Emergency Ride Home Application

Countywide Emergency Ride Home Application

Application Agreement and Baseline Survey
  • To qualify for the Countywide ERH Program you must travel to work at least one day a week by: bus, carpool, vanpool, bicycle, electric bicycle, or walking, and you must agree to complete one follow-up survey within a year. This baseline survey is to help the Ecology Action establish commuter habits of Santa Cruz County residents. All information will remain anonymous. I plan to use the following travel methods to get to work in the upcoming year (put estimated number of days per week):
  • What obstacles prevent you from using an alternative mode of transportation more often to commute to work?
  • Please read the following carefully:Participant Agreement:I understand the guidelines of the Emergency Ride Home Program. I am eligible to use this program by traveling to work at least one day per week using an alternative mode of transportation.I understand that I can be reimbursed for up to two rides per calendar year, and that the rides are to be used during work hours, and only on days when I have used an alternative mode of transportation for my commute. I agree to complete one follow up survey with my reimbursement submission.By clicking the "Submit" button, I agree to comply with the conditions of this program and hereby release Ecology Action from any liability, claims, and demands for personal injury, loss, theft, or damage to my personal property; loss of income, consequential damage resulting from delays or absence of a taxi/ride hail, or termination of the program.
  • This field is for validation purposes and should be left unchanged.