Just complete this form and click on Submit when ready to send.
Your information is then sent to sats@partaonline.org in email form.

*Your name:
Address:
Phone number:
*VALID email address:
*Required field - Schedules and various updates are sent via email.

Academic Period: (select one)

Fall
Spring
Finals Week
Summer I
Summer II
Summer III

 

(Replace text in boxes with your actual schedule.)
Days
MTWHFS 		Pick-Up Time
Requested 		Appointment
Time 		Pick-Up
Location 		Drop-Off
Location 		Ride Type
C, H, S

Pick-Up Time Requested: The time you would like picked-up.
Appointment Time: The time you need to be at your destination by (the class start time for a ride to class).
Ride Types: C=Class, H=Home, S=Somewhere else

If you have more schedules than fit on his form, please submit another form with the additional schedules.

 

Any comments?

 

 

PARTA does not discriminate in provision of services or employment because of handicap, race, color, creed, national origin, sex or age. ©PARTA, 2006   site index