Rideshare Registration Form

1. Membership to the LLUH Rideshare Program and the resulting incentives is limited to the full time and part-time employees of Loma Linda University, Loma Linda Medical Center, Loma Linda University Children’s Hospital, Loma Linda University Health Care, Loma Linda University Behavioral Medicine Center, Loma Linda University Shared Services, Loma Linda Adventist Health Center, Faculty Physicians and Surgeons of LLU School of Medicine and the General Conference of SDA.
2. In order to qualify for Rideshare membership, employees assigned to any shift other than a 12 hour shift must participate a minimum of three work days per week. Employees assigned to a 12 hour shift must participate a minimum of two workdays per week. 
3. Participants must return their Claim Card monthly for carpool benefits and quarterly for all other benefits to the Department of Parking & Traffic, ETC staff to process eligible benefits.
4. All incentives are subject to applicable taxes. Carpool benefits will be issued through the Department of Parking & Traffic. The Payroll Department will process approved eligible walk/bike benefits and credits will be posted to the employees payroll check.
5. If you do not turn in your claim cards for 6 months (2 quarters) you will be dropped from the Program and all benefits will be forfeited.
6. Rideshare benefit cards will be accepted up to 14 days after end of the quarter only. 

“The organization reserves the right to modify or discontinue the program at any time, without prior notice to the program participants”

Were you driving alone before joining this program? If not please contact our office at 909-651-3033.

By completing the following form you are agreeing to the following statement:

I hereby agree to abide by all rules and regulations of the Rideshare Program. I agree to immediately notify the Department of Parking & Traffic of any changes in my commute status. Falsification of Rideshare documents shall be considered as “Falsification of Company Records” to receive benefits and may result in immediate termination of employment.