LMUSD Transportation Request
Submit this completed form at least 10 days prior to the date requested
School Site *
Name of Trip *
Specify sport, field trip etc..
Your answer
School Group
FFA, Gate, Grade Etc..
Your answer
Date of Departure *
When do you want to go?
Your answer
Destination *
Address, Site or Drop Off Location
Your answer
Total Number of Passengers *
Students, Teachers, Parents
Your answer
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.
Your answer
Departure Time *
Time
:
Return Time
Time
:
Advisor, Trip Contact *
Your answer
Intermediate Stop *
Food, Rest Break
If YES, List specific stop location
Your answer
Type of Vehicle Requested *
E-Mail Address *
Your answer
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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