Please fill in the information below, sign and either submit the online form, or choose the print friendly pdf and email to: info@rideWOTA.org or mail the pdf to:  205 W. Livingston Rd.  Highland, MI 48357

Passenger Application

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • West Oakland Transportation Authority (WOTA) requires verification by a professional in order to qualify disabled individuals requesting service for transportation. Please use the Professional Verification form
  • In Case of Emergency

  • Companion Rider (18+ years)

  • Date Format: MM slash DD slash YYYY
  • Applicant Eligibility

  • NOTE: For Safety reasons, All Mobility Devices cannot be more that 33 inches wide and/or be more that 1,000 lbs INCLUDING the Passenger while on the lift.
  • *PLEASE NOTE: Based on the status of our riders, if you are a regular rider and you are scheduled but you do not call to cancel your ride, you do not answer your phone and nor do you come out when the driver arrives, we reserve the right to call for a non-emergent welfare check to ensure your safety and well-being.
  • I have read and understand the rules and regulations regarding the use of transportation through the West Oakland Transportation Authority (WOTA). By signing this form, I acknowledge I will follow the rules and regulations of scheduling and riding the organization’s vehicles.
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.