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HomeMy WebLinkAboutGO_Plus_ATJACCESS TO JOBS TRANSPORTATION PROGRAM APPLICATION Please print clearly. Complete ALL questions or the application cannot be processed. NAME: HOME ADDRESS: PHONE NUMBER: NAMES AND AGES OF DEPENDENTS (spouse, children under age of 18 in your household for whom you are the parent or legal guardian AND/OR children under the age 18 who do not live with you and for whom you are court ordered to pay child support) YOUR INCOME: $ CHECK ONE: hourly weekly bi-weekly monthly annually FAMILY INCOME: Income of all family members, (spouse, mother, father, etc) living under the same roof. Family Member: JOB INFORMATION IF THIS JOB IS THROUGH A TEMP AGENCY, WHICH ONE? NAME OF COMPANY: COMPANY ADDRESS: NAME OF CONTACT PERSON: PHONE NUMBER: HOW MANY HOURS A WEEK DO YOU WORK? WHAT HOURS OF THE DAY DO YOU WORK? I hereby authorize to furnish any information they may have concerning me which they have on record, or otherwise. I voluntarily and knowingly release and all individuals connected therewith, from all liability whatsoever incurred in furnishing such information. APPLICANT’S SIGNATURE DATE: APPLICATIONS CAN BE MAILED TO: GO Transit FAXED: (920) 232-5343 926 Dempsey Trail Oshkosh ,WI 54902 THERE WILL BE A $4.00 ADMINISTRATIVE FEE FOR THE CARD (CASH OR CHECK ONLY) IF YOU HAVE ANY QUESTIONS, PLEASE CALL (920) 232-5340 Falsifying information on this document represents fraud and may result in prosecution. For office use only: Name of Person Reviewing Form Date Employment Verified With: Card Issued: Yes Yes, with Stipulation: No Name of Company Name of Company ( ) INCOME: $ CHECK ONE: hourly weekly bi-weekly monthly annually Family Member: INCOME: $ CHECK ONE: hourly weekly bi-weekly monthly annually EMAILED: transit@oshkoshwi.gov PROGRAM INFORMATION 920.232.5340 www.rideGOtransit.com Effective: February 2024 What is the Access to Jobs Program? The Access to Jobs (ATJ) Program is a shared- ride, demand response transportation service de- signed to allow low-income individuals to access their employment site. The service is available when the bus is not in service or does not provide reasonable access (walking distance from bus stop is not reasonable). The service is for going to and from work only. GO Plus is the name of the paratransit system provided by GO Transit. ATJ is one of the para- transit programs provided under GO Plus. How do I qualify? To qualify, you must: • live and work within the City of Oshkosh; • work 30 hours or more per week; • have a work assignment for a minimum of 2 weeks in duration; and • have a household income that is at or below 275% of the federal poverty level. If you are able to get to and from work via GO Transit buses, you must travel by bus. If you need transportation outside bus operational hours, your card will the hours it is valid. How much does a ride cost? The one-way fare is $4.00. All rides need to be scheduled before 4:30 pm the day prior to the requested ride. Any rides not scheduled in advanced will not be covered by the progam and rider will be subject to full meter fare. How do I apply? The reverse side of this brochure contains the full application. The application must be out completely and truthfully. There is a waiting period while your application is processed. Employment and wage will be After the application has been reviewed and approved, a card will be issued allowing you to use the transportation pro- gram. You will be instructed when your card will be available for you to pick up at our There is a $4.00 administrative fee every time a card is issued or changed. This fee must be paid when the card is picked up. ACCESS TO JOBS The Access to Jobs Card Each successful applicant will receive a program card. The front of the card lists the applicant’s name. The card will also list your home address and place of employment. These are the only locations the cab company will be authorized to transport you under this program. If you move or change jobs, you will need to have a new card issued. If the change is for a different job, a new application will need to be out. There is a $4.00 administrative fee every time a card is issued or changed. This fee must be paid when the card is picked up. The card is not transferable. Possession and use of the card by other than the person signing the application will result in suspension from the pro- gram and may result in prosecution. How to use the program? To use the program, ATJ participants call Oshkosh City Cab (426-1551) to schedule a pick-up. When scheduling a ride, participants tell the dispatcher that they have an Access to Jobs card and the time the participant needs to be at work. The cab company will tell the participant an expected pick-up time. Participants must schedule rides in advance to give the cab company ample time. If applicants know their work schedule, trips can be scheduled for an extended period of time (a.k.a., standing order or subscrip- tion service). This eliminates the need to call for rides everyday. However, please cancel if not needed for a particular day. Complete program instructions and regulations are provided with each ATJ card issued. Transportation to Childcare Provider The ATJ Program can also be used for childcare transportation related to employment. In order to qualify, applicants must have their Department of Workforce Development caseworker provide documentation of this need. The applicant must supply child safety seat(s) for all accompanying children.