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2. PLEASE COMPLETE ONE (1) FORM FOR EACH REQUEST IN ITS ENTIRETY.
   This form is to be completed when requesting a Floater Vehicle from Fleet Department.
4. Today's Date:*
   Today's Date:

   Today's Date:
5. Department:*
7. Contact Person/Driver:*
8. Telephone Number:*
10. SPECIFY DATE & TIME VEHICLE IS NEEDED:
    If you are unable to pick up the key, gas card, and travel log at the specified time, please notify Fleet Department staff to ensure our availability. As a security precaution, key, gas card, and travel log must be hand-delivered to Fleet staff or deposited into Fleet Drop Box upon return.
12. Date & Time for Pickup:*
    Date & Time for Pickup:

    Date & Time for Pickup:
13. Destination:*
15. Date & Time to Return Vehicle:*
    Date & Time to Return Vehicle:

    Date & Time to Return Vehicle:
16. Number of Passengers:*
    -- Select One --One (1) PassengerTwo (2) PassengersThree (3) PassengersFour (4) - Six (6) PassengersSeven (7) - Fifteen (15) Passengers
18. If requesting the Transit Wagon, please confirm that six (6) or more passengers will be transported.
19. Please select appropriate answer:*

    1. Yes
    2. No
21. DRIVER'S COMMENTS:
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit Submit and Print

* indicates a required field