Fill and Sign the Carpool Application and Agreement at a College or University Ride Sharing Form

Carpool Application and Agreement at a College or University Each participant in the carpool group will need to provide the information below, sign and date this application. Upon approval, participants will be notified via e-mail. Carpool participants will automatically be eligible for the Guaranteed Ride Home and the Alternative Transportation Parking Pass incentives. Freshmen carpool participants are not permitted to park on campus. Participants must submit proof of local address – driver’s license, vehicle registration, lease agreement, etc. Rider # 1 Name (Last, First, M.I.) _______________________________________________________ ID # _______________________________________________________________________ Local Address ______________________________________________________________ City, State, Zip ____________________________________________________________ Phone# Home ____________________ Cell _______________Work __________ Email ________________________________________________ License Plate ________________________________________________ State ________________________________________________ Vehicle Make ________________________________________________ Vehicle Model ________________________________________________ As a participant in the carpool program, I agree to adhere to the Carpool program policies, local parking and traffic laws and the University parking regulations found on the parking website. I understand that Parking & Transportation Services must be notified if I am no longer participating in a carpool group. Signature _____________________________________ Date________________ Rider # 2 Name (Last, First, M.I.) _______________________________________________________ ID # _______________________________________________________________________ Local Address ______________________________________________________________ City, State, Zip ____________________________________________________________ Phone# Home ____________________ Cell _______________Work __________ Email ________________________________________________ License Plate ________________________________________________ State ________________________________________________ Vehicle Make ________________________________________________ Vehicle Model ________________________________________________ As a participant in the carpool program, I agree to adhere to the Carpool program policies, local parking and traffic laws and the University parking regulations found on the parking website. I understand that Parking & Transportation Services must be notified if I am no longer participating in a carpool group. Signature _____________________________________ Date________________ Rider # 3 Name (Last, First, M.I.) _______________________________________________________ ID # _______________________________________________________________________ Local Address ______________________________________________________________ City, State, Zip ____________________________________________________________ Phone# Home ____________________ Cell _______________Work __________ Email ________________________________________________ License Plate ________________________________________________ State ________________________________________________ Vehicle Make ________________________________________________ Vehicle Model ________________________________________________ As a participant in the carpool program, I agree to adhere to the Carpool program policies, local parking and traffic laws and the University parking regulations found on the parking website. I understand that Parking & Transportation Services must be notified if I am no longer participating in a carpool group. Signature _____________________________________ Date________________ Rider # 4 Name (Last, First, M.I.) _______________________________________________________ ID # _______________________________________________________________________ Local Address ______________________________________________________________ City, State, Zip ____________________________________________________________ Phone# Home ____________________ Cell _______________Work __________ Email ________________________________________________ License Plate ________________________________________________ State ________________________________________________ Vehicle Make ________________________________________________ Vehicle Model ________________________________________________ As a participant in the carpool program, I agree to adhere to the Carpool program policies, local parking and traffic laws and the University parking regulations found on the parking website. I understand that Parking & Transportation Services must be notified if I am no longer participating in a carpool group. Signature _____________________________________ Date________________ Notification of enrollment will be provided within 10 business days. Carpool Program Policy Purpose Parking and Transportation Services is committed to providing alternative transportation options to the campus community. We encourage faculty, staff and students to take advantage of the carpooling program. Eligibility _____________________ (Name) University faculty, staff and students are eligible to participate in the carpool program. Eligible carpools consist of two or more individuals sharing one permit per carpool (members can register more than one vehicle). Resident students are not eligible to participate in the carpool program. Benefits Carpoolers take advantage of many benefits:  Financial savings – share the cost of a parking permit, save on the cost of gas, save on wear and tear on your vehicle.  More convenient, less stressful commute.  Contribute to a cleaner environment. One less car on the road equals less gas emissions.  Automatic enrollment in Guaranteed Ride Home which provides transportation home for an emergency or last minute schedule change.  Automatic enrollment in the Alternative Transportation Parking Pass Program which offers four free parking passes per semester. Freshmen will be issued vouchers to park at a county garage. How It Works  All members of the Carpool must sign the application and agreement. The form can be obtained online at the Parking & Transportation website or from the office located in the Union Garage.  Return form to the Parking and Transportation office, Attn: Coordinator.  The carpool group will need to determine who will purchase the permit at the Auxiliary Services Business Office (ASBO). All other carpool recipients will be restricted from purchasing a permit. The group is responsible for transferring the permit among the participants. Freshmen are restricted from parking on campus and will be issued a permit to park at a county garage.  Each carpool vehicle will need to be registered with the carpool group. All members of the carpool will need to submit proof of current address (driver’s license, registration). A copy of the registration certificate for each car that might be used in the carpool group should be submitted with the application.  Upon approval each participant will be enrolled in the Guaranteed Ride Home Program and the Alternative Transportation Parking Pass Program.  All carpool members are responsible for knowing and complying with the parking regulations on campus. Visit www.xxxxx.edu/parking and click the Parking Information link to review the policies and regulations.  If a member of the carpool chooses to leave the carpool or leaves employment with the university, a new carpool agreement must be signed by the remaining members. The Parking & Transportation records will be updated based on the new information. If only one member remains in the group, Parking and Transportation Services must be notified, and all alternative transportation programs will be cancelled. A parking permit may not be transferred to another individual.  If a citation is issued, it will be assigned to the permit holder. Upon request a citation can be reassigned to another carpool member’s registered vehicle.  The carpool application will be approved if the carpool makes sense. Carpool participants must submit a current address.  If the carpool dissolves, applicable refunds will be issued.  Prior to approval, any current permits will need to be returned to ASBO. Applicable refunds will apply.