P. O. Box: Current address

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AVALON RAPID TRANSIT (ART) APPLICATION
AVALON RAPID TRANSIT IS A PUBLIC TRANSPORTATION PROGRAM DESIGNED
FOR RESIDENTS OF AVALON.


Submit the following to process your ART membership:
1) Completed Application
2) Copy of identification with your date of birth and residential address
3) Copy of City of Avalon subsidy card or proof of residency (See requirements for proof of residency)
APPLICANT INFORMATION
Name:
Date of birth:	Phone:	P.O. Box:
Current address:
City:	State:	ZIP Code:
Male Female (Please circle)
EMERGENCY CONTACT (Optional)
Primary Contact:
Type of Relationship:			Phone:
Secondary Contact:
Type of Relationship:			Phone:
Additional Comments:
ADDITIONAL FAMILY MEMBERS
Spouse:
Children (must be under the age of 18-Please list names and ages):

Additional Comments:
SIGNATURE
I assume full responsibility for and release the City of Avalon, Catalina Transportation Services as well as its drivers from any
Liability for my safety and well-being before I board and after I exit the ART vehicle.
Signature of applicant:			Date:
For Administration Purposes Only
Date Mailed:
Processed By:
Comments:
This form is provided by Catalina Transportation Services

Catalina Transportation Services*P.O. Box 2141*228 Metropole Avenue*Avalon*CA*90704

Telephone: 310-510-0342 Fax: 310-510-1193

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AVALON RAPID TRANSIT (ART) APPLICATION