Rider Information Name * First and Last Name Email * Verify Email * Phone Number * Enter a phone number where you can be reached. Adaptive Equipment Used Additional information Pickup Schedule Start Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 Enter the date you need rides to start. If you need a ride today, please call the access shuttle phone at 541-852-2561. End Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 The last day you will need a ride on the current schedule. Days of the Week * Monday Tuesday Wednesday Thursday Friday Please enter the days if the week that you will need a ride for. Monday ScheduleFirst Ride First Pickup Location * First Pick Up Time * Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm First Drop Off Location * Time You Need To Be At The Destination * Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Second Ride Second Pickup Location Second Pick Up Time Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Second Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Third Ride Third Pickup Location Third Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Third Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Fourth Ride Fourth Pickup Location Fourth Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Fourth Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Tuesday ScheduleFirst Ride First Pickup Location * First Pick Up Time * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm First Drop Off Location * Time You Need To Be At The Destination * Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Second Ride Second Pickup Location Second Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Second Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Third Ride Third Pickup Location Third Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Third Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Fourth Ride Fourth Pickup Location Fourth Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Fourth Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Wednesday ScheduleFirst Ride First Pickup Location * First Pick Up Time * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm First Drop Off Location * Time You Need To Be At The Destination * Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Second Ride Second Pickup Location Second Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Second Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Third Ride Third Pickup Location Third Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Third Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Fourth Ride Fourth Pickup Location Fourth Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Fourth Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Thursday ScheduleFirst Ride First Pickup Location * First Pick Up Time * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm First Drop Off Location * Time You Need To Be At The Destination * Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Second Ride Second Pickup Location Second Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Second Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Third Ride Third Pickup Location Third Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Third Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Fourth Ride Fourth Pickup Location Fourth Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Fourth Drop Off Location Time You Need To Be At The Destination Hour Hour01234567891011121314151617181920212223 : Minute Minute000510152025303540455055 Friday ScheduleFirst Ride First Pickup Location * First Pick Up Time * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm First Drop Off Location * Time You Need To Be At The Destination * Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Second Ride Second Pickup Location Second Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Second Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Third Ride Third Pickup Location Third Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Third Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Fourth Ride Fourth Pickup Location Fourth Pick Up Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Fourth Drop Off Location Time You Need To Be At The Destination Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm
