Fleet Vehicle Reservation Form

This form must be submitted prior to the date of the trip in order to confirm your vehicle reservation.

Please Note

  • Use "tab" to move between fields within the form. Pressing the "Return" (or Enter) key on your keyboard will attempt to submit the form (even if it is incomplete).
  • Fields with an asterisk ( * ) are required for the form to submit correctly.

Your Name
*
Your E-Mail
*
Your Phone
*
Vehicle(s) Needed
Date Needed
Date Returned
Destination
*
Number of Passengers
Purpose of Trip
*
Account Number
*
Faculty Member's Approval
I affirm the person(s) listed as driver(s) to be reliable and qualified. I give approval of this trip as being in the interest of Earlham College. I have reviewed with the driver(s) the Campus Policies with respect to all passengers on this trip.
*
Name
*
Phone
*
Department

Please Note

  1. If your requested drivers have not had their licenses registered with the Department of Campus Safety and Security, it must be submitted and approved before they drive the vehicle.
  2. College vehicles are not for personal use or any purpose other than that authorized above. Insurance may not cover vehicle/passengers if it is used for another purpose.
  3. The driver(s) agree to obey all traffic laws governing use of motor vehicles. Driver(s) are personally responsible for any fines or charges incurred for violation of laws.
  4. If gasoline credit cards are issued, the driver(s) are personally and financially responsible for their use.
  5. For trips outside of the Richmond/Wayne County area, a list of passengers is required before departure. Emergency contact numbers must also accompany the list.
  6. For those traveling outside the Richmond/Wayne County area, it is important that a cell phone be available for emergency communication. The cell phone number must be listed on the passenger listing.
Driver #1
*
If driving a 12-passeneger van, has the driver taken the Coaching the Van Driver course?
  
Driver #2
*
If driving a 12-passeneger van, has the driver taken the Coaching the Van Driver course?
  
Is a faculty/staff member going on the trip?
(Required for trips greater than 100 miles)
  
Faculty/Staff Member's Name