CSB VEHICLE RESERVATION APPLICATION FORM

TO REQUEST A CSB VEHICLE RESERVATION USING THIS FORM, complete ALL of the following fields of information and then click <SUBMIT>.

Complete a separate application form for each reservation PERIOD. A "reservation period" is defined as (a) a single day or, (b) two or more consecutive days. Multiple, single-day (consecutive or non-consecutive) reservations require the submission of separate application forms for each date requested.

IMPORTANT NOTE: Reservation requests using this form made during a weekend or on a legal holiday are not processed until the next working day. Please contact the Security office in person or via phone if you require a quicker response.

	REQUESTOR'S NAME:
	BANNER NUMBER:

	Number of (5) passenger Cars needed:
	Number of (7) passenger Mini-vans needed:
	Number of (12) passenger Mini-buses needed:

[ Maximum vehicle capacities: AUTOMOBILE - 4 passengers plus a driver; MINI-VAN - 6 passengers plus a driver; MINI-BUS - 11 passengers plus a driver.

	RESERVATION - Starting DATE:				RESERVATION - Ending DATE:
	RESERVATION - Starting TIME:				RESERVATION - Ending TIME:

Where are you going (City/State)? What is the PURPOSE of your trip? (Enter "MEDICAL" if this reservation is being made to attend a doctor's visit or for other medical purposes, must be within 20 mile radius of campus.)

SPONSORING DEPARTMENT, CLUB or ORGANIZATION (Enter "N/A" if vehicle is being reserved for MEDICAL purposes):

Complete E-MAIL ADDRESS of the DEPARTMENT HEAD or ORGANIZATION CHAIRPERSON who is authorizing this reservation request. (Enter your own e-mail address if vehicle is being reserved for MEDICAL purposes).

DEPARTMENT BUDGET NUMBER: (Enter your Banner ID # if vehicle is being used for MEDICAL purposes.)

NAMES OF ALL DRIVERS WHO WILL BE OPERATING THE VEHICLE(S):

[ Please note that persons driving campus-owned vehicles must first have completed both parts of the Defensive Driving Program and must have signed the appropriate release form on his/her campus to allow a driver license check of their driving record. The Defensive Driving requirement does not apply to a CSB student who is renting a vehicle for MEDICAL purposes. Persons driving a mini-van or mini-bus must be a minimum of 20 years of age.]

NOTES/COMMENTS : [ Please include any additional information you would like us to know regarding your reservation request ]