FACILITIES VAN RENTAL REQUEST

All requests must be received at least 48 hours in advance.  This is required in order to assure
that the van has been properly prepared for usage.  The fee is $10 plus 60 cents per mile.  Please  
contact the Facilities Dept. with questions at x1-8305.

DATE:
DEPARTMENT:
DATE(S) OF USAGE:
DESTINATION:
PICKUP TIME:
RETURN TIME:
ACCOUNT # :
AUTHORIZED DRIVER:
AUTHORIZED DRIVER:


      PERSON(S) DRIVING MUST BE AUTHORIZED TO OPERATE COLLEGE-OWNED VEHICLES.  Please
        complete AUTHORIZATION TO OBTAIN MOTOR VEHICLE RECORD form through the Risk Management
        Department.  APPROVED form must be on file with Risk Management prior to van usage.  Thank You.

       
        Tell us how to get in touch with you:

Name     
E-mail   
Ext.     
FAX

 

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