Campus Safety

Transportation Request (Form 1)

IPFW.edu
Campus Safety
Transportation
Transportation Request (Form 1)

Please complete this form online at least 24 hours before your trip, then submit your order, otherwise it will not be processed.

You will receive a copy of the Form 1 with the charges after the trip is completed.

Note: The driver must pick up the requested vehicle in person and sign a certification that they are in compliance with the “Use of Vehicles for University Business Policy.”

Driver & Department Information

Driver(s):

Check if Student/Volunteer:

Department:
Fund: (8 digits)

Cost Center:(10 digits-if applicable)

SIO:

Internal Order:(10 digits-if applicable)

G/L Account:
Driver's Email:

Requester's Email:

Driver's Phone:

Transportation Request Information

Destination(s): (Please include city & state)
Note: Club Carts cannot be taken off the IPFW Campus. Please include building names.

Purpose of Trip:

All passengers accompanying driver:(Please list names only)

Note: The daily rate is based on a 24-hour clock. If you are departing prior to 10:00am, your vehicle will automatically be delivered the day prior by 4:00pm for your pickup. Monday rentals can be picked up on Friday.
*Please do not include the pickup date and time in your selection; this could affect the charges of your trip. Please only list your actual departing and returning dates and times.

Start Date:

Start Time:
End Date:

End Time:
Vehicle Type Requested:
Special Instructions:(if NO instruction fill in N/A )

Official Mileage to & from primary destination:

Estimated local mileage at destination:

Total Miles:

DEPT. CERTIFICATION: This trip has been authorized under Pres. Form 17 (REV) or 17B or ODOS Travel Planning form. The driver is a current employee of Purdue University or has been approved to drive by Risk Management
Note: After the form is filled out, please print a copy for your records before submitting the form. To avoid duplication errors, please only submit this form electronically.

What do I do next? Look at the Interactive Powerpoint for all items needed to reserve a vehicle.

© 2013 Indiana University–Purdue University Fort Wayne (IPFW). All rights reserved. IPFW is an equal access/equal opportunity university.
If you have trouble accessing this page because of a disability, please contact the Office of Institutional Equity at 260-481-6106 or accessibility@ipfw.edu.

Transportation Request (Form 1)

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