City Program Application Form
Please use this application if you are a resident of: Alameda, Albany, Berkeley, Castro Valley, Emeryville, Fremont, Hayward, Newark, Oakland, Piedmont, Pleasanton, San Lorenzo, or San Leandro.
Applicants from Union City should apply through Union City Paratransit.
Applicants from Dublin and Livermore should apply through Wheels Dial-a-Ride.
ADA paratransit service operators (East Bay Paratransit, Union City Paratransit & Wheels Dial-A-Ride) require a separate application process.
For more information about specific programs and services, please refer to your community page or call 211.
This application will be sent to the appropriate program based on the city you choose in the home address section below. You will receive an email receipt following a successful application submission. Once your application is reviewed, the city’s program administrator may contact you if additional information or documentation is needed.