Salem Keizer Bus Pass Program Application

Application for United Way's Bus Pass Program October - December 2017 Distribution.  This application must be completed by Tuesday, September 19, 2017.

Files must be less than 2 MB.
Allowed file types: gif jpg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Person responsible for reporting bus pass data to United Way of the Mid-Willamette Valley?

Application Prepared By?

Pick a maximum of three people that are authorized to pick up passes.

Organization Narrative..Answer each question as a response in your narrative. Answers should be no more than 500 words/

My organization meets the eligibility criteria for United Way's Bus Pass Program, and will use bus passes as intended. Our Bus Pass Tracking Form will be submitted in a timely manner.