Department Zipcar Membership Application

Who should use this form

Use this form if your department has designated you as the Zipcar administrator.

Who should not use this form

Do not use this form until your department has officially designated you as the Zipcar administrator.
Do not use this form if you want a personal Zipcar membership. Go to the Zipcar website and search for University of Wisconsin, Madison.

Comments
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