Movability Individual Membership Application

NAME*

First NameLast Name

EMAIL*

example@example.com

PHONE NUMBER*

INSTAGRAM HANDLE (OPTIONAL)

YOUR EMPLOYER (OPTIONAL)

MAILING ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

INDIVIDUAL MEMBER BENEFITS

20% discount at Bird MicroMobility
FREE snap-on trunk bag with e-bike purchase at MOD Bikes ($150 value)
Free CapMetro Local Monthly Pass (value: $41.25)
Invitations to member-only events
"Commuter Concierge" Support (value: $270)
Subscription to Member Lane newsletter
Discounted entry and tables at Movability events
Free access to Carbon Cred
Inclusion in the member-only digital forum on LinkedIn
Access to member-only resources
Recognition as a member on Movabilitytx.org
First access to annual Commuter Survey results
Support Movability's mission

*This membership only refers to individuals looking for individual services. Applicants looking for benefits for businesses and non-profits should apply for the membership level that aligns with their number of employees.

HOW DID YOU HEAR ABOUT MOVABILITY?

Social mediaI attended an event or participated in a challengeMovability newsletterA friend or colleagueI am a past memberI saw a promotion at a local businessAdvertisementMy organization is currently or has participated in one of Movability's programs (GoGrant, MovePass, SchoolPool, TDM Planning, Mobility Camps, Best Workplaces for Commuters)Other

IF A COLLEAGUE OR FRIEND REFERRED YOU, PLEASE LET US KNOW THEIR NAME SO WE CAN THANK THEM!

Payment Options

HOW WOULD YOU LIKE TO PAY FOR YOUR MEMBERSHIP? PLEASE BE SURE TO CHECK THE BOX INDICATING YOU ARE NOT A ROBOT AND THEN HIT SUBMIT. DO NOT CLOSE THE WEBPAGE UNTIL YOU SEE A THANK YOU PAGE CONFIRMING YOUR APPLICATION HAS BEEN SUBMITTED OR YOUR INFORMATION WILL BE LOST. THANK YOU!*

Online via credit card (processing fee incurred)Check (payable to Movability, Inc. 535 E. 5th Street, Austin, TX 78701)Send me an invoice (this option allows for credit card payments; payment is due within 15 days of invoice receipt)

Calculation

Please verify that you are human*

PAYMENT INFORMATION*

Individual Membership - Annual Billing Option (Save 20%)

$100.00

Individual Membership - Monthly Billing OptionThis membership level is paid in monthly installments of $10.00 for 12 months.

$10.00

Total

$0.00

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration