Van Request Form

Pitzer College has 4 mini-vans which seat 7 people each, including the driver. The vans may be used in support of the College’s academic program, for administrative purposes, and for approved student activities.
Programs must provide/arrange for their own driver(s). A list of approved drivers can be made available upon request.
The vans may only be driven by persons approved by the Office of Risk Management to drive college vehicles.
Persons who have not been approved may not drive the vans.
Please submit your request at least 72 hours in advance. You will be sent an email once the status of the reservation has been confirmed.
There is a mileage charge of 70¢ per mile for all van use.
Keys can be picked up in the Office of Student Affairs in Scott Hall.
Keys can be returned to OSA or placed in the outside drop box in front of the Mail Center, Atherton Hall.

Questions? Email Transportation or call 909.607.2344

Faculty Van Request Form

OSA – Van Request Form

Contact Name / Requestee(Required)

First Last

Contact Email(Required)

Contact Phone(Required)

Group or Organization(Required)

Pitzer Account Owner(Required)

Please list the office responsible for managing your account.

Office Responsible for Account(Required)

Workday Cost Center Number(Required)

Please enter your Workday Cost Center number.

Workday Fund Number(Required)

Please enter your Workday Fund number.

Pitzer Staff Supervisor(Required)

Destination Address

Street Address City ZIP Code

Event Type(Required)

Provide a short description

Number of Passengers – Including Driver(s)(Required)

Number of Vans Requsted(Required)

Please enter a number from 1 to 4.

No more than 4 vans are available.

Date(Required)

Begin Time(Required)

End Time(Required)

Is this a reoccurring request?

Yes

Dates and Times

Please list each date followed by start and end times as a new line.
Example: MM/DD/YY Start HH:MM End HH:MM

Additional Notes

Please include additional instructions or information here. (optional)

Terms and Conditions:

Please read these Terms and Conditions carefully before using the Pitzer Vans. Your access to the Pitzer Vans is conditioned on your acceptance of and compliance with these Terms. These Terms apply to all drivers driving the Pitzer Vans. By accessing or using the Pitzer Vans you agree to be bound by these Terms.

Pitzer Vans Program Terms and Conditions

Fill out the log-in sheet located in the Van book.

Enter the starting and ending miles.

Only use the Van during your scheduled time frame
- There are multiple sets of keys per van, others will be using the Van before and after your reservation.
Return the Van promptly, others may be waiting to use it.
Return the Van book to either the Office of Student Affairs or the Van drop box located outside the Mail Center at Atherton.
Inside the Van book is the Insurance Cards, Registration, and Best Roadside Service plan.
If at any time the Van breaks down, please use the Best Roadside Service card for assistance and follow Emergency Procedures located in Van Book.
The vans may only be driven by persons approved by the Office of Risk Management to drive college vehicles.

Persons who have not been approved may not drive the vans.

Please take all items and trash out of the Van when your reservation is over.
Report any damages during your trip to the Transportation Coordinator in OSA.
You are responsible for all passengers during your reservation time frame.
Driver will be responsible for any Vehicle/Parking violations during trip.
Always drive safe.

Agreement

By checking this box, you are agreeing to our terms and conditions.