CSR-Reduced Fare Program Application

Reduced Fare Program Application
This online form is used to gather data in order to determine your eligibility for reduced fares aboard Skagit Transit buses. If you do not feel comfortable providing the required documents online, you may provide them in person at Skagit Station, or at our main office.

Skagit Station- Hours of service: Mon-Fri 8:30AM-11:30AM, 12:30PM-4:00PM

105 E. Kincaid St, Mount Vernon

Skagit Transit main office- Hours of service: Mon-Fri 8:00AM-4:30PM

600 County Shop Lane, Burlington
Applicant Name*

First NameMiddle NameLast Name
Address*

Street Address

Apartment / Unit #

CityState / Province

Postal / Zip Code
Phone*
Email
example@example.com
I am applying for the Reduced Fare Program based on the following:*

I am 65 years of age or older.I am providing proof of Veteran statusI am providing proof of my eligibility for Social Security Disability Benefits or Supplemental SecurityI am presenting a valid Medicare or Medicaid card issued by the Social Security Administration.I am providing proof of my eligibility for Reduced Fares through another transit agencyI have an obvious physical impairment(s) meeting one or more of the Medical Eligibility CriteriaI am medically disabled as certified by a Physician, Psychiatrist, Psychologist Ph.D
Name of other Agency
Scan or Photo of proof of eligibility*

This can be your valid State-issued ID, Medicare card, or other accepted document for proof of eligibility
Cancelof
Signature*
Should be Empty: