Physical Plant

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Student Driver Authorization Form

For Viterbo University business use only

Name of student driver ________________________________________________

Date vehicle needed __________________________________________________

Hours vehicle needed _________________________________________________

Purpose of trip _______________________________________________________

Approximate mileage of trip _____________________________________________

Requesting department ________________________________________________

Departmental approval by _____________________________ Date ____________

Note: Student driver must be accompanied by a Viterbo University employee. When completed, return to the Physical Plant Department.