Rideshare Participant Withdrawal or Transfer

Rideshare Participant Withdrawal or Transfer
A participant may choose to withdraw from Rideshare at any time; however, their Rideshare Participant

Agreement and monthly fare will continue in force until the rider gives written notice ten (10) days before the
My name is:
I am withdrawing from Spokane Transit vanpool Group
This is effective on this date:
Please keep me active for future ride matching opportunities

I am withdrawing from the groupI am transferring to another group
Please check all that apply:

Shift ChangeUnresolved Vanpool IssuesRetiringOtherNew worksiteWould you like us to contact you about this?Physical Address ChangePlease keep me active for future ride matching opportunities
I am an approved driver, and I would like to keep my driving privileges.
Would you like us to contact you regarding this?
If transferring, my new group number is:
If transferring, the new driver is:
Pick up stop
Drop off stop
***Fairchild AFB – use cross streets only – (do not use physical address or Bldg #s)
Current Driver or Bookkeeper Name
Participant Signature

Clear
Today's Date
Should be Empty: