College Vehicle Request Form

This form is for use by Messiah College students, faculty and staff for college-related activities only.

Please fill out the form below to the best of your ability. Please remember this is a REQUEST for a reservation. Filling out this form does not confirm your reservation. Once we have received your REQUEST and our office has confirmed that a vehicle is available, you will receive an e-mail confirming your reservation.

If you have not received an e-mail confirmation, your reservation has not been officially approved. If you have questions about a college vehicle reservation, please e-mail VehicleRes@messiah.edu directly or by phone at extension 3770.

College Vehicle Reservation Request:

Vehicle Desired:	Select vehicle type Van Mini-Van Car
Special Requests or Notes for Van/Mini-Van:
Desired Pick-up Date:	Month January February March April May June July August September October November December   Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Year 2006 2007 2008 2009 2010
Desired Drop-off Date:	Month January February March April May June July August September October November December   Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Year 2006 2007 2008 2009 2010
Departure Time:	AM   PM
Return Time:	AM   PM
Destination:
Driver Name:
Contact Email:
Please charge to the following account:
Account Name:  (i.e., "Public Relations")	Account Number:  (i.e., "1234")
**Students must have a signature from a faculty/staff members to reserve a college vehicle. After completing the form, please print a copy and return it to the College Receptionist with the appropriate signature.
Faculty/Staff Approval
Signature:	Date: