The School Board of St. Lucie County, FL
Transportation Department
Pupil Accident Report
FILL OUT THIS FORM COMPLETELY, ANSWERING ALL QUESTIONS.
MAKE OUT THIS REPORT NO MATTER HOW MINOR THE INJURIES
ARE. TURN IN THE REPORT AS SOON AS POSSIBLE. (SAME DAY)
THE REPORT SHOULD BE TURNED INTO THE SAFETY OFFICER.
THANK YOU.
IMPORTANT:
Pupil's Name:
Phone No.:
Address:
Date of Accident:
Bus #:
Pupil Getting On
Enroute to
Age:
Time of Accident:
Sex:
A.M.
P.M.
Weather Condition:
or Off
The Bus.
or From
School.
School Pupil Attends:
Nature of Injury:
State What/How The Accident Happened:
Person Accident Reported To:
White: Safety Officer Canary: Risk Manager Pink: Driver
Driver's Signature:
TRA0007 Rev. 11/09