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Name*
Phone*( ) -
Email
Department/Ministry
Personal Use
My Department / Ministry
Others
If "Others" was selected above, specify if van will be used by a ministry different from the one you belong to
Place or Address(es) where the van will be used*
Purpose*
Pick Up Date* January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2025 2024 2023 2022 2021 2020 2019
Return Date* January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2025 2024 2023 2022 2021 2020 2019
Terms and Conditions
Yes, I agree