VITERBO UNIVERSITY
900 Viterbo Drive
LaCrosse WI 54601
608-796-3920
Student Driver Authorization Form
For Viterbo University business use only
Name of student driver _________________________________________________________________
Date vehicle needed ____________________________________________________________________
Hours vehicle needed ___________________________________________________________________
Purpose of trip ________________________________________________________________________
Approx. mileage of trip __________________________________________________________________
Requesting department _________________________________________________________________
Departmental approval by _________________________________________ Date _________________
Note: Student driver must be accompanied by Viterbo University employee.
When completed, please return to the Physical Plant Department.