Note: This application must be submitted 5 days in advance If this application is approved, I agree to the following conditions: Driver must wear seat belt (PA state law) When fueling the vehicle, have oil and water levels checked-if needed, bring to proper level Upon return, make sure the gas tank is full All lights must be off including the dome light List on mileage form any comments relating to the vehicle's performance Failure to abide by these condition could result in the suspension of future vehicle use. Driver and all occupants are required by the Campus Health & Safety Plan to wear an appropriate face covering while inside the vehicle, to help prevent the spread of COVID-19 and its variants. Driver must be on record as a certified driver for the College by Physical Plant. All fuel receipts must be turned into Campus Safety with the vehicle keys, upon completion of use. Vehicle Application Your Information First Name Last Name Email Cell Phone Campus phone Trip Information Driver Driver needs to be scheduled by Physical Plant I have a driver Name of Driver Date(s) Vehicle Needed Time Leaving Time Returning Destination Address Vehicles needed - check all that apply Van #6 - 10 passenger capacity Van #7 - 12 passenger capacity Van #8 - 12 passenger capacity Number of Passengers Name(s) of Passengers Are any of the passengers children? Yes No All passengers must comply with PA state law with regard to proper restraint, including the use of lap and shoulder belts and federally approved child safety seats. An updated list of passenger names must be supplied to Campus Safety at the time of vehicle key pickup. Specific Purpose of Trip Account Number Submit Leave this field blank
