ETC Information
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Company:
Date Submitted:     Current Quarter: First Quarter Second Quarter Third Quarter Fourth Quarter

Commute Smart Champion nformation
Name:
Title:
Email:
Comments:

Tell us what makes your employee a Commute Smart Champion!
Commute Mode(s) Used: Walk Carpool Ride the Bus Vanpool Bicycle Telework Compressed Work Schedule
Do they fill out their commute calendar?	Yes  No
Average days per month nominee uses a commute alternative:
How long has nominee been using a commute alternative to work?
How many one-way miles does the employee commute to work?
1. Why does the employee participate?
2. How does the employee display extra effort in overcoming obstacles to use commute alternatives?
3. How does the employee demonstrate enthusiasm for commute alternatives?
Note: In the event your Champion Commuter is chosen, please make sure they have read and signed our photo release form. (Click here to view)