DANVILLE AREA COMMUNITY COLLEGE CAMPUS
SERVICES TRAVEL REQUEST
DATE OF REQUEST: __________________________
DRIVER (S): ___________________________________________________________
___________________________________________________________
DEPARTURE TIME: __________________DATE:_____________________
EXPECTED TIME OF RETURN: ________________DATE:_________________
FACULTY / STAFF / STUDENTS / CHILDCARE (CIRCLE)
TOTAL TRAVELING (INCLUDING DRIVER): __________________
DESCRIPTION OF TRIP: ______________________________________________________________________
_____________________________________________________________________________________________
NUMBER OF VEHICLES REQUESTED: 1 / 2 / 3 / 4
(CIRCLE)
Vehicle Key Number: ________ Unit Number:__________
CREDIT CARD ISSUED: BP / MOBIL / SHELL / CASEY'S (GAS RECEIPTS)
CARD NUMBER: ___________________________ _____________
___________________________ _____________
___________________________ _____________
I understand that before returning the vehicle, it is my responsibility to clean all
contact surfaces areas to include, but not limited to seats, seat backs, steering
wheels, doors, and handles.
______ Initial
Cleaning Supply Kit Received:_______
Initial
Cleaning Supply Kit Returned:
_________Initial
SIGNATURE CHECKING OUT:_______________________________DATE:___________________
SIGNATURE CHECKING IN: _______________________________DATE:___________________
Unit Inspected By: _________________ Maintenance Contacted: Time: ____:____ Date:_______
Final Inspection: _____________________________(
name and date
) Returned to Service: ______________
ALL DRIVERS MUST HAVE LICENSE ON FILE WITH CAMPUS SERVICES
STUDENTS ARE PROHIBITED FROM DRIVING COLLEGE VEHICLES UNLESS APPORVED BY AN
ADMINISTRATOR OR HEAD COACH
FOLLOW BOARD POLICIES AND PROCEDURES MANUAL 4057.1 (VEHICLE USAGE)
