Transportation Request

This is the online version of our transportation request form.
We also have a printable version available for mailing.

Please read all instructions before completing the form.

Instructions

Transportation Request Forms must be completed and submitted at least three (3) days before requested date (i.e. for a Sunday pick-up, the deadline is the Thursday before).

Note that this form is only a request and does not guarantee a seat as seating is limited and seats are filled on a first come, first serve basis. Also, at this time our routes are limited to the Conyers, GA area.

Fill in the necessary fields below and submit the form. Required fields are bolded and marked with an asterisk (*). A confirmation email will be sent to the contact email address you provide from the following email address:

Once we have received and reviewed your request we will contact you with an approval decision as soon as possible and (if approved) we will provide more details about your pickup.

Form

Requested Pick-Up Date * mm/dd/yyyy or m/d/yyyy
Your Name *
Your Age * Numbers only
Address (Line 1) * House Number & Street Name
Address (Line 2) Apartment/Building #
City *
State *
Zip Code * First five digits only
Contact Phone Number * Show/Hide Input Format
Contact Phone Number Type *
Contact Email *
Additional Riders Name and age required
Name of Rider #2:	Age of Rider #2 (Numbers only):
Name of Rider #3:	Age of Rider #3 (Numbers only):
Name of Rider #4:	Age of Rider #4 (Numbers only):
Name of Rider #5:	Age of Rider #5 (Numbers only):
Additional Comments
Disclaimer Passengers understand that while van drivers will make every effort to ensure the safety of all travelers, accidents may occur. God's Vision Ministries Church, van drivers, trustees, officers, the pastor, auxiliaries, or affiliated organizations will not be held liable for accidents that may occur. In case of an accident, proper measures will be taken for passengers to receive emergency care. We reserve the right to refuse riders. Unruly riders will be asked to exit the van. The church van is a smoke-free environment. No alcoholic beverages, illegal substances, or weapons are allowed in the van. Riders agree to adhere to the designated route to and from God's Vision Ministries Church.
By checking this box, I certify that I, along with the riders listed above have read, understand, and herby agree to abide by the terms and conditions of the God's Vision Ministries Church Transportation Ministry.

Transportation Request

Instructions

Form

Disclaimer