Vanpool Driver Bonus Application

This form is for use by new vanpool drivers or backup drivers who have completed six months of being a new vanpool driver or backup driver.

Qualified drivers will receive a $100 subsidy.

1 Start 2 Complete

Driver information

This request is for (name) *

Daytime phone *

Email *

Date driver training completed *

Month

Day

Year

Home address

Address *

Unit

City *

State *

Zip *

Employer Address

Employer name *

Address *

Unit

City *

State *

Zip *

Vanpool agency *

Vanpool agency Other...

Vanpool number *

Participant must either live in, or work in the City of Redmond at an employer with a current Redmond business license.
One bonus per participant - this is a one time bonus.
The bonus is only available for drivers who have completed six months of being a new vanpool driver or backup driver.
Application must be received within 30 days of completing six months of being a new driver or backup driver.
Fraudulent use of any Go Redmond subsidy or reward, as determined at the sole discretion of the City of Redmond, immediately suspends all subsidies and obligations of the Go Redmond program for the participant.
Participants must be gainfully employed and incentives must be used for commuting purposes (i.e. traveling to and from work), and are not intended for trips taken to school, or other non-work related trips.
Requests must be received by the 20th of the current month in order to receive a bonus for the following month.

I agree to the Program Rules and certify that the information provided is accurate:

Signature *

Please type your full name. This will act as a digital signature.

Today's date *

Month

Day

Year