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The UReach / ACTS Transit ministry provides transportation five days a week for senior citizens and those with partial physical disabilities. Our service provides a way for these groups to get to much needed medical and dental appointments, shopping, banking, or just visiting family or friends. Unfortunately, no provisions are made for wheelchairs, and clients must be able to enter and exit a vehicle on their own.

If you are interested in using the UReach / ACTS Transit service, please submit a transit application and then call our office to schedule your first pickup, or call and request an an application (909) 796-8357.

If you are interested in becoming a volunteer driver, please fill out our Volunteer Application and we will see if there are any available opportunities.

ACTS TRANSIT APPLICATION

After submitting this form you are ready to ride with ACTS Transit! Please call us to schedule your first pickup.

Office: (909) 796-8357.

Client Information
Name *
Name
Home Address *
Home Address
Primary Phone *
Primary Phone
Primary *
Secondary Phone
Secondary Phone
Birth Date *
Birth Date
Partial Physical Handicap? *
Do You Use: *
Select All That Apply
Primary Doctor Phone
Primary Doctor Phone
Relative or Emergency Contact
Name *
Name
Son, Daughter, Neighbor, Etc.
Home Phone *
Home Phone
Cell Phone
Cell Phone
Address *
Address
Caregiver Contact
Name
Name
Home Phone
Home Phone
Cell Phone
Cell Phone
Electronic Signature
In lieu of a signature, please put your initials here. Please contact us as soon as possible with any changes to your phone, address or caregiver.