New Rider Application – Ride To Work Ministry Nonprofit, Inc.

Rider Application Form

Newsletter

Fields with an asterisk * are required.

* I consent to having this website store my submitted information so they can respond to my application inquiry.

Today's Date

Application Type:

This is a first-time application

I've applied before

Contact Information

First Name

Middle Name

Last Name

Gender

Male

Female

Are you a Veteran or First Responder?

Yes

Address (Street address, please. PO Boxes are not allowed.)

Address Line 1

Address Line 2

City/Town (must be in Oconee County)

State

Zip Code

Primary Phone to Receive Text/Voice Messages

Alternate Phone to Receive Text/Voice Messages

Your Email Address (check your spelling)

Emergency Contact Name and Phone Number

Background/Needs/Reasons

Ride To Work reserves the right to do a background check as a condition of riding. Please advise us of anything in your background that might need explanation, or enter "none."

Decribe any disabilities or medical conditions you have that would require accommodation in order to board or ride, or that the driver should be aware of, or enter "none."

Have you had or been exposed to COVID in the last week?

Yes

I was referred to the Ride To Work program or heard about it from

Why do you need a ride to work? (Check all that apply. Add any other useful information below)

I do not have a Driver’s License

My car broke down

My moped/motorcycle broke down or was stolen

The bus does not support my work location or work hours

My friend/family can no longer provide rides

I live more than one mile from my workplace

Other information regarding your need for a ride

Employment Information

Job Status

I am currently employed

My job is pending

If your job is through a temp agency tell us which agency:

The date I would like to begin using the Ride To Work program

Business Name

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Main Business Phone

What time each day do you start work?

What time each day do you get off work?

Supervisor's Name and Phone Number

Supervisor phone extension, if they have one

May the Ride To Work program call the business or your supervisor to verify your employment?

Yes

What is your driver's license situation (check the answer that applies. Add any other useful information below)

I have a valid South Carolina driver’s license

I have a valid out of state license

My driver’s license was suspended/revoked

I have never had a drivers license

I have a permit but not a license

I have a moped/motorcycle license

I am unable to get a drivers license (please tell us why)

Other information regarding your driver's license situation

My goal is to obtain my own transportation and "graduate" from the Ride To Work program by this date

I will achieve this goal by (select one):

Finding a carpool with a co-worker

Getting a moped

Buying a car

Getting housing or a work schedule that lets me take the bus

Other (please explain):

Your ride cost will be either $5 per day or $10 per day depending on the distance of your ride. RIDE TO WORK WILL NOT CHARGE FOR RIDES FOR THE FIRST WEEK in order to give you time to find payment. AFTER THE FIRST WEEK OF RIDES, NO ADDITIONAL RIDES WILL BE PROVIDED UNTIL RIDE TO WORK HAS RECEIVED PAYMENT.

I UNDERSTAND AND AGREE:

Yes

My hourly pay will be ($):

My weekly income will be ($):

After all expenses I can save ($ per week):

You're almost done!

Next Steps in the process are:

Your application will be reviewed and a RTW volunteer will phone you to determine if we are able to schedule rides for you and if so, determine wether the rideshare will be $5 or $10/ day and assign a coach who will personally contact you.

Prior to scheduling any rides, The coach will:
1) go over your application and the details of your situation
2) have you read and sign a liability waiver
3) go over rider rules and have you sign them
4) verify you have a working phone and that you can text
5) help develop a plan for your independence
6) verify your work schedule and pickup/drop addresses

I understand that riders are on ‘probation’ for the first several weeks. Progress and compliance will be reported weekly by the coach to the Ride To Work Operating Committee and formal reviews of rider progress will be presented by the coach monthly at the committee meetings.

I UNDERSTAND THAT THE DECISION WHETHER TO ACCEPT ME IN THE PROGRAM IS TOTALLY UP TO RIDE TO WORK AND IF I DO NOT FOLLOW THE RULES, MAKE ADEQUATE PROGRESS ON A SUCCESS PLAN, HAVE PROVIDED FALSE INFORMATION OR OTHER ISSUES ARISE, I MAY BE DROPPED FROM THE PROGRAM.

I give permission for RTW to verify all my information with other people and/or agencies as needed in their evaluation of my application and while I am part of the RTW program.

RIDE TO WORK ONLY PROVIDES RIDES TO RESIDENTS OF OCONEE COUNTY.
YOUR APPLICATION MUST BE RECEIVED AT LEAST 48 HOURS BEFORE YOU NEED YOUR FIRST RIDE.

Acknowledgement

I have read and accept these terms and conditions.

NOTE: Your application is not complete until you check the 'Submit Form' button on the next page.

Contact Information

Background/Needs/Reasons

Employment Information

You're almost done!

Thank you for your interest in Ride To Work!Please click the Submit Form button to send us your application.

Thank you for your interest in Ride To Work!

Please click the Submit Form button to send us your application.