Eagle Lift Assist Application

Main Page Content

Eagle Lift Assist Application

The following application is intended for current enrolled SUNY Brockport students who are in need of transportation assistance and support for academic needs. Please review each section carefully.

Applications will be reviewed by a committee 3x each semester. Upon confirmation, you will be notified on the type of transportation service, funds, and available options to best support your needs.

Name Name First Last
Email
Phone Phone - ### - ### ####
Banner Number (800#)
Please check the option that best describes your enrollment status:

Please check the option that best describes your enrollment status: Graduate Student (Masters Program) Undergraduate Student
****************************************************************************
For this next section of the application, please select the option(s) that best describe the reason for your transportation assistance.

Please fill out required criteria for each specific reason you check. This will help us in the review and approval process. Any missing information may delay approval.
Option 1

Option 1 CLASS / ACADEMIC travel assistance
For travel assistance to and from CLASS:: Please provide the following information:
-Course #
-Class location information
-Schedule/Frequency of need (one-time or ongoing)
Option 2

Option 2 INTERNSHIP travel assistance
For travel assistance to and from your INTERNSHIP:: Please provide the following information:
-Advisor/Contact name
-Location with address
-Frequency/Schedule during week that you will need travel assistance
Option 3

Option 3 EMPLOYMENT travel assistance
For travel assistance to and from EMPLOYMENT:: Please provide the following information:
-Work Schedule or frequency of need
-Location with address
-Explanation on how employment relates to course work
-Supervisor's contact information
Will you need travel assistance for a medical need (example: doctor visit)? By checking yes, someone will contact you from the Health Center to follow up to make sure your needs are met.

Will you need travel assistance for a medical need (example: doctor visit)? By checking yes, someone will contact you from the Health Center to follow up to make sure your needs are met. Yes No, not a medical need
****************************************************************************
Address for pick-up Address for pick-up *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Address for drop-off Address for drop-off *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

What is your preferred method of transportation?
Each application will be reviewed and you will be contacted to discuss options available that best fit the needs you described above.
	Lyft/Uber	RTS/Regional Bus	Eagle Run Shuttle	Carpooling
First Choice	First ChoiceLyft/Uber	First ChoiceRTS/Regional Bus	First ChoiceEagle Run Shuttle	First ChoiceCarpooling
Second Choice	Second ChoiceLyft/Uber	Second ChoiceRTS/Regional Bus	Second ChoiceEagle Run Shuttle	Second ChoiceCarpooling
Third Choice	Third ChoiceLyft/Uber	Third ChoiceRTS/Regional Bus	Third ChoiceEagle Run Shuttle	Third ChoiceCarpooling
Fourth Choice	Fourth ChoiceLyft/Uber	Fourth ChoiceRTS/Regional Bus	Fourth ChoiceEagle Run Shuttle	Fourth ChoiceCarpooling

Please describe any specific accessibility support, questions, or concerns below.
*********************************************************
Please read the application requirements and review process below.

**************************************************************************
Fall 2021 applications will be reviewed at the first of the month on 9/1/21, 10/1/21 & 11/1/21.

Fall 2021 applications will be reviewed at the first of the month on 9/1/21, 10/1/21 & 11/1/21. Please check this box ONLY if you need an exception to the review dates because you need travel assistance sooner.
For fair and equal access, the below guidelines are in place for these travel assistance funds.

-Funds for travel, when approved, can not exceed over $100 per student, per semester.

-A committee will review each request and also provide additional travel options available (for example RTS versus Lyft) when applicable.

-Once approved, the student is in charge of budgeting within their allotted travel funds given and will need to make accommodations outside of the assistance program if expenses exceed the fund cap

-Pick up and drop off needs to be within a 40 mile radius from Brockport

-Travel funds towards transportation can be used within the hours of 6:45 am - 10:00 pm Monday-Sunday.
*

By checking here you are acknowledging that you read and agree to the above requirements for travel assistance funds
*

By checking here you understand that reimbursement information will be given once application and travel assistance is approved by committee. Gas reimbursement and/or travel before the application approval date do not qualify for reimbursement.
*********************************************************************

*****************************************************************************************
To explore the current transportation options that are readily available to you now, please check out the following links::

SUNY Brockport Parking & Transportation: brockport.edu/support/parking/

RTS: myrts.com
Thank you for filling out the application. Your request will be reviewed at the beginning of each month and you will be notified regarding the status of your applicaiton.

For any questions, concerns, or comments please reach out to our committee at downtown@brockport.edu

Close mobile navigation

Main Page Content

Eagle Lift Assist Application

**************************************************************************** For this next section of the application, please select the option(s) that best describe the reason for your transportation assistance.

****************************************************************************

********************************************************* Please read the application requirements and review process below.

For fair and equal access, the below guidelines are in place for these travel assistance funds.

*********************************************************************

To explore the current transportation options that are readily available to you now, please check out the following links:: SUNY Brockport Parking & Transportation: brockport.edu/support/parking/ RTS: myrts.com

Thank you for filling out the application. Your request will be reviewed at the beginning of each month and you will be notified regarding the status of your applicaiton.

****************************************************************************
For this next section of the application, please select the option(s) that best describe the reason for your transportation assistance.

*********************************************************
Please read the application requirements and review process below.

To explore the current transportation options that are readily available to you now, please check out the following links::

SUNY Brockport Parking & Transportation: brockport.edu/support/parking/

RTS: myrts.com