Student Transportation in Private Vehicles Form

Student Transportation in Private Vehicles Form

This form is to be completed and forwarded to the Assistant Superintendent of Schools whenever
a private vehicle is used for a school-sponsored activity.

School ___________________________________ Date ________________________

Driver’s Name _________________________________________________________

Driver’s Age ____________ Time of Activity: ___________ Leave ___________

Year and Make of Vehicle __________________ Return ______________________

Purpose of Activity ______________________________________________________

Number of students ________ Destination ______________________________

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Signatures of the adult and principal on this form indicate that all procedures found in district
policy have been followed. Verification of vehicle safety, driver’s license and insurance
requirement will be made by the school principal.

In addition, a letter explaining the activity will be forwarded to the parent of each student
involved which will be returned to the school with the parent’s signature.

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Adult Driver ___________________________________________________________

Principal ______________________________________________________________

Assistant Superintendent ________________________________________________