Special Event Transportation Request Form

Special Event Transportation Request Form
Trip Name:*
Contact Name:*
Phone Number:*
Please enter a valid phone number.
Other Phone Numbers (if applicable):
Email:*
example@example.com
Number of Passengers:*
Departure

Pick Up Details
Departure Date:*

MonthDayYear
Date
Departure Time:*

Hour Minutes

AM/PM Option
Departure Location:*
Departure Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Drop Off Details
Destination Name:*
Destination Address (Physical address that can be used for mapping):*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Notes:*
Return

Pick Up Details
Departure Date:*

MonthDayYear
Date
Departure Time:*

Hour Minutes

AM/PM Option
Passenger Loading Location:*
Drop Off Details
Destination Name:*
Destination Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Notes:*
Please read the following and sign below:

Charter rate is $75.00 per hour with a 3-hour minimum. We will send you an estimate for the charter and once the service is completed we will send an invoice. Invoices and charges to be paid by requesting department.

Departments agree to pay the full invoice for charters cancelled within 3 working days of the start date. NOTE: Additional charges will be incurred if you exceed the time allotted for any reason and the department agrees to pay the hourly charge. All times are calculated for 30 minutes prior to and following the charter for required pre- and post-trip inspections.

I have read and understand the above. I agree to the charges. All dates and times are correct unless noted.

ANY AND ALL CHANGES CAN ONLY BE REQUESTED BY EMAIL (shuttleservice@bgsu.edu) - PLEASE NO CHANGES BY PHONE OR IN PERSON
Signature*

Clear
Print Signature:*

First NameLast Name
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Should be Empty:

Special Event Transportation Request Form

Departure

Return