Transportation Bus Request Form (07.01.25)

Transportation Bus Request Form

TRANSPORTATION BUS REQUEST INFORMATION
Organization's Name*
Event Description*
Event Start Date*

MonthDayYear
Date
Departure Time*

Hour Minutes

AM/PM Option
Event End Date*

MonthDayYear
Date
Return Time*

Hour Minutes

AM/PM Option
The Event End Date cannot be before the Event Start Date!*
Drop Off Location
Drop Off Location (Name)*
Example: Liberty Science Center
Drop Off Location (Address)*
Example: 123 Main Street
Drop Off Location (City)*
Drop Off Location (Other City)*
Drop Off Location (State)*
Drop Off Location (Zip Code)*
Pick Up Location
Pick Up Location (Name)*
Example: Liberty Science Center
Pick Up Location (Address)*
Example: 123 Main Street
Pick Up Location (City)*
Pick Up Location (City Other)*
Pick Up Location (State)*
Pick Up Location (Zip Code)*
Bus Request and Estimated Cost
Number of Attendees*
Estimated Bus Cost
Estimated Driver Cost
Estimated Total Cost
Kindly choose the category of passenger buses you prefer*

54 Passenger39 Passenger29 Passenger24 Passenger
How many 54 Passenger bus?*
How many 39 Passenger bus?*
How many 29 Passenger bus?*
How many 24 Passenger bus?*
Additional Comments

REQUESTOR’S CONTACT INFORMATION
Requestor's Name*

First NameLast Name
Title*
Requestor's Email Verification
Your email requires verification before submission.
1. Please input your email address below.
2. Click the Verify Email button.
3. An email will be sent to you. Please make sure you check your spam or junk mail.
4. Check your email then copy and paste the verification code into the box and click Confirm Code.
Sample Email:
Email Validator*
Office Phone #*
Please enter a valid phone number.
Mobile Phone #*
Please enter a valid phone number.

SUPERVISOR’S INFORMATION
Supervisor's Name*

First NameLast Name
Supervisor's Title*
Supervisor's Email*
Supervisor's Office Phone #*
Please enter a valid phone number.
Supervisor's Mobile Phone #*
Please enter a valid phone number.

TRANSPORTATION REQUEST REMITTANCE INFORMATION
Name of person responsible for transportation request payment*

First NameLast Name
Organization's Billing Street Address*
Organization's Billing Street Address 2
Organization's Billing City*
Organization's Billing City (Outside Hudson County)*
Organization's Billing State*
Organization's Billing Zip Code*

SIGNATURE
Signature
By requesting use of HCST transportation you are responsible to enforce all of the state and federal regulations with respect to the use of this transit and furthermore by accepting the use of this equipment you agree that you or your organization will be solely responsible to defend and indemnify the Hudson County Schools of Technology in the event that a COVID related claim is made as a result of your use.
Name*

First NameLast Name
Signature*

Clear
Date*

MonthDayYear
Date

SUBMIT
Telephone (201) 662-6581 or (201) 662-6583 | One High Tech Way | Secaucus, NJ 07094

Mission Statement
We are an innovative, collaborative and diverse community that empowers lifelong learning by educating students for careers.

“IT IS THE POLICY OF THE BOARD OF EDUCATION OF THE HUDSON COUNTY SCHOOLS OF TECHNOLOGY NOT TO DISCRIMINATE IN EMPLOYMENT OR EDUCATIONAL OPPORTUNITY AGAINST ANY PERSON BY REASON OF RACE, COLOR, NATIONAL ORIGIN, ANCESTRY, AGE, SEX, AFFECTIONAL OR SEXUAL ORIENTATION, MARITAL STATUS, LIABILITY FOR SERVICE IN THE ARMED FORCES OF THE UNITED STATES, OR ATYPICAL HEREDITARY CELLULAR OR BLOOD TRAIT OF ANY INDIVIDUAL, IN EMPLOYMENT OR IN EDUCATIONAL OPPORTUNITIES. FURTHER STATE AND FEDERAL PROTECTION IS EXTENDED ON ACCOUNT OF DISABILITIES, SOCIAL OR ECONOMIC STATUS, PREGNANCY, CHILDBIRTH, PREGNANCY-RELATED DISABILITIES, ACTUAL OR POTENTIAL PARENTHOOD, OR FAMILY STATUS.” Inquiries regarding affirmative action, discrimination (including Title IX requirements), sexual harassment or equity should be directed to: Alicia Abraham Affirmative Action Officer/504 Officer/Title IX Coordinator Hudson County Schools of Technology One High Tech Way, Secaucus, NJ 07094 201-662-6724 or Email: aabraham@hcstonline.org

Organization's Name Completed
Event Start Date and Departure Time for Calendar

MonthDayYear
Date
Hour MinutesAM/PM Option
Event End Date and Return Time for Calendar

MonthDayYear
Date
Hour MinutesAM/PM Option
Drop Off Location*
Pick Up Location*
54 Passenger Bus Concatenate
39 Passenger Bus Concatenate
29 Passenger Bus Concatenate
24 Passenger Bus Concatenate
Number of Buses Requested
Requestor's Email
Transportation Remittance Name
Billing City
Transportation Remittance Address
Transportation Remittance City State Zip
Signature Name
Transportation Staff Concatenate
Board Secretary
Business Administrator

Transportation Department's Approval
TRANSPORTATION BUS REQUEST # {transportationRequest3}
Date of Request: {date}

TRANSPORTATION REQUEST INFORMATION
Organization's Name: {organizationsName}
Event Description: {eventDescription}
Event Start Date: {eventStart}
Departure Time: {departureTime}
Event End Date: {eventEnd}
Return Time: {returnTime}
Drop Off Location: {dropOff}
Pick Up Location: {pickUp}
Number of Attendees: {numberOf}
Number of Buses Requested: {numberOf24}
Additional Comments: {additionalComments}

REQUESTOR’S CONTACT INFORMATION
Requestor's Name: {requestorsName}
Title: {title}
Email: {requestorsEmail}
Office Phone #: {officePhone}
Mobile Phone #: {mobilePhone}

SUPERVISOR’S INFORMATION
Supervisor's Name: {supervisorsName}
Supervisor's Title: {supervisorsTitle}
Supervisor's Email: {supervisorsEmail}
Supervisor's Office Phone #: {supervisorsOffice}
Supervisor's Mobile Phone #: {supervisorsMobile}

TRANSPORTATION REQUEST REMITTANCE INFORMATION
{nameOf}
{transportationRemittance51}
{transportationRemittance52}
Transportation Department
Vehicle Driver Availability?*

YesNo
Transportation Staff's Name*

Felix Henriquez, Assistant Supervisor of TransportationLeigh Ann Spatz, Chief DispatcherScott Winter, Chief DispatcherOther
Transportation Staff's Email*
Transportation Department - Today's Date*

MonthDayYear
Date

Transportation Supervisor's Approval
TRANSPORTATION BUS REQUEST # {transportationRequest3}
Date of Request: {date}

TRANSPORTATION REQUEST INFORMATION
Organization's Name: {organizationsName}
Event Description: {eventDescription}
Event Start Date: {eventStart}
Departure Time: {departureTime}
Event End Date: {eventEnd}
Return Time: {returnTime}
Drop Off Location: {dropOff}
Pick Up Location: {pickUp}
Number of Attendees: {numberOf}
Number of Buses Requested: {numberOf24}
Additional Comments: {additionalComments}

REQUESTOR’S CONTACT INFORMATION
Requestor's Name: {requestorsName}
Title: {title}
Email: {requestorsEmail}
Office Phone #: {officePhone}
Mobile Phone #: {mobilePhone}

SUPERVISOR’S INFORMATION
Supervisor's Name: {supervisorsName}
Supervisor's Title: {supervisorsTitle}
Supervisor's Email: {supervisorsEmail}
Supervisor's Office Phone #: {supervisorsOffice}
Supervisor's Mobile Phone #: {supervisorsMobile}

TRANSPORTATION REQUEST REMITTANCE INFORMATION
{nameOf}
{transportationRemittance51}
{transportationRemittance52}
Transportation Department's Approval
Vehicle Driver Availability: {vehicleDriver}

Approved By: {transportationStaffs}

Approval Date: {transportationDepartment77}
Transportation Supervisor
Transportation Supervisor - Do you Approve or Deny this request?*

ApproveDeny
Transportation Supervisor's Name*
Transportation Supervisor's Email*
Transportation Supervisor's Signature*

Clear
Transportation Supervisor - Today's Date*

MonthDayYear
Date

Transportation Staff to Input
Bus Request Status*
# of Buses*
Rate $*
Total Driver Hours*
Other $*
If none, input 0
Amount*
Transportation Notes
Select the Transportation Staff who completed these notes*

Felix Henriquez, Assistant Supervisor of TransportationLeigh Ann Spatz, Chief DispatcherScott Winter, Chief DispatcherOther

Business Department - Invoice
Transportation Notes Completed By {selectThe}

Bus Request Status: {busRequest}
# of Buses: {Of}
Rate $: {rate}
Total Driver Hours: {totalDriver}
Other $: {other}
Amount $: {amount}

Transportation Notes: {transportationNotes}
Is there a charge?*
No charge as per*

Office of the County ExecutiveNicholas Fargo, Business AdministratorDr. Justyna Flynn, Hudson TechnicalOther
Date Invoiced*

MonthDayYear
Date
Invoice #*
$ Amount Invoiced*
$ Amount Invoiced Calculation
Due Date*

MonthDayYear
Date
$ Gas Price
Accounts Receivable - Invoice Notes
Accounts Receivable - Today's Date*

MonthDayYear
Date

Business Department - Bus Request Payment
Payment Information for Invoice {invoice}

Date Invoiced: {dateInvoiced}
$ Amount Invoiced: {Amount126}
$ Gas Price: {Gas}
Date Check Received*

MonthDayYear
Date
Check #*
$ Amount Received*
$ Amount Received Calculation
Accounts Receivable - Invoice Payment Notes
Should be Empty:

Transportation Bus Request Form

Drop Off Location

Pick Up Location

Bus Request and Estimated Cost

Requestor's Email Verification

Signature

Transportation Department's Approval

Transportation Department

Transportation Supervisor's Approval

Transportation Department's Approval

Transportation Supervisor

Transportation Staff to Input

Business Department - Invoice

Business Department - Bus Request Payment