CONFIRMATION OF RESERVATION
FOR UNIVERSITY VEHICLES
Student Organization:
Date
Please list the following information for all of the students who will be driving the requested vehicles.
Driver’s Name
Drivers License No.
Issuing State
Exp. Date
Driver’s Name
Drivers License No.
Issuing State
Exp. Date
Driver’s Name
Drivers License No.
Issuing State
Exp. Date
Rental Dates
Destination
Purpose of Trip
As the student officer authorized to represent my organization in these matters, I confirm that the
requested vehicles will be used only within the scope of a legitimate organization-sponsored
program, in accordance with Northwestern University’s Vehicle Policy, and that all student drivers
have completed the driver training course conducted by the Office of Risk Management. In the
same capacity, I also state that the organization and the members listed above hold the authorizing
University official(s) free of all liability arising from the organization’s use of the vehicle(s).
Officer’s Signature
Title
Date
(Student Organization President or Treasurer Only)
University Official’s Signature __________________________________
*
Date
*Local travel can be authorized by Organization Advisors. Travel out of the metropolitan area or that will take
more than one day to complete also requires an authorization from the Director of Center for Student Involvement.
COMMITMENT APPROVAL / AUTHORIZATION OF PAYMENT
Organization Name
Account No
This is to certify that the drivers listed above, members of the student organization affiliated with
Northwestern University, has/have permission to proceed with the
.
We approve their agreement with Motor Pool for an amount not to exceed
.
Organization President/Treasurer
SOFO/ Dept. Assistant
THIS COMPLETED FORM MUST BE SUBMITTED AT LEAST 24 HOURS BEFORE VEHICLE IS NEEDED .
FAX TO MOTOR POOL AT 847-467-2188
REV. 08/04