TATE COUNTY SCHOOL DISTRICT

BUS PERMIT APPROVAL SHEET

Permit
Number

_________________

Circle one: FIELD TRIP OR ATHLETIC TRIP

Date of Request:__________________________ Requesting

School:__________________________

Teacher(s) Requesting:____________________________
Grade/Class/Club__________________________

Bus No.:_________________________ Name of

Driver:____________________________

Destination:_______________________________________________________________________________

Route:___________________________________________________________________________________

________________________________________________________________________________________

Number of traveling students:________________

Supervisor(s):______________________________ __________________________________

_______________________________
__________________________________

Departure Date:____________________________ Return

Date:_______________________

Departure Time:___________________________ Return

Time:_______________________

Departure Site:_____________________________ Return

Site:________________________

Signature of Instructor:_______________________________________
Date:____________________

Signature of Principal:________________________________________
Date:____________________
Signature of Superintendent:_______________________________
Date:________________

Driver’s Actual Depart Time: _____________________________ Return

Time__________

Odometer Reading: Beginning:___________ Ending: ___________ Miles:

___________

Bus permit approvals should be sent to the central office

3 days prior to the departure date.
Be advised: In house mail isn’t always on time.
You may need to make pickup arrangements to receive your permit before
your departure date.
Fax forms to: 662-562-8516 * Please use separate forms for each bus needed.