Transit Subsidy Application

Will you be able to produce the required documentation?

Yes

You will be required to produce the following documentation:

Proof of TriRegion address: CRA Notice of Assessment, current bank statement, drivers’ license/government identification, a municipal tax notice, or utility bill.
For low-income applicants, most recent income tax summary or income statements from Assured Income for the Severely Handicapped (AISH), Income Support or other financial assistance programs.
For newcomer applicants, government documentation stating refugee, student, or work permit status.

Do you consent to the use of your personal information as detailed?

Yes

This program is offered in partnership with the City of Spruce Grove. The personal information requested on this form is collected under the authority of Section 33(c) of the Alberta Freedom of Information and Protection of Privacy Act (FOIP Act) for the purpose of administering this program, including fulfilling grant reporting requirements using non-identifying information required by the Government of Alberta. The information will be collected, used, and disclosed in accordance with the FOIP Act. If you have any questions, please contact the FOIP Coordinator for the City of Spruce Grove at foip@sprucegrove.org or 780-962-2611.

First Name

Last Name

Date of Birth

Phone (we will call to set up appointment to pick up the pass)

Email (Optional, we will use this to send you a short survey)

Are you or any member of your household currenlty on Income Support (Alberta Supports)?

Yes

Are you or any member of your household currenlty on Alberta Income for the Severely Handicapped (AISH)?

Yes

Would you like to add another adult individual? (+1)

Yes