South Florida Vanpool Registration

Commuters vanpooling to and from work at least three days a week are eligible for the SFCS’ Emergency Ride Home (ERH) program. Please complete the following form to register for the ERH program. You will need to have your primary vanpool driver's name and vanpool ID # in order to complete the form below.

Registrants will be automatically enrolled in SFCS’ ERH Online Voucher System which allows you the ability to view information on used vouchers, track unused vouchers, and print vouchers directly from your computer. If you would prefer not to participate in the Online Voucher System, make sure to select the opt-out option at the end of the form to receive SFCS pre-printed vouchers in the mail.

Your vanpool registration will be valid for one year. At the end of your registration period, SFCS will send you an ERH renewal notification. You will need to renew your registration in order to remain in the ERH program.

Click Here for a printer friendly PDF version of this registration form.

First Name:*

Last Name:*

Email:

Home Address:*

Home Apt/Unit #:

Home City:*

Home State:*

Home Zip:*

Home Phone:

Cell Phone:

Company Name:*

Work Address:*

Work Suite #:

Work City:*

Work Zip:*

Work Phone:*

Work Hours From Approximately:*

Work Hours Until Approximately:*

Vanpool Primary Driver Name:*

Vanpool ID #:*

How did you hear about the Emergency Ride Home Program?*

Online Voucher System OPT-OUT:

	Yes
	No

Verification Statement:*

I AGREE - that the information provided above is accurate
to the best of my knowledge. I also understand that
by submitting this form, I will adhere to the rules and
regulations of the Emergency Ride Home program.

Opt-Out of Future Updates:

Opt-Out - SFCS is a program of the Florida Department of
Transportation and as a participant in our program we will
periodically provide you with updates on transportation related
programs and services related to you. If you are not interested in
receiving updates, check this box.