Ambassador Driver Application

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Your Name *

Your Email *

Please select the level at which you can speak the following languages.

Fluent/Native speaker

Proficient

Conversational

None

English

Spanish

Ukranian

Mandarin

Cantonese

Haitian Creole

Other

Clear selection

What times are you available to drive? *

7am to 11am

11am to 3pm

3pm to 5pm

5pm to 7pm

7pm to 9pm

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Are you willing to have recuring rides with the same passenger? *

Yes

Maybe

How far away are you willing to drive? (Select all) *

Up to 10 miles

Up to 20 miles

Up to 50 miles

Over 50 miles

Required

How long of rides are you able to provide? (Select all) *

1-2 hours

2-3 hours

3-4 hours

4-6 hours

6-10 hours

Required

Which of the following activities are you willing to provide assistance with?

Shopping for groceries

Wheelchair/Walker Assistance

Carrying heavy items

Getting in and out of the car

I would not like to provide assistance

What times are you available for a 20-minute Ambassador Driver training session?

9AM-10AM

10AM-12PM

12PM-2PM

2PM-4PM

Monday

Tuesday

Wednesday

Thursday

Friday

Clear selection

How much notice do you need before being able to provide a ride? *

Under 24 hours

Between 24 and 72 hours

Over 72 hours

5 days

More notice

Required

Are you comfortable exchanging contact information with your passengers ahead of the ride?

Yes

Maybe

Clear selection

Any other information would like to share with us?

Submit

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