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When You Can Use It
How it Works
How to Enroll
Program Restrictions
Taxi and Rental Car Information (PDF)
Contact Us
Links
Employee Registration Form (PDF)
Online Registration >
Employer Information:
Employer Registration Form (PDF)
Emergency Use Instructions (PDF)
Employees whose employers have pre-registered may use this on-line registration form to enroll in the program.
STEP 1:
Complete the On-Line Registration form below and click "
Go to Step 2
"
STEP 2:
After you submit the form, you will be prompted to print a copy of the liability waiver, sign it, and mail or fax it in. Your registration will not be complete until we receive your signed liability waiver.
If you wish to download and print the entire registration form instead of using this form,
click here
.
Step 1: On-Line Registration
Please fill out form completely.
Your Name (First, Last)
Employer
Department (if any)
Work Address
City
ZIP
Work Phone
Home Address
City
ZIP
Home Phone
Email
Number of miles you live from your work site:
If you use a cheelchair or would otherwise require an accessible vehicle, please check box:
Please indicate the number of days per week you use each of the following for your commute to work:
Number of Days
per Week
Carpool
Vanpool
Train/BART
Ferry
Bus *
Walk
Bicycle
* If you ride the bus, which service do you use? (check all that apply)
AC Transit
Muni
LAVTA (Wheels)
SMART/SJRTD
Other
If you would like assistance in forming or joining a carpool or vanpool, contact 511 Regional Rideshare by dialing 5-1-1 or visiting
http://rideshare.511.org
How did you find out about the Guaranteed Ride Home Program?