New Passenger
Request Form

This application form is for NEW PASSENGERS ONLY.  It is a secure, encrypted form used only for assessing your eligibility for transportation programs we may be able to offer. A separate form must be completed for each NEW PASSENGER requesting transportation services.

This form is not for the regular scheduling or canceling of rides.
If you are already an OUTS rider, please contact the office at: (910) 346-2998 between 8:00 am and 5:00 pm to schedule or cancel a ride.

New Passenger Request Form

Complete a short application to determine which transportation programs you may be eligible to enjoy. This information will be encrypted and will only be used to assess your transportation needs.

"*" indicates required fields

Step 1 of 3

Your Contact Information

Your Name*
Your Email Address*