Is this a new van request or are you amending a previous request?
This is a new Request
This is to amend a previous van request. Please make any changes and describe the changes in the comments portion of this form.
This is to cancel a previous van request.
Dates requesting for Van Rental
Church / Ministry Requesting Van Reservation:
YES we are affiliated with SLBA
No, we are not affiliated with the Salt Lake Baptist Association.
Please Note: NON-SLBA churches and ministries may only request the van 1 month prior to the dates needed. This is to allow SLBA churches / ministries priority. (Request longer than 1 month in advance require special permission from Dan Walker.)
Contact Person
Contact email
Contact phone(s)
Purpose of the vehicle:
(please include location the van will be going)
Do you understand the SLBA charges $30 per day?
Yes, I understand the van rental is $30 per day. We also understand that we must return the van full of diesel.
To whom/where should SLBA send the bill for van usage?
In the event of an accident and the SLBA is required to pay the insurance deductible (up to $1,000), does your church/ministry or agree to reimburse the SLBA for the total deductible amount?
Yes, in case of an accident, our church/ministry agrees to reimburse any deductible amount up to $1,000.
(If no, please call before completing request form)
Please list the name of all drivers
(All drivers must give SLBA a copy of their valid drivers license)
Driver 1 is over 21 w/ valid license
Driver 2 is over 21 w/ valid license
Driver 3 is over 21 w/ valid license
Returning the Van Procedure
Before returning the SLBA van, do you agree to (1) fill the tank and (2) clean the van inside and out?
(If the van needs to be cleaned by SLBA staff, then we will bill your church/ministry a $50 cleaning fee. If the van only needs to be filled with gas we will pass those fuel charges on plus a $10 convenience fee.)
YES we agree to clean and fill up the van
No, please bill us for fuel and cleaning charges.
Other comments, questions or information