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A vibrant Seattle through transportation excellence Grace Crunican, Director

Commuter Cash Home
Sign up for Commuter Cash or Refer-A-Friend
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Commuter Cash Application

We’re glad that you’ll be reducing drive-alone commuting. Thanks for being part of the solution!

First, we need some information about you.

Your First Name:
Your Last Name:
Your Street Address:
City:
Zip Code:
Your neighborhood:
Daytime phone number:
Alternate contact info:
(Please provide a second phone number or a SECONDARY email)
Your E-Mail Address:
Important – remember the email address you provide. This will be you user ID for the program.
ADDITIONAL INFO
How did you hear of this program?
Would you be interested in talking to the media about your experiences in this program? Yes     No
 
Please provide us with the following information about your employer. This is helpful for our program tracking.
Employer name:
Employer street address:
Employer city:
Zip:
Distance to work 1-way:

Please provide a contact who can verify your commuting patterns.
Verifier name:
Verifier day phone:
Verifier email :

Were you referred to the program by a friend?. Please fill out the following so they can earn their reward if you participate in the program.

Referrer’s first name:
Referrer’s last name:
Would you like some advice or assistance on planning your commute?
Yes     No

Why do you want to participate in this program? (Please limit your wording to 250 characters, thank you.)


characters left
On average, how many days per week do you normally commute without driving alone?  
I pledge to reduce my drive alone commuting for at least 3 months for an average of days per week.
To measure how much you change your commuting, we need you to complete the short BEFORE survey below. At the end of the program, you'll complete an AFTER survey so we can track the change in your commute patterns.

Please provide your commute information for a very recent commute week that is typical of your commute habits.
I am providing info for the week of: (mm/dd/yyyy)
Please list the number of ONE WAY commute trips you took for each of the following travel modes for the week entered above. A typical 5-day work week would have 10 ONE WAY trips.:

Drive Alone
Carpool
Bus/train
Walk
Bike
Work from Home


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