Scootaround Rental Request Form

Please complete this inquiry form and we will forward you a detailed quote online directly to your e-mail Inbox!
• Fields marked in BOLD are required
• This is not a booking form -- all rentals must be confirmed.

Personal Information
First Name
Last Name
Street Address
City
Country State / Province
Other Country
ZIP / Postal
Your Height
Your Weight
Preferred Contact Method
Contact me by:
Please provide both your telephone and e-mail address in case we cannot reach you at your preferred method		 Telephone E-mail
Area Code + Phone
Area Code + Work Phone
Email Address
Rental Information

Deliver Rental To:

Convention Hotel

Note: If you choose the "Convention" delivery option, please use the box at the bottom of this form to enter the center's name.
The two available Convention venues are:
• Alliant Energy Center
• Monona Terrace Convention Center
Destination City
Destination Address
Date Needed From
Date Needed To
Hotel Guest Information
Name Registered Under
Hotel Name
Room Number
Guest Arrival Date
Guest Departure Date
Delivery Requirements or other Special Needs:
This is not a booking form
All rentals must be confirmed!