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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

If you are human, leave this field blank.

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 Spring 2019 semester would be: CSCRFLS2019.

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: Unless previously approved, all codes for the Spring 2019 semester will begin on Monday, January 28 and be terminated on Friday, May 3, 2019.

Enter amount needed per code, $X. *

NOTE: If your amount per code exceeds your 2018-2019 transportation budget allocation, your code will NOT be approved.

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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