BELLEVIEW UNITED METHODIST CHURCH

Located at 5640 SE Brown Road, Belleview FL 34420

Mailing Address: P. O. Box 567, Belleview FL 34421
Phone: (352) 245-2100 * Fax: (352) 245-2130
Email: bumcoffice@embarqmail.com
Website: http://www.belleviewumc.net

Church Bus - Use Request Form

PLEASE PRINT ALL INFORMATION
Date filled out

20

Name of Group or Organization

Name of person requesting use
Signature:
Home phone

Cell phone

Brief description of need:

Dates requested: From

To

Number of people being transported:

Destination (city and state):
Approximate number of miles (round trip):
Approved drivers:

You are responsible for returning the bus with a full tank of gas.
You are responsible for filling out the pre-departure walk around form and the trip log.
Office Use Only
Disposition of Church Officials and/or Pastor
Approved
Disapproved

Official Signature:

Date: