Non Profit Agency
Pass Request
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Non Profit Agency Pass Request
Valley Regional Transit sells regular adult bus passes to 501 (c) (3) non-profit organizations for
their clients at a discount. Non-profit organizations can also purchase student/senior/disabled/
Medicare card holder passes, which are already discounted, through Valley Regional Transit.
The nonprofit discount for bus passes does not apply to government agencies.
To request ValleyRide bus passes, complete the short request form below. When completed,
send your completed Pass Request Form, a letter on company letterhead stating your
organization possesses IRS classification as a 501 (c) (3) organization, and payment to:
Valley Regional Transit
Customer Service Department
700 NE 2nd Street, Suite 100
Meridian, ID 83642
Fax: 208-258-2730
Email: [email protected]
If you have questions, please call 208-345-RIDE (7433). Please allow 2 to 3 business days for
processing your order.
AGENCY INFORMATION
Agency Name:
Type of Service Provided:
Contact Name:
E-Mail Address:
Telephone number:
MAILING ADDRESS:
Street:
City:
State:
Zip Code
BILLING ADDRESS (if different):
Street:
City:
State:
Zip Code
PASS USE AT YOUR ORGANIZATION
We will give passes to clients at no charge
Yes
We will sell passes to clients
Yes
□
□
No
No
□
□
Pass Request Quantity
One Day Local‐Adult One Day Universal‐Adult One Day Local (Student/Senior/Person with Disabilities/Medicare Cardholder One Day Universal (Student/Senior/Persons with Disabilities/Medicaid cardholder 31 Day Local Pass‐Adult 31 Day Universal Pass‐Adult
31 Day Local Pass (Student/Senior/Persons with Disabilities/Medicare care holder 31 Day Universal Pass (Student/Senior/Persons with Disabilities/Medicare care holder Three Month Local Pass‐Adult
Three Month Universal Pass‐Adult
Three Month Local Pass (Student/Senior/Persons with Disabilities/Medicaid Cardholder) Three Month Universal Pass (Student/Senior/Persons with Disabilities/Medicaid Cardholder) $12 Stored Value Card $24 Stored Value Card Village Van (qualified passengers through human service agency referral) _____
_____
Price $1.50 $4.50 _____ $1.00 _____ $3.00 Total
_____
_____
_____ _____ _____ $27 $52 $18 _____ _____ $35 _____ _____
_____
$70 $135 _____
_____
_____ $46 _____ _____ $90 _____ _____
_____
_____
_____
_____ $10 $20 $1.50 _____
_____
_____
_____
_____ TOTAL _____