Charter Request and Justification Form

Name of Student Group:

Trip Destination: Date(s):

Reason/Type of Trip:

Staff Point of Contact:

While it is recognized that transporting students is the work of the district bus drivers and the administration continues to support the use of district buses and RSD Bus Drivers for extra trips, it has been agreed that there are times when it may be appropriate to use alternative modes of transportation for extra-curricular trips instead of using district drivers and buses. The agreed upon criteria for this deviation from normal practice is outlined below. Please note the applicable criteria and provide all of the relevant supporting detail to substantiate this request.

q No RSD buses or drivers are available to transport students for the requested trip.

o This criterion is reserved for the Director of Transportation and must be justified in detail based upon fleet and driver availability.

q Funds for the trip have been raised through fundraisers and no district funds are being used for the trip (i.e., student transportation, lodging, etc.)

o Identify funding source and amount for each of the following that are applicable (Please differentiate between curricular budget, ASB general, ASB fundraiser and Booster funds. Also list all fundraiser activities done to support the trip):

§ Registration:

§ Transportation:

§ Lodging:

q Storage of instruments, luggage and personal items is more than the capacity of the district buses and designated trailers.

o Total # of Students: Total # of Adults/Chaperones:

o Luggage Requirements (include number of nights and required uniforms):

o Instrument/Equipment Requirements:

o Additional Instrument/Equipment Transportation Availability:

q Trips to State Playoff competitions.

o Date(s) of Tournament:

Submitted By: Date:

Received By: Date:

q Approved for Charter

q Work Retained by MOT