Transportation Video Request Form

Video request fulfillment priority:

1st - Student injury/assault/abuse - Video pulled & sent to requesting parties same day

2nd - Student management or behavior - 1 - 2 business days

3rd - Bus stop investigation/seating issue/non-violent altercation - 1 - 3 business days

Please complete the following questions below:

Incident Reporting

Name of Student (s) Involved

Date of Incident

Time of Incidents

Please indicate at least one (1) time selection. Format HH:MM (footage will be plus/minus 10 min from the time indicated.

1- time incident

2- time incident

3- time incident

Requesting School

Name of School

School Contact Name

School Contact Phone Number

Vendor Name

Type of Service

AM OnlyPM Only

Is this video request due to a Student Behavior Incident?

YesNo

What is the Student Behavior Incident ticket #?

Incident Description

Submitter's Name

Submitter's email address