• Please advise transportation of any changes relating to school bus drivers, change of stops or change of route, etc.
• Students reported must reflect School Board data as of October 31st.

Insurance Agent

Policy Number

Amount of liability insurance

Comprehensive general liability insurance

Yes

No

*

Driver's license

Yes

No

*

Vehicle Registration

Yes

No

*

Driver Information

Staff ID Active

Last Name

First Name

Birth Date (YYYY/MM/DD)

License #

Hire Date (YYYY/MM/DD)

Start Date (YYYY/MM/DD)

Retirement Date (YYYY/MM/DD)

Roles

Driver

Operator

Other

Position

Languages Spoken

Preferred Language

Preferred Phone Home Work Cell

Home Phone

Work Phone

Cell Phone

Fax

CPR / First Aid Certification Expiry

Notes

School Bus Vehicle

Manufacture Seating Capacity 86 Passenger 72 Passenger 66 Passenger 54 Passenger 48 Passenger 36 Passenger 34 Passenger 22 Passenger 20 Passenger 18 Passenger Car/Van

Size of Vehicle paid for 72 Passenger 54 Passenger 54 Wheelchair 20 Wheelchair 20 Passenger Car/Van

Year of Manufacture

Make or Model

School Bus License

Vehicle Registration #

Special Features Car/Van Long nose bus Flat nose bus Wheelchair

Date of Purchase

Odometer kms

GPS ESN Enter "N/A" if not applic.

Pre-school children on vehicle

Yes

No

*

Two way Radio in Bus

Yes

No

*

Phone in Bus

Yes

No

*

Cell # Enter "N/A" if none available.

SINGLE RUN(S)

Mileage is calculated:

A.M.

Loaded: Number of Kms from the first student picked up to the last school.

 kms

Deadhead: Number of Kms from the last school to the first pickup via the shortest possible route.

 kms

P.M.

Loaded: Number of Kms from the school to the last drop-off.

 kms

Deadhead: Number of Kms from the last student's drop-off returning to the school via the shortest possible route.

 kms

TOTAL DAILY KMS

 kms

MULTIPLE RUN(S)

All students are dropped off at the last school of the first route and the bus continues to pick-up the students at the last school of the second route.

Mileage is calculated:

A.M.

Number of Kms from the first pick-up to the last school of the first route.

 kms

Number of Kms to the first pick-up of the last school of the second route.

 kms

Number of Kms from the first pick-up to the second school.

 kms

Number of Kms from the last school back to the first pick-up of the first run via the shortest route.

 kms

P.M.

Number of Kms from the school to the last drop-off of the first run.

 kms

Number of Kms to the second school via the shortest route.

 kms

Number of Kms from the second school to the last drop-off.

 kms

Number of Kms from the last drop-off to the first school via the shortest route.

 kms

Number of Kms, via the shortest possible route between the first school and the last school (will be added once daily).

 kms

TOTAL DAILY KMS

 kms

Information has been verified

Yes

No

Submitted by

Last Name

First Name

Email

Confidentiality Statement

In accordance with the Personal Information Protection and Electronic Documents Act, Article 29, Paragraph (2), personal information requested in this form will assist in providing transportation services. The information is gathered in accordance with the Education Act S.R.O. 1980, c. 129, s.166 (1).