CarFree Week Registration

Take the pledge: *

I pledge to improve our environment and my health by trying to go CarFree or Car-lite.

To be entered into the raffle to win a $100 gift card to Ruth’s Chris Steakhouse in Jersey City, you must provide an email address and phone number so we can let you know if you won the raffle. You will not receive any contact from us for any other reasons. The information will remain confidential and deleted after the program. Your contact information is not needed for any other purpose and will not be shared.

First Name

Last Name

Email Address *

Phone Number

Street Address

City
(Only one registration per person/household.)

State

What will you do differently to go car free? *

Take a rain or bus
Ride a bike
Walk
Work from home
Carpool or vanpool
Other

Please explain further—to where, how often, etc.

Additional Comments:

How did you hear about us?

Website
Radio
Newspaper
Facebook
My Employer
TMA Transit Fair at my Worksite
TMA Transit Fair at a community event
Brochure/Flyer
NJ.com
Other