Commuter Information
* Parent's First Name:
Middle Initial:
* Last Name:
* Home Phone Number:
* Work Phone Number:
Ext
Your E-mail Address:
Where would you
prefer to be contacted?:
Either
Work
Home
Street Address
* Address:
* City:
* State:
DE
MD
PA
NJ
* Zip Code:
* Cross Street:
County:
< Please select >
New Castle (DE)
Kent County (DE)
Sussex County (DE)
Chester (PA)
Delaware (PA)
Philadelphia (PA)
Salem (NJ)
Camden (NJ)
Cecil (MD)
Other (indicate below)
Mailing Address
(if different from street address)
Address:
City:
State:
DE
MD
PA
NJ
Zip Code:
School Information
* School Name:
Address:
* City:
County:
< Please select >
New Castle (DE)
Kent County (DE)
Sussex County (DE)
State:
DE
Zip Code:
Grade(s) of student(s):
K
1
2
3
4
5
6
7
8
9
10
11
12
K
1
2
3
4
5
6
7
8
9
10
11
12
K
1
2
3
4
5
6
7
8
9
10
11
12
K
1
2
3
4
5
6
7
8
9
10
11
12
K
1
2
3
4
5
6
7
8
9
10
11
12
Schedule
Describe your child's school schedule, assistance you are seeking
from School Pool, extracurricular activities, etc.
(i.e, Need help in morning; my child has sports in the afternoon,
and I can take home)
Your Preferences
What travel route do you use to commute to school:
< Please select >
I95
I295
I495
Route 2 (Kirkwood Highway)
Route 4 (Maryland Avenue)
Route 4 (Chestnut Hill Road)
Route 7 (Limestone Road)
Route 13 (DuPont Highway)
Route 40 (Pulaski Hwy)
Route 113
Route 141
Route 202 (Concord Pike)
Route 273
Route 896
Other (indicate below)
How does student currently commute to and from school?
< Please select >
Bike
Carpool
Drive Alone
Transit
Private Shuttle
School Bus
Other
Vanpool
Walk
* Your carpool preference:
I can drive others
My child needs a ride
Share driving duties
How often do you wish to carpool?
Daily
Occasionally
Emergency situations only
Match us with:
Same school only
All schools (for more matches)
How did you hear about The School Pool Program?
< Please select >
Employer
Internet Search
Local Business
Print Ads
Telephone Book
Radio Ads
Referral
School Referral
School Referral
Additional Information / Comments
PLEASE READ BEFORE SUBMITTING YOUR APPLICATION
DART's RideShare Delaware is acting solely as a referral service for
potential carpoolers and does not assume any liability, and makes no
representation that any driver is qualified, competent or insured.
By submitting this application you hereby release RideShare Delaware
from any liability, claims and demands for personal injury, loss,
theft, or damage to my personal property, loss of income, consequential
damages resulting from delays or absence of RideShare partners or termination
of the program. RideShare Delaware reserves the right to change the existing
program guidelines and procedures.