AIDT RIDE Transportation Program

ALABAMA TRANSPORTATION INCENTIVE

This form is only to be completed by candidates who are applying to or individuals currently employed with companies who are AIDT clients. Please do not complete this form if you do not see your company listed in the company dropdown field.

This is a limited transportation service provided for AIDT and its affiliates at no cost. All rides must be pre-approved by AIDT at least 24 hours before the scheduled pickup time.

"*" indicates required fields

Company*

Select the company you require transportation to. (This must be a company you have applied to or are employed with.)

Name*

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Enter Email Confirm Email

Phone*

Can we text you?*

Yes

At this time, do you know when you will need transportation services?

Special Request /ADA needs

Yes

Do you require special assistance?

Special needs required

Please list the special needs required

Emergency Contact

Enter the name of your emergency contact.

Emergency Contact Phone

Signature*

Date of signture*

ex. July (07)

ex. 25

ex. 2024

Comments

This field is for validation purposes and should be left unchanged.