UMBC                                                               
The Commons Administration                                                                  Contact information:
The Commons, Suite 335                                                                              Phone: 410-455-3455
1000 Hilltop Circle                                                                                             Ms. Patti Schuyler
Baltimore, MD  21250                                                                                     paschuyl@umbc.edu
www.umbc.edu/thecommons

 APPLICATION
The MTA Bus Pass Financial Assistance Program is administered by The Commons.  If you require financial assistance to obtain an MTA bus pass for the purpose of utilizing the MTA discounted student bus pass program offered through the Office of Off-Campus Student Services and are enrolled in class or are undertaking an internship requiring travel between UMBC & UMB campuses, please complete the following form and return to The Commons Administration at The Commons, Suite 335.  This application requires the chair* of your academic program to verify your enrollment in class or internship requiring inter-campus travel.

Your Name ______________________________   UMBC ID______________________________

UMBC E-mail _________________________ Phone Number _____________________________

Name of the Academic Program/Department you are enrolled in which requires your inter-campus travel:

 _____________________________________________________________________________
And/or
Name of your Internship requiring inter-campus travel: _________________________________________________________________________
And/or
Name and number of the Class you are attending requiring inter-campus travel:
______________________________________________________________________

Please describe your financial need:

 

 

 

___________________________  __________   
             Applicant’s signature                          Date

The applicant’s inter-campus travel is required for the following months (Chairperson, please initial applicable individual month(s) for spring semester 2010 and sign below if approved:
February____ *                 March ____*                April ___ *               May ___*
___________________________  __________________________           ________________
             *Chair’s signature                                  Chair’s Printed Name                                                 Date