Borrow a Car
Please call SPIN-Zone @507-423-1000 if you need assistance filling out this form.
Applicant: (Driver #1)
Drivers Licence Number
Home Phone
Exp Date
State of Issue
Cell Phone
Date of Birth ie(03-15-1966)
Street Address
# of accidents in the last 3 yrs
City
Martial Status (select one)
Single
Single Parent
Divorced
Married
Widowed
State
Zip Code
E-mail Address
Request to borrow Vehicle from
Date Out
Date Return
Other Licensed Drivers in Household
Driver #2
Drivers Licence Number
Home Phone
Exp Date
State of Issue
Cell Phone
Date of Birth ie(03-15-1966)
Street Address
# of accidents in the last 3 yrs
City
Martial Status (select one)
Single
Single Parent
Divorced
Married
Widowed
State
Zip Code
E-mail Address
Auto Insurance Company
Policy Number
Agent Name
Agent Phone Number
Please describe the circumstances causing the need to borrow a car. (details please)
Household Occupant Information
Please supply all names, ages and relationships of people living witht the applicant. (do not include applicant)
Name
Age
Relationship
Occupant 1
Occupant 2
Occupant 3
Occupant 4
Occupant 5
Occupant 6
Reference Information
Name
Relationship
Street Address
Daytime Phone
City
Evening or Cell Phone
State
Zip Code
How did you hear about SPIN-ZONE?
By “submitting” the information on this application to SPIN-zone, the applicant authorizes SPIN-zone to investigate the applicant for purposes of assisting in making the determination of applicant eligibility to borrow a car from SPIN-zone. This investigation will include questioning personal references, and accessing motor vehicle records.
D. A. Hoff Charitable Foundation
480 East 4th Street North
507-423-1000
Cottonwood, MN 56229