Share-A-Ride

Registration Information

*Indicates a required field.User Information

(Please enter your name in title case. Ex. "John Smith" not "JOHN SMITH")
*	First Name:
	Middle Initial:
*	Last Name:
	How did you find out about the car/van pool program?

Home Address

To find a carpool or vanpool partner please enter your Home Street Address and enter a nearby intersection for a more accurate search.

(Please enter your address information in title case. Ex. "Elm Street" not "ELM STREET")

*	Address (Street number, Street name):
	Address Line #2 (Apt #, etc.):
*	City:
	State:
*	Zip Code:
	Home Phone Number:	( ) -
	Cell Phone Number:	( ) -

Nearby Intersection (example: Eagle River Loop Road and Citation Road):
and

Work Address

Share-A-Ride has registered a number of work sites in the Anchorage area. Please check the list and select your work site if you find it, and the address will be automatically filled in below. Otherwise, enter your work address in the space provided.

(Please enter your address information in title case. Ex. "68th Avenue" not "68TH AVENUE")

*	Complete Company Name:
*	Address (Street number, Street name):
	Address Line #2 (Department, Building, Suite):
*	City:
	State:
*	Zip Code:
	Work Phone Number:	( ) - ext
	Fax Number:	( ) -

Nearby Intersection (Ex.: 36th Avenue and C Street)
and

Mailing Address
(Please give us your mailing address if it is different from your home address. This includes P.O. Boxes.)

	Address:
	Address Line #2 (Apt #, etc.):
	City:
	State:
	Zip Code:

Profile Preferences

	*	Work Start Time:	:	*	Work End Time:	:
My work hours are flexible by:	*	My arrival time can vary by:	minutes	*	My departure time can vary by:	minutes

Matching Preferences

Do you smoke?	Yes No
Avoid smokers:	Yes No
How do you currently travel to work?
Carpool Interest: I would like to be a
Vanpool Interest: I would like to be a
I have a vehicle available and I am willing to be a driver or share driving:	Yes No
I would like people interested in ridesharing to contact me by:
Show my cell phone number on match reports?	Yes No
The following fields determine how far around your home/work the system will look for a ridematch.
Carpool Home Search Radius:
Carpool Work Search Radius:
Park and Ride Search Radius:
Comments: Please enter any other information that other commuters should know, such as what days you work if other than Monday through Friday, whether you need a ride both ways or just one way, whether you like to listen to the radio/music as you commute, etc.
Do you want information about bus transportation service in your area?
	Transit Information - Anchorage
	Transit Information - Mat-Su

Login Information

Please enter your email address and password to use for future logins.
*	Email Address:
*	Password:
*	Confirm Password:

The Share-A-Ride program is a service of the Anchorage Public Transportation Department dedicated to helping commuters and employers find and use alternative means of transportation to driving alone in a vehicle. The program is funded by the Federal Highway Administration and the State of Alaska Department of Transportation. The program provides a referral service to its participants by establishing a database of potential rideshare partners.

Share-A Ride does not recommend, endorse, certify or vouch for the character, nature or integrity of any Share-A-Ride referral. Each participant is strongly advised to screen each potential referral carefully to ensure personal satisfaction.

By submitting this application, I agree that the information submitted will be entered into the Share-A-Ride rideshare database. I understand that potential rideshare partners will receive notification containing my contact information, but without my home phone (unless I have requested this) and without my home street number. I understand that my information is for the purpose of helping me form and/or join a carpool or a vanpool and will not be provided to any marketing company. I understand that participation in the Share-A-Ride carpool program is a voluntary decision on my part and that ride sharers are solely responsible for their participation and/or operation of their respective carpools. I understand that participation in the Share-A-Ride vanpool program is voluntary however it must be in accordance with the current Alaska Vanpool Driver Guide.

I understand and agree that the Municipality of Anchorage, its employees and agents shall have no responsibility or liability for any claims, expenses or damages resulting from my participation, or any other individuals participation, in the Share-A-Ride Program. Further, I agree to hold the Municipality of Anchorage harmless from any and all claims, lawsuits or liability, including attorney�s fees and costs, arising out of, in connection with, or incident to any loss, damage or injury to persons or property allegedly caused by me as a result of my participation in the Share-A-Ride program.

Share-A-Ride 3600 Dr. Martin Luther King Jr., Avenue Anchorage, AK 99507
Phone: 562-7665 Fax: 249-7329 Email: pool@muni.org