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Wooster Transportation Assistance Application

City of Wooster

Transportation Assistance Application

‎If you prefer to print your application to be emailed or faxed, please download the file below. Return it and copies of any required documentation to Community Action Wayne/Medina fax (330.264.4573), email (transportation@cawm.org) or mail to Transportation at Community Action Wayne/Medina at 905 Pittsburgh Ave, Wooster, OH 44691. All of your information is confidential and will not be shared without your permission.

Online Application - Wooster Transportation Assistance

Failure to fill out form completely AND provide required documentation for proof of eligibility will cause rejection of application. There is a $1 charge for new ID cards and $3 for replacement of lost ID cards. YOU MUST LIVE WITHIN THE WOOSTER CITY LIMITS.

First Name *
Last Name *
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Required Documentation
Photo or scanned file of any of the following: state issued 10/ driver's license, Voter ID card, Utility Bill, Rental Agreement, real estate tax form, school transcript, pay stub, bank statement
No file selected
Photo or scanned file of: state issued ID/ Driver's license, Passport, Student ID, Gun /Concealed Weapons permit, military ID, Offender release ID, INS ID, OR birth certificate AND S.S. card
No file selected
Any of the above proof of identity examples that also lists birth date
No file selected
Disability award letter/statement OR Medical statement from a doctor
No file selected
DD214 discharge papers OR Military ID
No file selected
Current award letter proving qualification in a program under the 200% income guideline—Medicaid, SS, HEAP, SNAP, free & reduced lunch, etc.
No file selected
By signing this application, I understand that I choose to take part in the subsidized transportation program sponsored by the City of Wooster. I understand that the City is merely assisHng with the cost of transportation: and the City assumes neither responsibility nor liability for the conduct or operation of the transportation providers in this program. Participants in this program assume all risks associated with their choice of a transportation provider
If applicant is under 18 years old

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