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Rideshare Registration

Complete all sections of this application that apply to your commute and click "submit" to the Rideshare Office.

All Rideshare benefits and incentives, including carpool permit upgrade, transit or vanpool subsidy, bike locker, guaranteed ride home, Beach Bucks, and other cash-value items will be issued on the basis of this application and your Monthly Rideshare Record.

Phone:work (562) 985-4091

Fax:fax (562) 985-7832

rideshare@csulb.edu

Once you are accepted and registered into the system, you must complete and submit a monthly Rideshare Record by the 5th of each month.

Required: *

Personal Information

* First Name:

* Last Name:

* Campus ID #:

* Extension / Phone:

* Home Address: (Kept Confidential)

Mail Stop:

* City:

*Zip Code:

Department:

* Email:

Typical Work Hours
Start Time:

End Time:

If your work hours vary from day to day, please check here.

* Status - Please select only one. CSULB Faculty CSULB Staff Student Worker (CSULB Only)

Commute Information

* Please indicate the one-way distance of your commute to CSULB. miles from CSULB

For assistance in estimating your commute, use the Google Maps service.

Faculty & Staff Bicycle / Hand Bike Registrants Only (B)

Bike Registrants Thanks for riding your bike to work! Please contact the Kinesiology Dept. locker room at 985-4051 if you would like to arrange for use of a locker & shower facilities.

Compressed Work Week (CWW) Registrants Only

I am on compressed work week: 3/36 4/40 9/80

Public Transit (PT)

I am requesting a monthly transit subsidy for (select all that apply) U-PASS = LBT subsidy provided automatically with your CSULB ID

OCTA Employee Annual Pass

$50 MTA Commuter Cash Subsidy

Carpool (C) Registrants Only

Carpool Permit #:

Please check all that apply.

I am carpooling with: CSULB Faculty/Staff CSULB Student V.A. Employee(s)
Other local non-CSULB employee/student I get dropped off

To park in a CSULB carpool space, you must display a valid carpool permit AND park with carpool partner/s in the car. If you are dropping others off before you park, you should park in a general staff/student space to avoid getting a ticket.

Carpool Partner 1

Name:

Ext. / Phone:

Dept / Job Site / School:

Carpool Partner 2

Name:

Ext. / Phone:

Dept / Job Site / School:

Carpool Partner 3

Name:

Ext. / Phone:

Dept / Job Site / School:

Zero Emission Vehicle Registrants Only

Year:

Make:

Model:

Color:

Licence Plate #:

Fuel:

Van Pool Registrants Only

Vanpool Permit #:

Vanpool Company:

Contact Phone:

By clicking the "Submit Application" button I agree to immediately inform CSULB Rideshare of any changes in my contact information, employment, enrollment or commute status. I understand that Rideshare incentives may be subject to federal & state taxes. I understand that falsification or willful misrepresentation of Rideshare claims to obtain any available incentive may result in disciplinary action, including repayment of any monetary incentives and/or termination.

Rideshare @ the Beach