Dixie State University :: Facilities Management :: Fleet Request Vehicle Rental Form

First Name *

Last Name *

Email Address *

Dixie ID *

Index Code *

Travel Authorization Number (TA) *

Number of Individuals in Group *

Type of Vehicle *

passengers: 1–4
cost: $0.49 per mile

passengers: 1–5
cost: $0.49 per mile

passengers: 4–7
cost: $0.49 per mile

passengers: 7–9
cost: $0.69 per mile

passengers: 10–12
cost: $0.69 per mile

Destination *

Departure Date (Office opens at 8am) *

Departure times earlier than 8 a.m. will be booked for pick-up the previous day

Departure Time *

Return Date *

Return Time

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Vehicle Specifications/Additional Comments

Fleet Vehicle Rental Request