Easy Street NY - Commuters: Commuter Contact Form

ABOUT
EASY STREET^® NY

commuter contact form

PROPERTY MANAGERS

DISCUSSION FORUM

Please fill out this form and we will notify you when a vanpool becomes available that matches your commute. Vanpools are forming regularly. Don't miss your ride!

To learn more about the advantages of vanpooling, visit our EasyStreet commuter area, email us at info@easystreetny.com, or call us at 1-800-FIND-RIDE (1-800-346-3743).

* required

Commuter Information:
Last Name*:
First Name*:
Initial:
Address*:
Cross Street:
City*:
State*:
ZIP Code*:
Home Phone*:
Work Phone*:
Extension:
Work Email*:

Employer Information:
Employer Name*:
Address*:
City*:
State*:
ZIP Code*:

My Schedule and Preferences:

1. Where would you like to be contacted?

Home:

Work:

2. How would you like your ridematch list sent to you?

Mail:

E-mail:

3. Which days do you commute to work?

Mon-Fri:		Mon:		Tues:		Wed:
Thurs:		Fri:		Sat:		Sun:

4. What time do you normally start work?

Time:

AM:

PM:

5. What time do you normally leave work?

Time:

AM:

PM:

6. Are your work hours flexible by:

not flexible:		15 minutes:		30 minutes:
45 minutes:		60 minutes:

7. What is your rideshare preference?

Drive:

Ride:

Share the Driving:

8. I would prefer non-smoking partner(s):

Yes:

No:

For Your Employer

Would you like to receive a packet of information about Easy Street to give to your employer?

Yes:

No:

How did you here about us?

	Billboard		Internet
	Easy Street^® van		Newspaper
	Employer		Magazine
	E-ZPass		Radio
	Highway sign		Television
	Mail		Other

Thank you for contacting us!

improve your quality of life! let someone else do the driving!

Easy Street^® NY is a not-for-profit program sponsored by the New York State Department of Transportation and administered by MetroPool.
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Easy Street^® is a registered trademark of The Rideshare Company.