This is the Faith SDA Church Transportation pickup request form. Please use this form to request pickup for church services or events.

This form must be filled out and submitted no later than noon (mid day) on Friday's for Sabbath services.

Please fill out all required fields on the form and submit.

Note that if your plans change and you no longer need pickup, please call 1-860-578-4206 and speak to an attendant or leave a message with your cancellation.

Date Request was Entered

mm/dd/yyyy

Name of Person Requesting Pickup*

First

Last

Enter the Pickup Address*

Address 1

Address 2

City

State

Postal Code

Country

Phone Number of Person Requesting Pickup*

Email Address of Person or Department Requesting the Church Bus

Requested Pickup Date*

mm/dd/yyyy

Pickup / Drop-off Time

Is this a recurring request?*If this is a recurring request please choose the appropriate function.

Yes

No

If more than 5 persons, please state how many passengers

Number of Wheelchair Passengers*

None

One (1)

Two (2)

More than 2

Special Event / Trip DetailsInclude details (including destination address for special events) in an attachment to transport@faithsdachurch.org

Church Transportation Pickup Request