Motor Pool Vehicle Request Form

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Complete this form, print, obtain appropriate signatures, and fax to 898-5071 or forward to Motor Pool Services, Box 32.  For reservations and/or assistance, call 898-2415.

Indicate your division:

   Academic Affairs     Business & Finance   President's Office/Athletics  
   Student Affairs     Development & University Relations   Information Technology

 Other
Type of Travel: Student Activity:
  Instruction   Athletics
  Department Research/ Contracts/Grants Continuing Education and Extension
  Cheerleaders
  Debate
  Administration   Band
  Other (Specify):    Other (Specify): 

Purpose:  

 
Date to pick-up key:   Date of return:  
Time to pick-up key:   Time of return:  
Destination:   Number in party:  
Department name:   Object Code:  
Account number:  

Estimated mileage:  

Additional Comments: 

 
Person Requesting Vehicle (Print/type:)  

Phone   Box #

Approved, Department Head Signature:   ________________________________________
**Signature of Appropriate Vice President:   ________________________________________

**University policy requires the appropriate Vice President's signature when only one person is traveling out of state.  For details on Motor Pool Services policy and procedures, see MTSU Policies Manual IV:02:01                                                                                                         

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