Request to book the District Minibus
User's name
*
First Name
Last Name
User's Email
*
example@example.com
Name of organisation
Invoice address
*
Street Address
Street Address Line 2 (or n/a)
City/Town
County
Post Code
Email address for invoice
*
example@example.com
User's home telephone number
-
Area Code
Phone Number
User's mobile telephone number
*
Date required from
*
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date required to
*
-
Day
-
Month
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Destination
*
Purpose
*
Driver 1
*
First Name
Last Name
Hertfordshire County Council mini-bus permit held?
*
Yes
No
Driving licence class D1 held?
*
Yes
No
Driver 2
First Name
Last Name
Hertfordshire County Council mini-bus permit held?
*
Yes
No
Driving licence class D1 held?
*
Yes
No
GDPR statement
*
I agree to the personal information I have supplied to be used in connection with this booking.
Disclaimer
*
I have read and understood the rules in relation to the use of the minibus. I agree to returned it on time, clean (both inside and out) and refuelled to maximum with diesel.
Please verify that you are human
*
If this form fails to submit, please check that you have completed all required fields.
Submit
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