FIND A CARPOOL--FILL OUT THIS FORM AND SEND IT NOW!!

This form is for people who live or work in the Capital District only

Please indicate if this is a:

  new listing   modification to an existing listing

COMMUTER REGISTER LISTING REQUEST FORM

1. City or Town You Commute From (please specify actual location if different from mailing address; e.g. if your mailing address is Albany and your home is in the Town of Guilderland, specify Guilderland):

2. Nearest Intersection, Neighborhood or Landmark that best identifies where you live:

3. Name and Address of the Workplace That You Commute To:

4. Please Indicate Your Work Schedule:

    start work:    am     pm

    leave work:    am     pm

    Are these work times flexible?     yes     no

5. Do You Prefer To?      

6. Phone numbers where you can be reached:

    home:()  -   

    work: () -

    Ask For:    e-mail:

7. Additional Information (i.e. looking for a "bike buddy"; wish to rideshare part-time; prefer non-smoker; etc.):