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RideKC Plus Temporary Eligibility Form

For RideKC Bus Customers Impacted by COVID-19 Service Reductions

This form is for customers that meet the following criteria:

You were a regular RideKC Bus rider prior to the service reductions that began operation on November 23, 2020.
You are no longer able to utilize bus service because of these changes, due to no longer having a bus route near your home or work.
Your home and work location are both within ¾-mile of a RideKC bus stop (even if the route serving these stops is no longer operating as of November 23).
Your desired trip is to access essential employment. (KCATA retains the right to determine which trips are essential based on staff review and the region's emergency safety orders.)
You are interested in using taxi-based transportation as a temporary replacement for reduced bus service.
Passengers must be ready five minutes before their scheduled departure time.
Passengers must present photo ID to the driver to confirm identity.

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* 1. Name:

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* 2. Email:

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* 3. Phone number:

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* 4. How have you been impacted by reduced bus schedules due to COVID-19? (choose all that apply)

There is no longer a route near where I live

There is no longer a route near where I work

Other (please specify)

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* 5. Which route(s) did you use prior to the November 23, 2020, service reductions?

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* 6. What is your home address?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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* 7. What is the address of your primary destination (work address)?

Business Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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* 8. Please describe any disability, health condition, or mobility aid (such as a wheelchair) that requires special provisions for this trip:

What days and times do you need to travel to work?
Please provide information for a typical week.
Note: The purpose of these questions is to determine demand for service. Additional information on scheduling trips will be provided after eligibility has been determined.

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* 9. Monday

I need to travel on Mondays (Yes/No)

Arriving at destination by:

Leaving destination at:

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* 10. Tuesday

I need to travel on Tuesdays (Yes/No)

Arriving at destination by:

Leaving destination at:

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* 11. Wednesday

I need to travel on Wednesdays (Yes/No)

Arriving at destination by:

Leaving destination at:

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* 12. Thursday

I need to travel on Thursdays (Yes/No)

Arriving at destination by:

Leaving destination at:

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* 13. Friday

I need to travel on Fridays (Yes/No)

Arriving at destination by:

Leaving destination at:

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* 14. Saturday

I need to travel on Saturdays (Yes/No)

Arriving at destination by:

Leaving destination at:

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* 15. Sunday

I need to travel on Sundays (Yes/No)

Arriving at destination by:

Leaving destination at:

Thank you for your responses. KCATA will contact your with any additional questions and to let you know if you are eligible for this program.