SWOSTS EmergencyReport_Operator

Date & Time

District

School

Operator

Route

Run

Driver

Communicated by

Type of event

Event preventable

Event non-preventable

Lost child

Name

Grade

Child not met at the stop

Name

Grade

Student Manifest

Please provide a route copy clearly indicating which student(s) were on board

Student Injuries

Yes No

School Name	Student Name	Grade	Injury Detail	Hospital released or admitted

Please provide detailed description of event.

Persons advised

	Yes	No
STS Service Coordinator	TechnicianYes	TechnicianNo
STS Manager	STSManagerYes	STSManagerNo
School Staff	SchoolStaffYes	SchoolStaffNo
Parents	ParentYes	ParentNo
Others	SchoolOtherYes	OtherNo

Attachments

Police Report Company Accident / Incident Report

Number

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After clicking on 'Submit Request', the blank required fields are marked with *

Submitted by

Last Name

First Name

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).

School yard	Loading zone	Intersection	Railway crossing
Other

Backing	Left or right turn	Rear-ender	Collision with parked vehicle or fixed object
Other (please specify below)

Clear	Rain	Fog	Snow	Sleet
Other:

Dry	Muddy	Snow covered/slushy	Wet	Icy
Other:

SWOSTS EmergencyReport_Operator

Accident location

Accident type

Damage estimated at less then $1000

Bus Driver charged

Weather Conditions

Road Conditions

Please provide detailed description of event.

Upload

SWOSTS EmergencyReport_Operator

Accident location

Accident type

Damage estimated at less then $1000

Bus Driver charged

Weather Conditions

Road Conditions

Please provide detailed description of event.

Upload

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