TRIP Cash Incentives Monthly form
2006


PLEASE NOTE CHANGES IN THE ADMINISTRATION OF MONTHLY CASH INCENTIVES:

This form must be received in the Office of Human Resources,  by email or hard copy, no later than the 15th of the month to be paid incentives for the previous month.
If not received by that date you will forfeit your incentive for that month.
   

ALL CASH INCENTIVES WILL PAY ON THE LAST PAY DATE OF
THE MONTH FOR THE PREVIOUS MONTH'S PARTICIPATION.

The Transportation Reduction Incentive Program (TRIP) is for prime morning traffic hours (6:00 a.m. to 10:00 a.m.)
Monday through Friday, not including holidays


Note: Submitting this form  verifies that the information is accurate.  Any misrepresentation of this form is considered to be falsification of  documents and is subject to disciplinary action, up to and including termination.

* REQUIRED FIELDS

 *Name:  

 *Department:

 

 *Month

 *Your Pay Cycle

 *Total Days Participation
How did you hear about RIDESHARE? 
  * Work Hours: Start: (Indicate a.m. or p.m.)
Stop: (Indicate a.m. or p.m.)

 *Mode of Transportation

  Days:
  Days:
  Days:

  If other
 

  *Carpool 2-3 people

Rideshare partners

  *Carpool 4-5 people

 

 

Rideshare partners

  (PLEASE FILL IN THE MONTH AND DAY E.G. 05/24, FOR EACH DAY YOU PARTICIPATED)

  Monday Tuesday Wednesday Thursday Friday
Wk 1
Wk 2
Wk 3
Wk 4
Wk 5