Academic Support Vehicle Preference Form

This form must be returned if you are planning to claim travel expenses.

Semester: (Use format AF99, AS00, A300) 
Instructor (assigned driver): Email address:

Class Days:   Class Times:   Class Location:   Dept/Course/Section:
1
   
2
   
If #2 departure days, times, or location are different, please fill out a separate form. 
I will use my own vehicle.      License Plate Number: 
 
Reserve a state vehicle for me.
Only for these dates:

 

 
For all  weeks.
Beginning on (date) 
Click appropriate days.
S
M
T
W
TH
F
S
Important:
If you are not going to use the vehicle, you must cancel your
reservation at least 24 hours in advance by email
(Transportation Services) or fax (4975).You will not be reimbursed for mileage if you fail to cancel. 
 NEW REQUIREMENT!
You must complete  a Vehicle Use Agreement  and a Driver's License Record Check Authorization before you will be allowed to use a Motorpool Vehicle.  Forms are available at Motorpool or  Risk Management.
(Required Motorpool/Risk Management Forms)

Depart Time:   Return Time:

 

Special Instructions

Last Modified:08/02/07 at 09:33:35 AM