Refer-A-Friend Registration Please submit this form BEFORE your friend registers for the CommuteWorks program you referred them to try in order to be eligible for the $25 Amazon gift card. Popout Contents Referrer Information Your Name Work Email Daytime Phone Your Employer - Select -Beth Israel Deaconess Medical CenterBoston Children"s HospitalBrigham and Women"s HospitalColleges of the FenwayDana-Farber Cancer InstituteEmmanuel CollegeHarvard Medical SchoolHarvard School of Dental MedicineHarvard T. H. Chan School of Public HealthIsabella Stewart Gardner MuseumJoslin Diabetes CenterJudge Baker Children"s CenterMASCOMassachusetts College of Art and DesignMCPHS UniversityMassachusetts Eye & Ear InfirmaryMassachusetts Mental Health CenterMerckSimmons UniversityTemple IsraelWentworth Institute of TechnologyWheelock CollegeThe Winsor School Participation Check all that apply CommuteFit Emergency Ride Home CommuteSwap Carpool Incentive Vanpool None - please tell us why not None (please specify why not) Are you a current or past participant in any CommuteWorks programs? Source Check all that apply CommuteWorks email CommuteWorks website Social Media Employer HR or Commuter Services Other - please specify below Other (please specify) How did you learn about the Refer-A-Friend Incentive? Referred Friend Information Friend"s Name Friend"s Employer - Select -Beth Israel Deaconess Medical CenterBoston Children"s HospitalBrigham and Women"s HospitalColleges of the FenwayDana-Farber Cancer InstituteEmmanuel CollegeHarvard Medical SchoolHarvard School of Dental MedicineHarvard School of Public HealthIsabella Stewart Gardner MuseumJoslin Diabetes CenterJudge Baker Children"s CenterMASCOMassachusetts College of Art and DesignMCPHS UniversityMassachusetts Eye & Ear InfirmaryMassachusetts Mental Health CenterMerckNew England Baptist HospitalSimmons CollegeTemple IsraelWentworth Institute of TechnologyWheelock CollegeThe Winsor School CommuteWorks program friend is joining - Select -CommuteSwapCarpoolVanpool Consent Release of Liability The referring individual acknowledges that in order to receive the incentive award of the $25.00 Amazon gift certificate the following terms and conditions must be met: 1. The individual referred must enroll in and complete the CommuteWorks Program; 2. The referring individual must be a current employee of the CommuteWorks Program Member Institution at the time the referred individual completes the CommuteWorks Program; 3. The referring individual acknowledges that neither CommuteWorks nor the CommuteWorks Program Member assumes responsibility for any tax consequences resulting from the award. The referring individual will confer with their own tax advisor on this matter; and, 4. The referring individual understands that they may be contacted by MASCO concerning commuting and transportation related information; or, to request feedback regarding commuting and transportation services. Thank you for registering for the CommuteWorks' Refer-A-Friend Incentive. By submitting this form, you agree to the terms & conditions stated above. Please hit Submit now to send your info. Leave this field blank