Independent Trip Request Form

Member Resources

If you are interested in requesting approval for a Carpool Rotation or Independent Trip, please complete the form below. You will receive an emailed copy of your submission.

Please review the Carpool Rotation and Independent Trip Policy (See section 10.11.2, Carpool Rotation and Independent Trip Policy) for information on eligibility and requirements. Under this policy, members must complete four (4) carpool trips before becoming eligible to request one (1) independent (solo) trip.

After the solo trip is used, the next four trips must again be completed by carpool before another independent trip may be approved. A maximum of two trips per fiscal year will be covered, and members are responsible for providing verification of attendance at meetings that required a carpool.

Your information

First name *

Last name *

Street address *

City/Town *

Province *

Postal code *

Phone number (work) *

Phone number (personal) *

Email address *

Independent Trip Request

(Per Policy 10.11.2.2 – one independent trip may be requested after four completed carpool trips.)

Name of meeting/event *

Location *

Date(s) of event *

Verification of Required Carpool Trips

(Per Policy 10.11.2.1–10.11.2.4, four completed carpool trips are required before requesting an independent trip. Verification of attendance is required.)

I verify that I have completed the following four (4) carpool trips in the current fiscal year:

Carpool Trip #1 *

Location *

Date(s) *

Carpool Trip #2 *

Location *

Date(s) *

Carpool Trip #3 *

Location *

Date(s) *

Carpool Trip #4 *

Location *