CyRide    Bus Pass Order Form

Name (print)______________________________________

E-mail _______________________________________

Send to: Street___________________________________

               City____________________________________

What type of fare are you?
    ____Reduced   ____Regular   ____ISU Staff/Faculty

  Reduced fares are available for Medicare cardholders, persons over 65 or with a disability, and K-12 students.

Check which pass you would like:
___Fall  ___School Year  ___Winter  ___Spring  ___Summer

Send the pass: ___Now      ___Later (date)____________

Payment Options:
___Check enclosed for the amount of $_________

___MasterCard or Visa (circle one)

     # __ __ __ __-__ __ __ __-__ __ __ __-__ __ __ __

     Exp. Date ____/____


    Signature _________________________________

                                             Office use only
              Pass No.______________   Date Issued_______________

Make check for the exact amount payable to CyRide. No cash please.

ISU Students with a current ISUCard do not need a pass.
Just show your student ISUCard and ride for free.

Thank You!