Guaranteed Ride Program Registration

If you've thought about ridesharing, but don't know how to get started, TRAFFIX can help. First, fill in the following questions, then submit them to TRAFFIX or call at 1-800-700-RIDE.

Name
Address
City, State, Zip
Home Phone
Work Phone
Email

I would be interested in the following rideshare programs:
Silverleaf Commuter Station
 Carpooling
HOV Express Bus Drive Only
Park-and-Ride Locations
 Ride Only
Silverleaf Commuter Station
 Vanpooling
Indian River Park-and-Ride
 Use My Van
Greenbrier Mall Park-and-Ride
 Ride Only
Lease a Van

The nearest intersection to which I live is:
1)
2)

The nearest intersection to which I work is:
1)
2)

Company Name or Command
Work Address
City, State, Zip
Start work
End work

Are your hours flexible within 15 minutes:
Yes No

I get to work now by:
Walk/Bike
 Drive Alone
Park-and-Ride
 Carpool
Vanpool
 Bus

Do you smoke?
Yes No

I heard about the TRAFFIX program mainly through:
Radio
 Newspaper
Road Sign
 Poster/Leaflet
Employer/School
 Friend
Phone Book
 TV
Web Site
 Other (Please Specify)

When a letter is sent out with names, addresses, and phone numbers of potential car or vanpoolers, would you like your home address to be included?
Yes No