Vehicle Use

Information

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* = required field

Site Information

*Site you are registering for:

Cedar Rapids Main Campus

You may have the opportunity to request permission for additional sites after you are approved for your primary site. Request for additional permissions is done via the My Profile link.

User Information

(*Last Name, *First Name,

Middle Name):

Salutation:

*Username:

*Login Password:

*Re-enter Password:

Contact Information

Organization:

Title:

Department-GL Unit #:

*GL Unit # (enter number above):

*Phone Preference:

*Business Phone: Ext

Mobile Phone:

Other: Ext

Preferred Email:

*Work Email:

Personal Email-if no KCC email:

Additional Information

Supervisor/Approver Name:

Supervisor/Approver Phone:

Supervisor/Approver Email:

License Expiration Date:(MM/DD/YYYY)

Additional Information - Reservations

GL Fund (1st 2 digits):

Location (2nd 2 digits):

Function (3rd 2 digits):

Object (Last 6 digits):

Project (optional):

Use the space below to provide:
1) A description of your motor pool requirements,
2) Any unique requirements you may have (e.g. Always require cargo space, require wheelchair lift), and
3) Any other comments you may have for the motor pool staff.

4) Passenger list if other will be traveling with you.

Comments:

Please enter the text you see in the picture into the text box before submitting your registration.