Ride United: Last Mile Delivery Partner Information Form
The survey will take approximately 6 minutes to complete.

Thank you for your interest in becoming a partner of the Ride United: Last Mile Delivery program in concert with our local United Way, United Way World Wide, and Door Dash. Your completion of the form below will allow us to begin and complete the process of getting your site approved.

For questions related to this form, please contact Jessica Martin at jmartin@unitedway-cny.org or (315) 428-3744.
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Agency Name *
Please provide the address of your desired pick up location and a name for the location:
 *
(i.e; Office #1: 980 James Street, Syracuse, NY 13203) or (Pantry #1: 982 James Street, Syracuse, NY, 13203)
Please select the items that you plan to be deliver: 
 *
Required
Please select the items that you plan to be deliver: 
 *
Required
Select the Agency Classification that fits best: *
Select all national affiliates to which this local partner is connected: 
In order to complete the site set up in the system, two photos are required of the desired site's building and entrance.  Please submit these photos via email to CIAdmin@unitedway-cny.org. *
Required
Please provide your agency website (if any) *
If no website is available, please type in N/A.
Estimate the number of weekly deliveries you think you will schedule *
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