6g Sample Car Share Scheme Registration Form
Attached is a sample of Car Share Scheme Registration Form. Whilst it
shows all of the relevant questions to ask, there are several other things
that you will need to distribute to potential car sharers, either as part
of a pack or as a leaflet:
- An explanation of what car sharing is, noting how flexible the scheme
can be
- Why your organisation is starting a scheme up
- An explanation of the benefits of car sharing (including any incentives
that your organisation is offering and how to take advantage of them)
- Guidelines for behaviour/Code of conduct/frequently asked questions.
In this section you might want to discuss such issues as how much car
sharers offer towards the cost of petrol, what to do if you are unable
to car share, insurance implications, etc.
- An assurance to all participants that their details will be kept
in the strictest confidence and only used for the purposes of car sharing.
Also note that only their work contact details will be given out to
other sharers
- A return address for the completed form
- Contact details for the administrator of the scheme, in case anybody
has a query
For more details on car sharing see Section 3h: Car Sharing to Reduce
Car Journeys.
Sample Car Share Scheme Registration Form All information will be treated
in the strictest confidence.
It will only be used to find a suitable car sharer.
| Title |
_______ |
| First name |
________________ |
| Surname |
_____________________ |
| |
|
| Home Details |
|
| Street |
_______________________________ |
| Town |
_______________________________ |
| Postcode |
________________ |
| |
|
| Work Details |
|
| Department |
_______________________________ |
| Site |
_______________________________ |
| Telephone |
________________ |
| |
|
| Working Patterns |
|
| Please circle the days that you normally come to work:
|
| |
|
| |
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday |
What are your normal working hours?
Office hours:
Start __________ Finish __________
Shift hours:
Start __________ Finish __________
Start __________ Finish __________
Start __________ Finish __________
| Sharing options As a driver |
Y N |
| As a passenger |
Y N |
| With opposite sex |
Y N |
| With smoker |
Y N |
|
Raising
Awareness
Establishing
User Groups
Analysis
& Feedback
The
Use of Consultants
Travel
Plans & Income Tax
Example
Questionnaire
Example
Registration Form


|