TRANSPORTATION ASSISTANCE PROGRAM - BUS PASS REQUEST FORM Please note, this form must be completed each semester that you request a bus pass.Name* First Last NSCC A#*Campus email*This must be your @my.nscc.edu email address Which transit system do you use?* Clarksville Transit System WeGo Transit Terms and Conditions*By checking each box, you are indicating that you understand and accept the terms I affirm that I am currently enrolled as a student at NSCC. I understand that my participation in the Transportation Assistance Program is contingent upon my continued enrollment as a Nashville State student. If I withdraw from my classes, my access to the program will be revoked. I understand that participation in this program is a privilege; if I am found to be abusing the privileges of the program (such as sharing my WeGo transit pass with others) my access to the program will be revoked. I agree to notify the NSCC Foundation immediately at (615) 353-3222 if my transit pass is lost or stolen. I understand that if my transit pass needs to be replaced due to loss or theft, I will be required to pay the $10 replacement fee. CAPTCHACommentsThis field is for validation purposes and should be left unchanged.