Your Name (required)

Home Address (required)

Your Email (required)

Phone Number (required)

Employer (in Mission Bay) (required)

Manager's Name (required)

Manager's Email(required)

Manager's Phone(required)

Employment Type:
I am a full time employee at the above worksite and earn less than $50,000 annuallyI am a part time employee at the above worksite and earn less than $50,000 annually

I understand that my free SPIN e-scooter monthly pass may be used for unlimited rides of up to 30-minutes and must take place within the City of San Francisco. Any time over 30 minutes will be billed to me.

Ifat any time during this program, I no longer work in Mission Bay, I understand my monthly pass will be cancelled.

Your Signature - please type your full name: