Transportaton Request Form

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REVISED (05-27-14)
St. Paul African Methodist Episcopal Church
TRANSPORTATON REQUEST FORM
85 Bishop Allen Drive, Cambridge, MA 02139
(617)-661-1110
Rev. Ellis I. Washington, Pastor/Teacher
Bro. Winston Marshall, Chair – Transportation Committee
INSTRUCTIONS – (TO RESERVE MINI –BUS)
1. A Request Form must be submitted for each trip and placed in the Transportation Ministry Mail Box
2. Each Form must be approved by the Transportation Committee
3. DRIVERS FOR TRIPS TO BE CONFIRMED BY COMMITTEE MEMBERS ONLY!
4. A copy of this form will be placed in the Ministry/Organization mail box upon approval.
THIS SECTION TO BE COMPLETED BY ORGANIZATION
NAME OF ORGANIZATION___________________________________________________________________________
NAME OF DRIVER
_________________________________________________
(To be completed by Transportation Committee)
Date of Trip:_______________ Organization Representative Name___________________________________________
Departure Time:_____________Return Time:______________ Destination____________________________________
Number of Riders:___________ Organization’s Chairperson__________________________________________________
Date Submitted:___________________________________
Time:________________________________________
Comments: ________________________________________________________________________________________
__________________________________________________________________________________________________
Approved by:_______________________________________________________________________________________
(Either Organization’s Chair or Representative’s Signature)
_________________________________________________________________________________________________
THIS SECTION TO BE COMPLETED BY TRANSPORTATION COMMITTEE
Date Received:___________________________________Date Acknowledged:__________________________________
(Notification to Organization)
Comments_________________________________________________________________________________________
__________________________________________________________________________________________________
Approved by:__________________________________________________ Date Approved_______________________
(Form must be approved and signed by a member of Transportation Committee before trip can commence)*
Driver Assigned________________________________Gas (Start)_________________ Gas (Return)_________________
Mileage (Start of trip)________________________Mileage (Return from Trip)_____________Total Mileage_________
Time (Start)____________________Finish_____________________Total Time__________________________________
Driver’s Signature__________________________________________________Date______________________________
*All inquiries should be directed to either Bro. Winston Marshall, Sis. Cynthia Harris, Sis. Charlotte Nelson in this order. DRIVERS
SHALL SIGN FORM AND RECORD GAS AND MILEAGE CALLED FOR ON THE FORM – RETURN COMPLETED COPY TO TRANSPORTATION
COMMITEE’S MAILBOX.
To God Be the Glory!
Please Note: No trip shall commence without the completion and approval of this form!

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