VTA SmartPass Card Request Form

Name *

First Name Last Name

Student Email Address *

doejohn123@students.itu.edu

Student ID Number *

I have paid my student tuition and fees. *

Yes

Terms and Conditions of Use

I understand a Student ID Card & VTA pass card is required to utilize the VTA bus and light rail lines.

VTA Bus - When boarding a bus, tag your SmartPass Clipper on the Clipper card reader and show your ITU Student ID Card to the bus driver.
VTA Light Rail - At the Light Rail station before boarding, you must tag your SmartPass Clipper on the card reader located on the platform, then board the Light Rail.
On the Light Rail train, be prepared to show your SmartPass Clipper and Student ID Card to the fare inspector upon request.
Express Bus - SmartPass holders are allowed to board other VTA Express buses by paying a surcharge of $2.25 per ride. The surcharge must be paid with E-cash value previously loaded on the SmartPass Clipper Card.
VTA Fare Inspectors will issue a citation to any ITU student without a Student ID Card and will not accept an expired or deactivated SmartPass.

By selecting this field, I verify that I have read and understood the above information about Student ID & VTA card requirements. *

I have read and understood the above.

Illegal Use of SmartPass Clipper Card

The transfer or use, of the SmartPass Clipper card, by another person is strictly prohibited. Attempts to transfer, sell or misuse the SmartPass Clipper will result in immediate deactivation of the SmartPass card.

Anyone who files a false claim, alters, sells, transfers, or duplicates the SmartPass Clipper card with the intent to make money or evade the payment of any fare is in violation of California Penal Code 640. Violation of Penal Code 640 is punishable by a fine of up to $250 and 48 hours community service.

Violators may be liable for the following:

SmartPass Clipper Card access frozen and no longer eligible to participate in the program.
Charged the amount equal to the cost of a VTA Adult Express Annual Pass (approximately $1500).
Referred to the ITU Office of Student Conduct & Ethical Development for assessment of violation of student code of conduct, and the resulting administrative disciplinary action(s).

By selecting this field, I verify that I have read and understood the above information about illegal usage of the SmartPass Clipper Card. *

I have read and understood the above.

SmartPass Replacement Policy

If you loose your SmartPass Clipper card or it gets stolen, immediately report loss to ITU through the support ticket system.

The replacement fee is not refundable, if original card is found. No more than one (1) replacement card per calendar year.

Bring card with validation defect or other problems cards to the VTA Coordinator. Do not discard. The staff will determine whether a no-charge replacement can be issued.

The VTA Coordinator will not replace an SmartPass card for free due to damage caused by negligence or mishandling. Do not punch holes, bend, cut or mishandle card. It will render the card void.

By selecting this field, I verify that I have read and understood the above information about the SmartPass Replacement Policy. *

I have read and understood the above.

Signature *

Date *

Month Day Year

Note: New students - VTA pass card will be available for pick-up within two weeks before start of classes.