Lyft Ride Code Request Form

Lyft and the Lyft logo are trademarks of Lyft, Inc.

Are you a member of a Center for Social Concern student initiative? If so, consider taking a Lyft ride to/from your service site(s). Before completing the Lyft Ride Code Request form below, you MUST read the frequently asked Lyft ride questions. If you are ready to request a Lyft ride code, submit the form below. After completing this form, Ro Gambino, Program Specialist at Lyft, will email you with a Lyft ride code within 3-5 business days, which can be used by all members of your student service initiative to travel to/from the submitted service site(s).

Still have questions? Contact Nairuti Shastry, CSC Student Leadership & Development Coordinator.

Lyft Ride Code Requests

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Contact Information

First name*

Last name*

Email*

Student Initiative type*

Name of Student Initiative (type full name)*

Lyft Ride Information

Please enter all information accurately so it does not cause any delay.

Enter code name (16 character limit).*

All Lyft ride codes should be formatted as CSC (initials of your Student Initiative)(semester indicated as S/F followed by the year). For example, a Lyft ride code name for Relay for Life in the Fall 2018 semester would be: CSCRFLF2018.

Approximately how many students will be using this code?*

Please enter the total number of students in your initiative.

Enter start date for code usage. *

NOTE: All codes will expire at the end of the semester, Friday, December 7, 2018.

Enter amount needed per code, $X. *

To calculate X, take the number of students using the code and multiply it by the average cost of a ride to/from a service site from the CSC. Multiply that number by the number of trips per week and then by the number weeks in the semester. (To estimate cost, visit https://www.lyft.com/cities/baltimore-md.) For example, for a group of 4 students traveling once a week to Keswick for 8 weeks (average round-trip ride = $18), "X" would equal $576 (4 students x $18 x once per week x number of weeks in the semester).

List addresses/locations for Lyft rides. *

NOTE: All rides must start and end at the Center for Social Concern (3103 N. Charles St. Baltimore, MD 21218. If you have multiple locations, please separate them with a semicolon.

Lyft Ride Code Request Form

Contact Information

Lyft Ride Information

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