The Junction TMO
The Junction Transportation Management Organziation

 
MassCommute
Member of the Massachusetts
Statewide TMA Council


 
 



 

The Junction TMO, Inc.
Stan Franzeen, Director
One Burtt Road
Andover, MA 01810

ph (978) 247-3100

 

Participant's Agreement

I have read and understand the Policies and Procedures of the Emergency Ride Home service and agree to participate in the service according to these rules. As a participant, I understand that transportation will be provided by a third party and that my employer or The Junction TMO cannot be held responsible for the performance of the vendor. I assume full responsibility for any risk which may result from participating in the service.

I understand that if I use the Emergency Ride Home service, my Employee Transportation Advisor (ETA) may ask me to complete a brief follow-up survey in order to ensure that my travel needs were met and to receive a new voucher for possible future use.

Please fill in and submit the form below or you may download a printable form in PDF File format that you may mail or fax:

Home Information
First Name Last Name
Home Address
City State Zip
Home Phone
Email
Work Information

Employer
Department
Work Phone Fax:
Work Address
Mail Stop:
City State Zip
Supervisor's Name
RIDESHARING INFORMATION
Estimated mileage (one way) from home to work: miles
I commute to the Lowell Junction/Ballardvale Steet area at least 2 days a week by:
Carpool          Public Transit
Vanpool Private Bus
Walk "Call and Commute"
Bicycle Company Shuttle
 
Carpool Members

Name

   Work Phone

Name

    Work Phone

Name

    Work Phone

Name

    Work Phone
I request to participate in the Junction TMO Emergency Ride Home Program.
I have read and agree to abide by the procedures and rules of the program.
  Enter initials here: Date:

 

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