Head Start Bus Maintenance Form

Missouri Ozarks Community Action, Inc
Head Start

Vehicle Maintenance Request

Vehicle Number :

Please indicate the priority:

Emergency (Health and Safety)
High
Moderate
Low

Vehicle Mileage :

Type of request:

Routine Scheduled Maintenance (Specify)
Safety Systems Repair (Specify)
Other Repair (Specify)
Other (Specify)

Describe Maintenance Need: Please indicate all work needed

Your e-mail address:

Your Name :

Center:

Your request will be sent to the Program Director and Bus Supervisor. You will receive an email receipt for this request.