metro.net Share the ride. Get the rewards. “Your incentive program takes very little of my time and our employees are very happy. When participating employees receive giftcards, their co-workers want to find out more about the program so they can participate too!” Andres Vasquez St. Johns Medical Center “You have a great program, and the employees have certainly enjoyed the ‘envelopes’ they received. So many of them carpool now, it seems ingrained. What a good thing!” Janet Ho=man Haldeman, Inc. Sign up your company for Metro Rewards and we’ll provide the giftcards. “I just wanted to thank you for the giftcards. Our rideshare employees who received them were really happy and very appreciative.” Eva Mihalka Jones Day – Los Angeles “As an Employee Transportation Coordinator for a large multi-tenant o;ce o ce complex, it can be di; ;cult to get the rideshare message to tenants. The giftcards have really made a di= di= =erence erence in getting employees to share the ride to work. Your program has helped us improve our AVR.” Cristina Corrales Howard Hughes Center 06-2378mr ©2006 lacmta “Your incentive program is the perfect vehicle to assist us in meeting the challenge of putting people in a position to rideshare so they see the rewards for themselves. Coordinating and managing this program requires little e= e= =ort ort and the materials you have are great.” Raphael Guillen City of Pico Rivera Stop driving. With Metro Rewards, it really pays to rideshare. We’ll pay your employees to share the ride! Here’s how: > Eligible employees* receive a $15 giftcard good at their choice of Target, Ralphs, Best Buy or Starbucks > Metro Rewards participants are entered into monthly and quarterly drawings for $100 giftcards > Metro Rewards is renewable annually as long as participants continue to rideshare * To qualify, employees must work at a participating worksite, rideshare at least eight workdays a month for three months or longer and must complete a Metro Rewards application. Metro Rewards is a great way to provide an employee rideshare incentive at no cost to your company or employees. So, sign your company up now! Just talk to your Metro Rewards representative to get all the details. Call Metro Commute Services at 213.922.2811. Share the ride. Share the rewards. Metro Rewards Employee Application Join Metro Rewards, Los Angeles County’s rideshare reward program for dedicated ridesharers, and we’ll send you a $15 giftcard of your choice from Target, Ralphs, Best Buy or Starbucks. Also, new Metro Rewards members will be entered into a one-time drawing for a $100 giftcard for the month they enroll. And, all participating Metro Rewards members will automatically be entered into ongoing quarterly drawings for $100 giftcards. To Qualify: • You must have been ridesharing with other working adults at least eight workdays a month for the past three months or longer. If not, you do not qualify for this program • You must work at a worksite located in Los Angeles County and enrolled in Metro Rewards • You must sign this form certifying that the information you provide is true and accurate COMMUTER INFORMATION (Please print clearly) Commuter Name (First*) _________________________ (M.I.) ____ (Last*) _________________________________ Home Address _________________________________________ City* _______________________ Zip* _________ Home Phone ( ) _______________ Work Phone* ( ) _____________ ext. ____ Employee I.D. * _____________ Fill in your e-mail address to receive the latest Metro updates ______________________________________________ This Metro Rewards Employee Application is for: New Membership Renewal How many miles do you travel from home to work (one way)?* _______ miles Have you been ridesharing at least eight workdays a month for the past three months or longer?* Yes No How many days a week do you usually rideshare to work?* (Check one) 1 day 2 days 3 days 4 days 5 days How do you most often rideshare to work?* (Check one) Carpool with other working adult(s) Public Bus/Rail Bicycle Vanpool Telecommute Other (Specify) __________________ Walk Please select your $15 giftcard (Check one) Target Ralphs Best Buy Metrolink Starbucks Note: If you do not choose a giftcard, Metro will make the selection for you. Commuter’s Signature* __________________________________________________________ Date* ____________ EMPLOYER INFORMATION (Please print clearly) Employer Business Name* ____________________________________ Employer Phone* ( ) __________________ Employer Address* ______________________________________ City* _______________________ Zip* _________ Employer Representative Name* (Print) _____________________________________ Fax* ( Employer Representative Phone* ( ) _________________ ) ________________ E-mail Address* __________________________________ Employer Representative’s Signature* _____________________________________________ Date* ______________ Employer Representative’s Supervisor’s Name* (Print) ____________________________ Phone* ( ) ___________ Employer Representative’s Supervisor’s Signature*___________________________________ Date*______________ Three signatures are required to process this application. This application is confidential and is used to compile a demographic and statistical profile of Los Angeles County commuters. All fields with an * are mandatory for processing. Please return the completed application to: Metro Rewards One Gateway Plaza Mail Stop: 99-19-5 Los Angeles, CA 90012-2952 Or Fax to 213-922-6267 11.28.2007 Comparta el viaje. Comparta la gratificación. Solicitud del Empleado para Metro Rewards Tome parte en el programa Metro Rewards, el programa de gratificación para las personas que comparten los viajes con regularidad en el condado de Los Angeles, y le enviaremos una tarjeta de regalo de $15 de Target, Ralphs, Best Buy o Starbucks. Además, los socios nuevos de Metro Rewards serán inscritos en la rifa para una tarjeta de regalo de $100 en el mes en que se registren únicamente. Y todos los socios participantes de Metro Rewards también serán inscritos automáticamente en las rifas trimestrales periódicas por tarjetas de regalo de $100. Para cumplir los requisitos usted debe: • Haber compartido los viajes con otros adultos que trabajan por lo menos ocho días laborales al mes durante los últimos tres meses o más. Si usted no cumple con éste requisito, no puede participar en este programa • Trabajar en una empresa ubicada en el condado de Los Angeles que esté registrada en el Programa Metro Rewards • Firmar esta solicitud declarando que la información proporcionada es correcta INFORMACIÓN DEL EMPLEADO (Favor de escribir con letras mayúsculas) Nombre (Primer*) __________________________ (Inicial) ____ (Apellido*) _______________________________________ Dirección _________________________________________ Ciudad* _______________________ Código postal* _________ Teléfono de casa ( ) _______________ Teléfono del trabajo* ( ) __________________ ext. ____ Identificación de empleado* ______________ Incluya su dirección de e-mail para recibir las últimas noticias de Metro ____________________________________________ Esta solicitud del empleado para Metro Rewards es una: Membresía nueva Renovación ¿Cuántas millas viaja de la casa al trabajo (viaje de ida)?* _______ millas ¿Ha compartido el viaje por lo menos 8 días laborales en un mes durante los últimos tres meses o más?* Sí No ¿Cuántos días a la semana comparte el viaje al trabajo?* (Marque una casilla) 1 día 2 días 3 días 4 días 5 días ¿Qué medio utiliza más frecuentemente para viajar hasta el trabajo?* (Marque una casilla) Auto de uso compartido con otro(s) adulto(s) yendo al trabajo Autobús/Tren público Bicicleta Metrolink Caminar Teletrabajo Otro (Especifique) _______________________ Camioneta de uso compartido Elija su tarjeta de regalo de $15 (Marque una casilla) Target Ralphs Best Buy Starbucks Aviso: Si usted no elige una tarjeta de regalo, Metro seleccionará una por usted. Firma del empleado* ____________________________________________________________ Fecha* _________________ INFORMACIÓN DEL EMPLEADOR (Favor de escribir con letras mayúsculas) Nombre de la empresa* _______________________________ Número de teléfono de la empresa* ( ) ________________ Dirección* ______________________________________ Ciudad* ________________________ Código postal* __________ Nombre del representante de la empresa* _____________________________________ Fax* ( Teléfono del representante de la empresa*( ) _____________________ ) ______________________ Dirección de E-mail* _______________________ Firma del representante de la empresa* ____________________________________________________ Fecha* ___________ Nombre del supervisor del representante de la empresa* _________________________ Número de teléfono* ( )________ Firma del supervisor del representante de la empresa* ________________________________________ Fecha* ___________ Para procesar la solicitud se necesitan tres firmas. Esta solicitud es confidencial y se utiliza para recopilar datos demográficos y estadísticos de los trabajadores en el condado de Los Angeles. Todas las secciones marcadas con una * deben estar rellenadas para el procesamiento de la solicitud. Favor de enviar ésta solicitud completa a: Metro Rewards One Gateway Plaza 99-19-5 Los Angeles, CA 90012-2952 O envíela por fax al 213-922-6267 11.28.2007