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Name of person submitting request
Date of request Date you are submitting this form
Date of travel
Destination
Start time of travel
End time of travel
Type of vehicle requested
Number of vehicles requested
Will you be transporting students?
Approximate number of passengers Including adults
Will You need a Driver?
Special Instructions
The Refugio Independent School District is committed to providing an appropriate learning experience for every child in the district, designed to motivate and assist each child in the attainment of his or her maximum potential intellectually, physically, socially, economically, and morally.

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