CommuterChoice.com: America's Way to Work

Local Information:

Thank you for your interest in CommuterChoice.com. Following the completion of this form, and review by our staff, your organization will be listed as a Commuter Choice Service Provider to all visitors. Whenever an employer in your service area states an interest in setting up a Commuter Choice program, an email message will automatically be sent to the principal email contact in our database. Further information about the client will be sent in that email message.

If you have any questions about this form, the CommuterChoice.com database, or how this process works, please contact members@CommuterChoice.com.

This form, to be completed over the next two pages, will take approximately five (5) minutes to complete.

All fields must be completed

Organizational Contact Information

1. Name of company or organization:

2. Type of company or organization (select one):: Governmental agency; Commercial / For-Profit; Non-profit organization (ie, TMA, TMO, Chamber of Commerce, etc.)

3. First name and last name of principal contact:

4. Principal street/suite address for firm or organization:

5. City, State, and ZIP:

6. Principal contact's phone number:

7. Principal contact's fax number:

8. Principal contact's email address:

9. Do you have a Commuter Choice oriented page on your organization's website? If so, please enter the full address without the "http://" (ie, "www.commuterchoice.com/index.html") here:

Organizational Services Offered

Please check all Commuter Choice services that your organization offers to employers. Commuter Choice visitors will only see those services for which you select on this form.

10. Services provided to employers: Check all that apply.

Vanpool Services
Vanpool passes, subsidies, and/or vouchers
Vanpool matching
General vanpool program set-up

Transit Services
Transit passes, subsidies, and/or vouchers
Transit routing and/or trip guides
General transit assistance

Worksite Services
Alternative Work Arrangements (compressed work weeks, flextime, etc.)
Telework assistance
Alternative transportation marketing and/or events
Alternative transportation friendly site design
Parking management, cash-out, or preferred parking set-up
Commuter Services
Ridematching assistance
Guaranteed Ride Home
Bicycle and Pedestrian programs
Other Services
Tax benefits implementation assistance
Incentives programs
Cost / Benefit analyses for transportation options
Regional transportation coordination and/or advocacy
Vanpool Services: Vanpool passes, subsidies, and/or vouchers; Vanpool matching; General vanpool program set-up
Transit Services: Transit passes, subsidies, and/or vouchers; Transit routing and/or trip guides; General transit assistance
Worksite Services: Alternative Work Arrangements (compressed work weeks, flextime, etc.); Telework assistance; Alternative transportation marketing and/or events; Alternative transportation friendly site design; Parking management, cash-out, or preferred parking set-up
Commuter Services: Ridematching assistance; Guaranteed Ride Home; Bicycle and Pedestrian programs
Other Services: Tax benefits implementation assistance; Incentives programs; Cost / Benefit analyses for transportation options; Regional transportation coordination and/or advocacy

11. Does your organization provide direct rail or bus services to commuters? Only transit agencies and similar organizations should answer "yes".: Yes (transit provider); No (not transit provider)

12. Does your organization provide direct vanpool subscription services to commuters? Only vanpool operators, transit agencies, MPOs, and similar organizations should answer "yes".: Yes (vanpool provider); No (not vanpool provider)

13. Does your organization charge employers for services? Please check all that apply.: No cost or fee for employers (every service is available free-of-charge); Membership required for services (membership fee or subscription is required for access to services); Administrative fee or surcharge for services (a set or percentage fee is charged for the administration of services); Direct cost for services (a set price is identified per service - for example, $1 per employee for guaranteed ride home); Other costs for services

Regional Operations

14. Does your organization offer Commuter Choice services in all 50 states and commonwealths?: Yes (nationwide Commuter Choice services provider); No (not nationwide Commuter Choice services provider)

15. What states and/or commonwealths does your orgnization provide services in? Check all that apply. If you selected "Yes" to question 13, above, you do not need to complete this section.

*States*
Alabama	Montana
Alaska	Nebraska
Arizona	Nevada
Arkansas	New Hampshire
California	New Jersey
Colorado	New Mexico
Connecticut	New York
Delaware	North Carolina
Florida	North Dakota
Georgia	Ohio
Hawaii	Oklahoma
Idaho	Oregon
Illinois	Pennsylvania
Indiana	Rhode Island
Iowa	South Carolina
Kansas	South Dakota
Kentucky	Tennesse
Louisana	Texas
Maine	Utah
Maryland	Vermont
Massachusetts	Virginia
Michigan	Washington
Minnesota	West Virginia
Mississippi	Wisconsin
Missouri	Wyoming
*U.S. Commonwealths*
American Samoa	District of Columbia
Guam	Northern Marianas
Puerto Rico	Virgin Islands

	© 2010 Commuter Choice.com : All Rights Reserved This website was orginally developed by Managerial Technologies Corporation (MTC) as a project supported by the Environmental Protection Agency (EPA), US DOT Federal Highway Administration and the Association for Commuter Transportation (ACT). After the government funding expired, Libraries and Directories, Inc assumed the full operational burden of maintaining the site because of the belief that the best way to address oil consumption is through conservation.