Youth Pass Pilot Application

Youth Pass Pilot Application
The Youth Pass Pilot is a partnership between the MBTA and the City of Boston’s Department of Youth
Engagement & Employment, Chelsea Collaborative, the City of Somerville, and City of Malden to offer
reduced fare Link passes to eligible 12-21 year olds. The pilot runs from July 1, 2015 to June 30, 2016.
Participants can purchase a monthly pass for $26 or a 7-day pass for $7 depending on availability in
their city.
Youth ages 12-18 are eligible to apply if they live in Boston, Chelsea, Malden or Somerville. Young
people ages 19-21 are also eligible if they live in Boston, Chelsea, Malden or Somerville, but must
ALSO be enrolled in a qualified program. 1500 participants will be randomly selected from those who
fill out this application. If selected, participants will be contacted by their city with further details and
instructions for enrolling in the Youth Pass Pilot.
The MBTA does not collect information from people 12 or younger. If you are (or your child is)
currently 12 you have to apply in person at the participating agency in your city. Email
youthpass@mbta.com for directions.
* Required
1. Full Name*
2. City where you live* (Check one)
Boston
Chelsea
Malden
Somerville
3. Date of birth*
(mm/dd/yyyy)
4. On July 1, 2015 I will be * (Check one)
12-18 years old
19-21 years old (must fill out final page)
5. Best Contact Email Address*
6. Best Contact Phone Number*
7. What is the Best Way to Contact You*
We will contact you to let you know if you are selected for the pilot. Throughout the pilot, once
a month, you will be contacted to answer important questions about using the T. Please select
just one of the following:
Email address
Text message
Phone call
Preliminary Research Study Questions
The Youth Pass Pilot is a research study to measure the costs and benefits of a full Youth Pass for the
MBTA. In order to participate in the pilot, you must be willing to answer surveys and have your MBTA
trips analyzed (without your name attached to them). Gathering data on youth travel patterns is key
to the success of the program; the pass is intended for use only by the applicant.
The answers to these questions will not affect your eligibility for the pilot.
8. What is your home zip code?
9. Are you enrolled in middle or high school?
Middle school
High school
Neither
10. Do you have a SuccessLink (formerly BYF’s Hopeline) tracking number?
Only for Boston applicants.
Yes
No
11. If you answered Yes to the above question, please enter your SuccessLink tracking number.
12. How many trips do you normally take on the T (bus and subway) in a week during the
school year? One trip is from where you start to where you are going, regardless of how
many buses or trains you ride. A round trip, going from home to school or work and then
directly back, counts as 2 trips.
13. On a typical weekday during the school year, how many buses and trains do you get on in
a day? If you transfer from one train to another, in one trip, that counts as 2.
14. On a typical weekend (Saturday and Sunday) how many buses and trains do you get on
(both days combined)? Remember to count your return trips and transfers!
15. How many trips do you normally take on the T (bus and subway) in a week during the
summer? Remember a round trip counts as two trips.
16. How do you pay for the T now?
Check all that apply.
M5 or M7 (Monthly Student Pass)
Student Stored Value (S-card)
Cash
CharlieCard (just one)
CharlieCard (multiple)
CharlieTicket
Weekly Pass
Monthly Pass
Other:
17. What kind of pass are you more interested in?
Your response will not limit you to that selection.
$26 monthly, purchased in the last week of the previous month
$7 weekly, purchased each week
18. What is your best estimate of the total annual income of your household (everyone living in
your house/family)?
Less than $22,000
$22,000-$41,999
$42,000-$61,999
$62,000-$99,999
$100,000 or more
19. How do you self-identify by race?
You can check multiple.
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Other:
20. Are you Hispanic or Latino/a?
Yes
No
21. How did you hear about the Youth Pass Pilot?
Check all that apply
At my school
From my city or youth employment program
Job training or education program
From a friend
On MBTA website
Social Media
Other
The following questions are about further eligibility requirements for 19-21 year olds. If you are 12-18,
you may skip this section.
19-21 Eligibility
You must also be enrolled in one of the following: high school, alternative education program (does
not include college or university), job training program, or receive benefits such as Mass Health. If you
are selected to participate in the pilot, we will contact you about verifying that you are enrolled or
receive the benefit.
I am enrolled in:*
You may select multiple.
High school
A benefit program (for example, Mass Health, food stamps, WIC, public house/section 8, or
others)
A job training program (for example, Youth Build, Health Careers for Youth, or others)
A GED or other adult education program
Name of the program or benefit
Thank you for filling out this application.
Participants will be randomly selected and notified in about a month.