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Vehicle Request Form


Complete this form, print, obtain appropriate signatures, and fax to (615) 898-5071 or forward to Motor Pool Services, Box 32.
For reservations and/or assistance, call (615) 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

2011 Middle Tennessee State University, a Tennessee Board of Regents institution 1301 East Main Street, Murfreesboro, TN 37132-0001 USA +1.615.898.2300

Middle Tennessee State University, in its educational programs and activities involving students and employees, does not discriminate on the basis of race, color, national origin, sex, religion, or age. Furthermore, the university does not discriminate against veterans or individuals with disabilities.

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