Gray/Clinton Methodist Van/Bus Request Form
Today's Date
Full Name of Person filling out this form:
First Name
Last Name
E-mail
Phone Number
-
Area Code
Phone Number
Which Group/Club/Organization is Requesting Vehicle Use:
Intended Use:
Approved Driver (s)
Date Needed
*
-
Month
-
Day
Year
Date
Additional Date Needed (ex: camp pick- up)
-
Month
-
Day
Year
Date
Time to Check out Vehicle:
Please Select
7AM
8AM
9AM
10AM
11AM
12PM
1PM
2PM
3PM
4PM
5PM
6PM
7PM
8PM
9PM
10PM
Estimated Return Time:
Please Select
7AM
8AM
9AM
10AM
11AM
12PM
1PM
2PM
3PM
4PM
5PM
6PM
7PM
8PM
9PM
10PM
Which Vehicle Would You like to Reserve:
Please Select
Veh. 1 - *33 Passenger Bus
Veh. 2 - 15 Passenger Mini Bus
Veh. 3 - 14 Passenger Mini Bus
If you need more than 1 vehicle use this option-Check ones needed:
Vehicle 1 33 Passenger Bus*
Vehicle 2 15 Passenger Mini Bus
Vehicle 3 14 Passenger Mini Bus
Who is paying for the Gas:
Please Select
Individual/Passengers using vehicle
Group/Club using vehicle (ie: Emmaus, Senior Adults,
*Youth Budget
*Choir Budget
*Children's Budget
*Must be approved by heads of these programs
* Bus Driver must have a commercial license with passenger endorsement.
Appointment
Submit
Should be Empty: