Bus Pass Donation Form

Bus Pass Donation Form
Greensboro Transit Agency is proud to support community organizations with access to free bus passes for qualified non-profits and government agencies. Organizations may request up to 100 free fixed-route bus passes per year. To apply, please complete this form.

For non-profits, please attach a copy of the signature page of your most recent IRS Form 990 or 6033(a) exemption letter. For questions, contact Kevin Elwood at 336-412-6309 or kevin.elwood@greensboro-nc.gov

Please submit your donation request at least 2 weeks prior to event date or when passes are needed.
Organization Name*
Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Person*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Program or Event Name*
Date of Program/Event*

MonthDayYear
Date
Number of Passes requested*
100 maximum
Upload the signature page of your organization’s most recently filed IRS Form 990, 990-EZ, 990-N or 6033(a). (If requestor is a local, state or federal government agency, you may skip this step).

Cancelof
Additional Comments
Signature of Authorized
Organization Representative: * Date:*
Internal Documentation

For GTA Use Only
ApprovedDenied
Reason
Status Update By:

First NameLast Name
Status Update Date

MonthDayYear
Date
Should be Empty: