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Free Ride Request / Solicitud de transporte gratis
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First Name / Nombre
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Last Name (not required) / Apellido (no requerido)
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Email (internal use only, providing your email will not sign you up for any lists or be shared and will be only used as a point of contact) / Correo electrónico (solo para uso interno, puede estar seguro que su correo electrónico no quedara registrado en ninguna lista ni se compartirá con nadie y solo se utilizará como punto de contacto)
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Need for ride / Propósito del viaje (i.e. groceries, work, getting to childcare center, etc.)
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If approved, would you like to receive your promo code via text, call, or email? / ¿Desea que le enviemos un mensaje de texto, que le llamemos, o que le mandemos un correo electronico con el código de promoción si es que recibe un viaje gratis?
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If yes, what is your phone number? / Si, si por favor escriba su numero de teléfono (XXX) XXX- XXXX
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What day do you need the ride? / Que día necesita el viaje?
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What time do you anticipate requesting a Lyft? / A que hora preve solicitar el Lyft?
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Do you need support downloading/using Lyft? / ¿Necesita ayuda para descargar o usar la aplicación de Lyft?
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For the person utilizing the ride: Have you experienced any COVID-19 (Coronavirus) symptoms or have you come in contact with someone with symptoms within the past two weeks? // Para la persona que utilizan este servicio: ¿Ha experimentado algún síntoma de COVID-19 (coronavirus) o ha estado en contacto con alguien con síntomas en las últimas dos semanas?
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In what city are you located? (COLOR & CIRC want to ensure that people from across the state can be accommodated/ En que ciudad se ubica? (COLOR & CIRC quieren asegurarse que las personas en todo el estado pueda ser considerado/a.
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