Department Zipcar Membership Application

Who should use this form

Use this form if your department has designated you as the Zipcar administrator. You must be a state-approved driver.

Who should not use this form

Do not use this form if you want a personal Zipcar membership. Go to the Zipcar website and search for University of Wisconsin, Madison.

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This field is for validation purposes and should be left unchanged.
Name of department*
Please only fill out this form if you have been approved by your department to be the departmental Zipcar administrator.
Name of proposed departmental Zipcar administrator*
First Last
Email of proposed departmental Zipcar administrator*
Work phone # of proposed departmental Zipcar administrator*
I understand as a departmental Zipcar administrator I am responsible for:*
Please indicate you have read and understood the following conditions of being a departmental Zipcar administrator by checking the box next to each statement.
- Approving employees to apply for departmental memberships and reserve Zipcars under our departmental account.
- Assuring that any employee who reserves and uses a Zipcar under our department's account is an approved state driver.
- Assuring that employees reserving and using Zipcars under our departmental account understand car use is meant for business purposes only and a personal Zipcar account must be made by the individual for personal use.
- Assuring that employees reserving and using Zipcars under our departmental account understand parking is not included in Zipcar's rates. A valid permit or paid visitor parking is required when parking a Zipcar on campus (besides in the reserved stall designated for that Zipcar).
- Making appropriate payments to Zipcar for use of vehicles under the departmental account. (I certify I have such authority/ability and will be responsible for selecting the correct funding stream and payment method.)
- Handling all other administration of the Zipcar departmental account
- Notifying Transportation Services if I am no longer able to serve as departmental Zipcar administrator