LAKE SUPERIOR
STATE UNIVERSITY
Physical Plant
Vehicle Request Form
To request a vehicle from the LSSU Motor Pool, please complete the entire following form, and then select "Submit Vehicle Request". If you wish to clear the form at any time, select "Reset Form".

Your Name:
Your Phone Number (or Campus Extension):
Your LSSU Email Address:
Your Department:
Account Number:

Use Authorization:
 
Your Supervisor's Name (required if Option 1 is selected above):
Your Supervisor's GroupWise Address (required if Option 1 is selected above):

Type of Vehicle Required:
      [Note that all persons driving the Laker Van must have a valid CDL endorsement.]
Destination (List all destinations):

Departure Date and Time
Date (mm/dd/yy): Time (hour:min am,pm):
Return Date and Time
Date (mm/dd/yy): Time (hour:min am,pm):
       
Estimated Mileage: Trip Classification:

Number Of Passengers (Include Driver):
List Any Other Persons That Will Be Driving Besides Yourself:

Other Information (Optional):

All form information requested (unless marked optional) must be provided or this vehicle request may not be accepted.

Please be advised that upon submitting this form, the above information will be transmitted via an insecure Internet connection to the LSSU Motor Pool and your Department Supervisor. Although the Motor Pool will attempt to maintain privacy of your request within their own department, it cannot be guaranteed that your transmission will not become public record, subject to public release and inspection.

All drivers will need a valid drivers license approved by the Motor Pool before obtaining keys for the vehicle. If you have not submitted your license number or an out of state MVR report to the Motor Pool within the last 12 months, please call Ron Raffaele at extension 2617, or e-mail the Motor Pool with your number.

After submitting this form, if you do not receive confirmation from the Motor Pool within a reasonable amount of time, please contact Ron Raffaele at extension 2617. The Motor Pool will confirm your vehicle request via telephone or email.

Vehicle Rates

  
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