Get Taxi Card Program

This guide provides a comprehensive overview of how to complete the Taxi Card Program registration form online. By following these instructions, you will successfully fill out the necessary fields required for enrollment.

Follow the steps to complete your registration smoothly.

1. Click ‘Get Form’ button to obtain the form and open it in the editing interface.
2. Begin by entering your full name in the designated field. This should reflect your legal name as required for registration.
3. Input your date of birth in the specified format. This information is necessary to confirm eligibility.
4. Indicate whether you are currently a TaxiCard holder by selecting the appropriate answer.
5. Provide your street address, including any apartment or unit number, followed by your city, state, and zip code.
6. Fill in your email address and two contact phone numbers. Ensure that the information is current for effective communication.
7. If your primary language is not English, note that in the designated section.
8. Answer the question regarding disability status by circling 'Yes' or 'No'.
9. Indicate your marital status by selecting one option from the provided choices.
10. Enter your monthly income in the required field, as this is necessary for the program.
11. State the number of people living in your household.
12. Choose your gender by circling 'Male' or 'Female' as applicable.
13. Select your race from the provided categories by marking the appropriate box.
14. If applicable, fill in your spouse’s name and birth date.
15. Provide the name and phone number of an emergency contact.
16. Answer whether you have family or friends who can assist you with transportation.
17. Indicate if you utilize the MTA's Mobility Service by selecting 'Yes' or 'No'.
18. Answer whether you use Medical Assistance Transportation.
19. Select if you are interested in learning more about CARE’s services.
20. Check all options that apply to difficulties you may experience regarding transportation.
21. Indicate any mobility equipment you use by checking the appropriate options.
22. Specify the reasons for using the TaxiCard by marking all that apply.
23. Finally, sign the form certifying that all provided information is accurate and complete. Include the current date next to your signature.
24. Once all sections are complete, save your changes, and if necessary, download, print, or share the form as required.

Complete your Taxi Card Program registration online today.