Last
Name:
First
Name:
Email Address:
(Work email
preferred in order to verify employment with a TMA
member company.)
Home Address:
Home
City, State, Zip:
Employer:
Work Address: (Include mailzone/ mailstop if applicable)
City, State, Zip:
Work Phone:
How many miles
(one way) is your commute?
A rrival
Time At Work:
Departure
Time From Work:
Type of Pass You Will Purchase (please be
specific, i.e. commuter rail zone, Peter Pan Bus,
C&J, etc.):
How much does
this pass cost per month?
How do you currently commute?
If applicable, where do you park?
If applicable, how much is your daily or monthly parking?
Referred by:
Terms of Agreement for Try
Transit On Us (Check each circle on the left
in order to participate.)
I
request to participate in Seaport TMA's Try Transit
program . My participation in the program is
based on the understanding that I currently drive
alone to work and will begin taking transit. I also
do not currently receive a transit pass through my
employer or purchase one on my own for commuting
purposes.
I
hereby release Seaport TMA and all service
providers from any liability, claims and demands for
personal injury, loss, theft or damages to my personal
property, loss of income, consequential damages
resulting from delays or absence of service provider,
or termination of the program. I also understand that
Seaport TMA has the right to discontinue
participant privileges at any time.
I
understand that Seaport TMA will require me to
complete a monthly status report for the Try Transit
On Us Program.
Furthermore, I understand that incorrect use of this
service may result in
restriction from using the service again.
