Charter Request - Department of Transportation University of Maryland


CHARTER REQUEST FORM
CUSTOMER INFORMATION First name Looks good! Last name Looks good! Address Please provide a valid address. City Please provide a valid city. State Please select a valid state. Zip Please provide a valid zip. Phone Please provide a valid phone. Email Please provide a valid name. Department Please provide a valid department name. Respresentative Please provide a valid name. Billing Contact Name Please provide a valid name. Phone Please provide a valid phone. Billing Contact Email Please provide a valid email. Charter Contact Name Please provide a valid name. Phone Please provide a valid name. Email Please provide a valid name. COACH Select Bus SMALL TRANSIT: SPRINTER Select Bus SMALL TRANSIT: SUV Select Bus LARGE TRANSIT BUS Select Bus SMALL TRANSIT:MINIBUS Select Bus SMALL TRANSIT: VAN Select Bus From Date To Date Purpose Please select a valid reason. Other Purpose Looks good! Number of Passengers Please provide a valid number. PICKUP ANY SPECIFIC PICKUP INSTRUCTIONS OR DETAILS PICKUP DATE PICKUP TIME NAME/TITLE OF PLACE Please provide a valid name. ADDRESS Please provide a valid address. CITY Please provide a valid city. STATE Please select a valid state. Zip Please provide a valid zip. DROP-OFF ANY SPECIFIC DROP-OFF INSTRUCTIONS OR DETAILS NAME/TITLE OF PLACE Please provide a valid name. ADDRESS Please provide a valid address. CITY Please provide a valid city. STATE Please select a valid state. ZIP Please provide a valid zip. RETURN PICKUP ANY SPECIFIC RETURN PICKUP INSTRUCTIONS OR DETAILS RETURN PICK UP DATE RETURN PICK UP TIME NAME/TITLE OF PLACE Please provide a valid name. ADDRESS Please provide a valid address. CITY Please provide a valid city. STATE Please select a valid state. Zip Please provide a valid zip. RETURN DROP-OFF ANY SPECIFIC RETURN DROP-OFF INSTRUCTIONS OR DETAILS RETURN DESTINATION DATE RETURN DESTINATION TIME ADDRESS Please provide a valid address. CITY Please provide a valid city. STATE Please select a valid state. Zip Please provide a valid zip. SPECIAL INSTRUCTIONS Please list any details you feel are necessary to your trip or would provide clarity for planning purposes. If ADA accommodations are required, please provide notice with your request. For airport transportation, please include: Airport Name, Airline Name, Flight Number, Flight Departure or Arrival Time, Flight Origin City or Destination City / Airport Codes Payment Option KFS Account Number (University Only) Check/Credit Card/RSTARS - You will be contacted for payment information Please provide a valid number. Submitting this form represents a request for an estimate for charter service. A member of the Charter Department will contact you with this information. Service will not be provided until a contract is signed You must agree before submitting.

CHARTER REQUEST FORM

CUSTOMER INFORMATION

First name

Looks good!

Last name

Looks good!

Address

Please provide a valid address.

City

Please provide a valid city.

State

Please select a valid state.

Zip

Please provide a valid zip.

Phone

Please provide a valid phone.

Please provide a valid name.

Department

Please provide a valid department name.

Respresentative

Please provide a valid name.

Billing Contact Name

Please provide a valid name.

Phone

Please provide a valid phone.

Billing Contact Email

Please provide a valid email.

Charter Contact Name

Please provide a valid name.

Phone

Please provide a valid name.

COACH

Select Bus

SMALL TRANSIT: SPRINTER

Select Bus

SMALL TRANSIT: SUV

Select Bus

LARGE TRANSIT BUS

Select Bus

SMALL TRANSIT:MINIBUS

Select Bus

Our minibus seats 29 passengers, with space for up to 14 standing passengers (43 total). Standing passengers are only allowed within the immediate campus area on roads with speed limits not exceeding 40 mph. This vehicle is available for single-day use only and cannot travel beyond a 50-mile radius of College Park.

SMALL TRANSIT: VAN

Select Bus

From Date

To Date

Purpose

Please select a valid reason.

Other Purpose

Looks good!

Number of Passengers

Please provide a valid number.

PICKUP

ANY SPECIFIC PICKUP INSTRUCTIONS OR DETAILS

PICKUP DATE

PICKUP TIME

NAME/TITLE OF PLACE

Please provide a valid name.

ADDRESS

Please provide a valid address.

CITY

Please provide a valid city.

STATE

Please select a valid state.

Zip

Please provide a valid zip.

DROP-OFF

ANY SPECIFIC DROP-OFF INSTRUCTIONS OR DETAILS

NAME/TITLE OF PLACE

Please provide a valid name.

ADDRESS

Please provide a valid address.

CITY

Please provide a valid city.

STATE

Please select a valid state.

ZIP

Please provide a valid zip.

RETURN PICKUP

ANY SPECIFIC RETURN PICKUP INSTRUCTIONS OR DETAILS

RETURN PICK UP DATE

RETURN PICK UP TIME

NAME/TITLE OF PLACE

Please provide a valid name.

ADDRESS

Please provide a valid address.

CITY

Please provide a valid city.

STATE

Please select a valid state.

Zip

Please provide a valid zip.

RETURN DROP-OFF

ANY SPECIFIC RETURN DROP-OFF INSTRUCTIONS OR DETAILS

RETURN DESTINATION DATE

RETURN DESTINATION TIME

ADDRESS

Please provide a valid address.

CITY

Please provide a valid city.

STATE

Please select a valid state.

Zip

Please provide a valid zip.

SPECIAL INSTRUCTIONS

Please list any details you feel are necessary to your trip or would provide clarity for planning purposes. If ADA accommodations are required, please provide notice with your request. For airport transportation, please include: Airport Name, Airline Name, Flight Number, Flight Departure or Arrival Time, Flight Origin City or Destination City / Airport Codes

Payment Option

KFS Account Number (University Only)

Check/Credit Card/RSTARS - You will be contacted for payment information

Please provide a valid number.

Submitting this form represents a request for an estimate for charter service. A member of the Charter Department will contact you with this information. Service will not be provided until a contract is signed

You must agree before submitting.

CUSTOMER INFORMATION

PICKUP

DROP-OFF

RETURN PICKUP

RETURN DROP-OFF

SPECIAL INSTRUCTIONS

Our location

UMD DOTS

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