Fillable Transportation Request Form (Coastal Alabama Community College)

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Transportation Request Form (Coastal Alabama Community College)

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Transportation Request Form
Other College Vehicle
Charter Bus Services
When College Bus is unavailable or approved
overnight trips or trips longer than 10 hours.
☐
54/56 Pass Bus
☐
Car
☐
SUV
☐
45/47 Pass Bus
☐
Truck
☐
Van
College Motor Coach
Authorized Bus Drivers Only
College Employee *
☐
* College Employee Driving: (Name)
* Attach copy of Driver’s License and CDL (if required)
Campus Departing From:
Campus Returning To:
Date:
Date:
Time:
Time:
Location of Pick-Up:
Location of Drop-Off:
☐
Bay Minette
☐
Atmore
☐
Gilbertown
☐
Bay Minette
☐
Atmore
☐
Gilbertown
☐
Fairhope
☐
Brewton
☐
Jackson
☐
Fairhope
☐
Brewton
☐
Jackson
☐
Gulf Shores
☐
Gulf Shores
☐
FH Airport Acad
☐
Monroeville
☐
FH Airport Acad
☐
Monroeville
☐
Mobile
☐
Thomasville
☐
Mobile
☐
Thomasville
☐
NBCT
☐
NBCT
☐
SBCT
☐
SBCT
Has travel to this event been approved:
☐
YES
☐
NO Approved PO #:
(Please attach a copy of the approved purchase order)
20 Pass Bus (Brewton Only)
20-29 Pass
48-55 Pass
30-47 Pass
AT & BR Campuses
BM, BF, FH & GS Campuses
MV Campus
Jennifer Pollitte, 251-809-1520 Nathan Taylor, 251-202-1236
Jennifer.Pollitte@coastalalabama.edu Nathan.Taylor@coastalalabama.edu
Bryant Turberville, 251-575-8283
Bryant.Turberville@coastalalabama.edu
Send the completed form to the individual below based on your campus location:
Please fill in all applicable information and return to the above named individual that coincides with your
base campus for the transportation request to be reviewed and processed. All transportation requests
should be submitted at least one week in advance with an approved purchase order
Date of Request:
Requested By:
Department:
Purpose of Travel:
Please complete the information requested below:
Type of Vehicle Requested: (Must have more than 15 Passengers to qualify for travel by bus)
Place of Event:
Address of Event:
Dates of Event:
# of Passengers:_________________
or attach a list :_________________________
Office Phone #: __________________ (for bus driver to communicate with you)
:
____________________________
GT & TV Campuses
Will Richerson, 334-637-3144
Will.Richerson@coastalalabama.edu
A
lternate Phone #
Names of Passengers
D
ean of Operations & Maintenance □ 1900 Highway 31 South □ Bay Minette, AL □ 36507
EMERGENCY PROCEDURES POLICY
In the event that an accident/emergency takes place while driving a Coastal Alabama Community
College vehicle, please follow the steps below:
I. In case of an ACCIDENT:
a. Locate the insurance information in the vehicle binder
b. Call law enforcement officials
c. Contact one of the following, per your base campus:
i. Nathan Taylor: (251) 202-1236
Bay Minette, Fairhope, Gulf Shores & Mobile Campuses
ii. Bryant Turberville: (251) 575-8275
Monroeville Campus
iii. Jennifer Pollitte: (251) 809-1529
Atmore & Brewton Campuses
iv. Will Richerson: (334) 637-3144
Gilbertown & Thomasville Campuses
d. If you are unable to reach one of the above, contact Campus Police to deliver the
information and take appropriate action: (251) 580-2222
II. In case of an ACCIDENT with INJURY:
a. Call 911
b. Locate the insurance information in the vehicle binder
c. Contact one of the following, per your base campus:
i. Nathan Taylor: (251) 202-1236
Bay Minette, Fairhope, Gulf Shores & Mobile Campuses
ii. Bryant Turberville: (251) 575-8275
Monroeville
iii. Jennifer Pollitte: (251) 809-1529
Atmore & Brewton Campuses
iv. Will Richerson: (334) 637-3144
Gilbertown & Thomasville Campuses
III. In case of vehicle trouble:
a. Nathan Taylor: (251) 202-1236
Bay Minette, Fairhope, Gulf Shores & Mobile Campuses
b. Bryant Turberville: (251) 575-8275
Monroeville
c. Jennifer Pollitte: (251) 809-1529
Atmore & Brewton Campuses
d. Will Richerson: (334) 637-3144
Gilbertown & Thomasville Campuses
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Transportation Request Form (Coastal Alabama Community College)

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Completed 25 July 2020

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