Carpool Monthly Submission Form | Longwood Collective

Participants will be mailed the following months gas cards after completing your monthly forms

Month Reporting for

Estimated number of days you used the carpool to get to work this month

Estimated number of days you took other modes than your carpool to travel to work

Estimated number of days your carpool continued to operate without you as a part of it

Carpool Member 1 (Registrant)

Name

Work Email

Longwood Collective Member Employer

If you are not the carpool driver, please write below if you incorporated other transportation modes as part of your trip into the Longwood District. For example, “My carpool parks in Downtown Crossing and I take the Orange Line to Ruggles station and use the shuttle.” If your carpool parks in Longwood or you get dropped off in Longwood, please indicate that below.