The Junction TMO
The Junction Transportation Management Organziation

 

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MassCommute
Member of the Massachusetts
Statewide TMA Council


 
 



 

 

Participant's Agreement

I have read and understand the Policies and Procedures of the Emergency Ride Home service and agree to participate in the service according to these rules. As a participant, I understand that transportation will be provided by a third party and that my employer or The Junction TMO cannot be held responsible for the performance of the vendor. I assume full responsibility for any risk which may result from participating in the service.

I understand that if I use the Emergency Ride Home service, my Employee Transportation Advisor (ETA) may ask me to complete a brief follow-up survey in order to ensure that my travel needs were met and to receive a new voucher for possible future use.

Please fill out the form below:

Home Information
First Name Last Name
Home Address
City State Zip
Home Phone
Email
Work Information

Employer

Department
Work Phone Fax:
Work Address
Mail Stop:
City State Zip
Supervisor's Name
RIDESHARING INFORMATION
Estimated mileage (one way) from home to work: miles
I commute to the Lowell Junction/Ballardvale Steet area at least 2 days a week by:
Carpool          Public Transit
Vanpool Private Bus
Walk "Call and Commute"
Bicycle Company Shuttle
 
Carpool Members

Name

   Work Phone

       

Name

     Work Phone 
       

Name

   Work Phone
       

Name

   Work Phone
       
I request to participate in the Junction TMO Emergency Ride Home Program.
I have read and agree to abide by the procedures and rules of the program.
  Enter initials here: Date:

 


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