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Glenbard Township High School District 87
Policy 4:110-E1

Operational Services


Exhibit – Bus Accident/Incident Form

School: _________________________________________  Date/Time of Incident: ______________________

Bus Company: ____________________________________ Bus/License Plate #: _______________________

Street address and city where accident occurred: _________________________________________________

Bus #, Route #, Type of bus: _________________________________________________________________

________________________________________________________________________________________
             
Driver Name & # of years experience: __________________________________________________________

What type of damage to vehicles: _____________________________________________________________

________________________________________________________________________________________

Names of Adult Witnesses: __________________________________________________________________

________________________________________________________________________________________

Description of accident (how serious?): _________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Road conditions/weather at the time: ___________________________________________________________

________________________________________________________________________________________

Who was involved in the accident/incident?
(Number of students/teachers/advisors)

________________________________________________________________________________________

________________________________________________________________________________________

Injuries involved: __________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________


_____________________________           _________________________________________
Date                                                                  Administrator Completing Form


Email completed form to Bob Verisario, Director of Building & Grounds at bob_verisario@glenbard.org as soon as possible.