Employee Public Bus Subsidy Application

The University will provide a monthly bus subsidy, based upon the availability of funds, to University employees (on University payroll), full-time or part-time arriving to campus before 11:00 am and use public transit as an alternate mode of transportation to the University at least four (4) or more days per week. The subsidy will be approx. 25% for employees who do not own a parking permit; These employees may also obtain up to four (4) Commuter 1-Day Parking Permits per month from calstatela.aimsparking.com. For employees who own a parking permit, the monthly subsidy will be approx. 15%; for these employees there will be no allocation for parking permits. Transit discounts or daily parking permits will not be accumulated if the employee failed to pick up their subsidized item on any given month or for not knowing of the existence of this program. Participants separating from campus or on extended leave must notify the Commuter Services Office immediately. Bus subsidy applications must be renewed once a year. Failure to renew the application on a yearly basis may lead to disqualification of this program.
NOTE: SUBSIDIZED BUS PASSES ARE AVAILABLE FROM THE 1st TO THE 20th OF THE MONTH.

Employee's last name
Employee's first name
Employee's middle name
Enter your 9 digit Employee ID Number
Employee's home address
City
Zip code
Best number to contact the employee
Employee's department
Location or building where the employee works
Employee's mail code
Employee's work phone extension
Approximately how many miles is your commute to work?
Do You Own A Permit?

Does the employee own a valid parking permit?
Senior/Person with a Disability pass?

Do you require a Senior/Person with a Disability pass?

What bus line(s) do you currently ride or will be riding to arrive campus? (i.e #65, #71, #483 etc). Enter the bus line(s) you currently ride or will be riding to arrive to campus below.

List MTA line(s) do you currently ride or will be riding to arrive to campus (i.e #65, #71, #483 etc)
List the Foothill line(s) you currently ride or will be riding to arrive to campus (i.e #65, #71, #483 etc)

What are the typical work hours? (i.e. MON 8-5, TUE 9-5, WED 9-12, etc. please specify) Saturday and Sunday work hours do not qualify. List the employee's typical work hours next to each day below Saturday and Sunday work hours do not qualify.

Work Hours
List the typical work hours, start and end for Mondays
Work Hours
List the typical work hours, start and end for Tuesdays
Work Hours
List the typical work hours, start and end for Wednesdays
Work Hours
List the typical work hours, start and end for Thursdays
Work Hours
List the typical work hours, start and end for Fridays
I certify that the subsidy I receive will be used by me to help reduce my out-of-pocket cost of a monthly bus pass. I understand that my eligibility is based upon my arrival on campus before 11:00 am and that I will immediately notify the Parking and Transportation Service Center if I am no longer eligible to participate in this program. I also certify that i will not transfer, loan or sell this item to anyone, including other campus employees. I understand that all information provided above is subject to verification and I am aware that falsification of this information will be caused for disciplinary action, up to and including termination of employment.
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