STO - Paratransit Service

Bienvenue dans l'univers Rapibus

On-line Reservation Form – Occasional Travel

(For individuals who already qualify for Paratransit Service only)

Passenger's personal contact information
(* Mandatory fields)
Last name *
First name *
Date of birth *	- - (YYYY-MM-DD)
E-mail address *

Trip To Only (please check if a return trip isn't needed.)

Trip To Destination
(You can reserve your trip up to two weeks in advance)
Travel date *
Desired departure time *	HH MM
Appointment time (if applicable)	HH MM
Attendant *	Yes No

Departure address
	Number * Apt.
	Street *
	City *
	Other (e.g., doorbell code, etc.)

Destination address
	Number * Apt.
	Street *
	City *

Return Trip
(Don't fill this part if you checked the No Return Trip box.)
Return time *	HH MM
	Cannot leave before the requested time
	Return trip reverse of trip to destination

Departure address
	Number* Apt.
	Street *
	City *

Destination address
	Number * Apt.
	Street *
	City *

Type of device used when travelling

	Manual wheelchair		Motorized/Electric wheelchair		Scooter
	Walker		Guide/Service dog		None
	Other (specify)

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