RSS Rental Vehicle Request Form

Rental Vehicle Request Form
Before attempting to complete the RSS rental vehicle request form, please have the following driver information available.

All information is required for each listed driver.
- Full Legal Name
- Date of Birth (DOB)
- Cell Number
- Driver License Number
- Driver License Number Expiration Date
- Name on Insurance Card
- Insurance Provider
- Insurance Policy Number
- Insurance Policy Expiration Date

Rental Vehicle Request Form
Today's Date

MonthDayYear
Date
Contact Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Sport Club Name*
Budget Purpose #*
Please refer to the Sport Club Handbook for your Budget Purpose (BP) #.

Rental Vehicle Request Form
Trip Information
Purpose of trip*
Destination*
Destination Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Without prior approval, Competitive Sports policy prohibits travel between the hours of 12:00 AM and 6:00 AM.
Date and Time of Rental Pickup*

MonthDayYear
DateHourMinutesAM/PM Option
Date and Time of Rental Return*

MonthDayYear
DateHourMinutesAM/PM Option

Rental Vehicle Request Form
SIU Travel Services Rental Policies
Each driver must be at least twenty-one (21) years of age with a valid driver’s license.
1. Driver privileges are restricted to current SIU students, SIU faculty members, and/or SIU staff members.
2. All drivers must possess valid automotive insurance.
3. All driver information must be provided. Failure to provide all informtation will result in a denied reservation request.
4. All vehicle reservations are filled on a first come, first serve basis. Last minute reservations may not be honored.
5. All traffic citations, parking citations, and toll violations are the sole responsibility of the driver(s). When applicable, the driver(s) will be required to reimburse the club and RSS for all citations and violations.
6. All accidents must be reported immediately to the Motor Pool Office (618-453-7736) and Victor (618-303-6173).
7. For any repairs on the road, contact Travel Services at 618-453-3357.

Rental Vehicle Request Form
Number of Enterprise Vehicles Requested*

One VehicleTwo VehiclesThree VehiclesFour VehiclesFive Vehicles
First Enterprise Vehicle
Type of Enterprise Vehicle Requested*
Full Legal Name of Driver*
Please provide your first and last name.
Please provide the driver's date of birth.*

MonthDayYear
Driver's Phone Number*

Area CodePhone Number
Driver License #*
Driver License Expiration Date*

MonthDayYear
Date of Expiration
Driver's Insurance Information*
Second Enterprise Vehicle
Type of Enterprise Vehicle Requested*
Full Legal Name of Driver*
Please provide the full first and last name.
Please provide the driver's date of birth.*

MonthDayYear
Driver's Phone Number*

Area CodePhone Number
Driver License #*
Driver License Expiration Date*

MonthDayYear
Date of Expiration
Driver's Insurance Information*
Third Enterprise Vehicle
Type of Enterprise Vehicle Requested*
Full Legal Name of Driver*
Please provide the full first and last name.
Please provide the driver's date of birth.*

MonthDayYear
Driver's Phone Number*

Area CodePhone Number
Driver License #*
Driver License Expiration Date*

MonthDayYear
Date of Expiration
Driver's Insurance Information*
Fourth Enterprise Vehicle
Type of Enterprise Vehicle Requested*
Full Legal Name of Driver*
Please provide the full first and last name.
Please provide the driver's date of birth.*

MonthDayYear
Driver's Phone Number*

Area CodePhone Number
Driver License #*
Driver License Expiration Date*

MonthDayYear
Date of Expiration
Driver's Insurance Information*
Fifth Enterprise Vehicle
Type of Enterprise Vehicle Requested*
Full Legal Name of Driver*
Please provide the full first and last name.
Please provide the driver's date of birth.*

MonthDayYear
Driver's Phone Number*

Area CodePhone Number
Driver License #*
Driver License Expiration Date*

MonthDayYear
Date of Expiration
Driver's Insurance Information*

Rental Vehicle Request Form
By signing below, I am confirming the following:
1. All information provided for each driver is accurate and complete.
2. Each driver has valid automobile insurance for the duration of the travel period.
3. The club accepts responsibility for the selection of the make and model of vehicles.
4. The club will ensure that all drivers and passengers comply with the SIU Travel Services' and Competitive Sports Office's policies and procedures before, during, and after the approved rental period.
5. In the event of any vechile accidents or incidents, SIU Travel Services and Victor (618-303-6173) will be contacted.
Please sign here*

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Rental Vehicle Request Form

Rental Vehicle Request Form

Contact Information

Rental Vehicle Request Form

Rental Vehicle Request Form

Rental Vehicle Request Form

Rental Vehicle Request Form