Greeley Evans Transit: Booking Step 1 of 5 20% Name(Required) First Last Home Address(Required)House number and streetHome Address - City(Required) Greeley Evans Garden City Email(Required) Phone(Required)Please send my confirmation via(Required) Phone - please leave message Phone - do not leave message Email I will be paying by(Required) Cash Punch Card Ticket Trips cost $3 each way Date of desired trip(Required) MM slash DD slash YYYY You can only use this form to request trips in the next 1-14 days.I would like to be at my destination by(Required) Hours : Minutes AM/PM AM PM AM/PM PickupI am wanting to be picked up from(Required) Home Other Location Pickup Location - Street Address(Required)Pickup Location - City(Required) Greeley Evans Garden City DropoffI am wanting to be dropped at(Required) Home Other Location Drop off Location - Street Address(Required)Drop Off Location - City(Required) Greeley Evans Garden City Return RideI will need a return ride(Required) Yes No I would like to be picked up at this time(Required) Hours : Minutes AM/PM AM PM AM/PM Return Ride - I want to be picked up from(Required) Drop Off Location Other Location Return Ride Pickup Address(Required)Street AddressReturn Ride Pickup Address - City(Required) Greeley Evans Garden City Return Ride - I want to be dropped off at(Required) Home Other Location Return Ride Drop off Address(Required)Street AddressReturn Ride Drop Off Address - City(Required) Greeley Evans Garden City I will be using the following assisting devices(Required) No assisting devices Cane Crutches Service Animal Walker Wheel Chair check any and all that applyI will have an attendant(Required) Yes No My attendant(Required) Is Ambulatory Uses a cane Uses crutches Uses a walker Uses a wheelchair I will have a guest(Required) No Yes - One guest Yes - Multiple guests Number of Guests(Required)My guest(s)(Required) Is Ambulatory Uses a walker Uses a cane Uses crutches Uses a wheelchair Additional guest informationAny additional information we may need to know Additional informationIf you have additional locations to travel to, please submit an additional request. If you need to make modifications to this trip, please contact dispatch at 970.350.9290. Requests are not official until you receive confirmation by phone or e-mail as requested. Your confirmation will include the time frame(s) you are scheduled. You should receive this confirmation within 15 minutes. If you do not receive a confirmation within 30 minutes, please contact dispatch at 970.350.9290. CAPTCHACompanyThis field is for validation purposes and should be left unchanged.
