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2. The Jule Half Fare ID Program offers a discounted fixed-route bus fare to qualified individuals. Half Fare ID Cards are non-transferable and non-refundable. Half Fare ID Cards will be valid for three years from the date of issue. Before the expiration date, you must resubmit the application form.
6. If you are applying for Half Fare eligibility based on a mental or physical disability you may have, you MUST have the attached form completed by your licensed medical provider before continuing with the online application. Submitting the signed and completed Physician Verification Form is part of the application process.
   Physician Verification Form
8. Please select the eligibility type you are applying for.

   1. I am 65 or older
   2. I am currently covered under Medicare
   3. I have one or more physical or mental impairments
10. Name*
11. Date of Birth*
13. Street Address*
15. City*
16. State*
17. Zip Code*
19. Telephone Number*
20. E-mail Address
22. Please check the appropriate box:

    1. First Card (A $1.00 fee applies)
    2. Renewal Card (There is no renewal fee)
    3. Replacement Card (A $5.00 fee applies for lost or stolen ID cards)
24. To complete this application, please upload the necessary documentation. You may also bring it to the Intermodal Transportation Center at 950 Elm Street between 8:00AM and 4:30PM.
    - If you are 65 or older, please attach proof of age
    - If you are covered under medicare, please attach a copy of your Medicare card
    - If you have a physical or mental impairment, please attach a signed and completed Physician Verification Form
28. I certify that, to the best of my knowledge, the information given on this application is true and accurate. I understand that providing false or misleading information or allowing others to use my card will result in my eligibility being revoked. I hereby authorize the release, either verbally or in writing, of any disability-related medical information to the Jule Transit. I understand that this information may be used in conjunction with this application when determining my eligibility for the Half Fare Program through The Jule Transit and will not be released without my written authorization.
30. Electronic Signature*
31. Date*
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field