Fixed Route Bus Pass Order Form

MY RIDE’S HERE! PLEASE SEND ME THE FOLLOWING PASS(ES)

Please print form, complete, enclose payment and send to the address below.

Type	Quantity / Cost Per Unit	Total
Full Fare, 10 Rides	___ @ $10.00	$__________
Reduced Fare*, 10 Rides	___ @ $5.00	$__________
Full Fare, Unlimited Monthly Pass	___ @ $35.00	$__________
Reduced Fare*, Unlimited Monthly Pass	___ @ $17.00	$__________
Those eligible for Reduced Fare include: Seniors (60+), Disabled, Veterans, and Students; BCC Students ride for free with a valid BCC Student ID. Medicare cards are accepted as proof for reduced fare. There is no charge for children under the age of five (5), or for transfers.
Name as it is to appear on Monthly Pass:	_______________________________________

Name:

_______________________________________________________

City:

___________________

State: _________

Zip Code: ____________

Phone:

_______________________________________________________

A 10 Ride Pass must be purchased in advanced at either Space Coast Area Transit bus terminal, by mail, or by phone.

The Space Coast Area Transit bus terminals are located at 401 North Varr Avenue, Cocoa, Florida, 32922 and 460 South Harbor City Blvd., Melbourne, Florida, 32901.
Checks up to $100, money orders and credit card orders are accepted by mail.
Credit card purchases may be made over the phone by calling 635-7815 x 403 or 604.

Make Checks Payable to:

Brevard County Board of County Commissioners
Space Coast Area Transit accepts checks up to $100.00.

☐ Visa

☐ Mastercard

☐ Discover

Credit Card Number: _____________________

Expiration Date:____________________ (month and year)

Credit Card ID #: _______ (3 Numbers on Back of Card)

Space Coast Area Transit
401 South Varr Avenue
Cocoa, FL 32922