to the next scheduled Board meeting.
Departure Time *
Time
:
Return Time
Time
:
Advisor, Trip Contact *
Intermediate Stop *
Food, Rest Break
If YES, List specific stop location
Type of Vehicle Requested *
E-Mail Address *
Is School Board Approval Required *
All overnight trips, and trips outside the Butte, Glenn, Tehama and Shasta County area require Board approval. Board approval requests must be received by the District Office at least 8 calendar days prior to the next scheduled Board meeting.
If YES, Date approved
MM
/
DD
/
YYYY
Submit
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