FACULTY& STAFF RAM RUSH REQUEST FORM
INSTRUCTIONS: For Faculty and Staff electing to participate in the RAM RUSH Transportation Program, please complete the following form
(sections A, B, C, and D). To continue the RAM RUSH Transportation service from semester-to-semester, you must complete this form to renew the
service at the beginning of each semester. RAM RUSH will not be activated until the transportation fee is paid in full and an updated request form is
on file. Upon completion of this form, please submit to ramrush@asurams.edu for processing. For further information, please contact Kristine Jones
at 229-317-6771. *NOTE: All RAM RUSH Transportation fees are non-refundable.
A
Employee Information : To be completed by Employee
Employee’s Name:
Employee 900#:
B
Office Information: To be completed by Employee
Building/Office #:
Office Phone Number:
Cell Phone Number:
ASU Email Address:
C
Employee Status: To be completed by Employee
£
Part-Time Staff
£
Full-Time Staff
D
Payment Method: To be completed by Employee
Once Auxiliary Services receives an approved verification from payroll or banner that the fees are paid in full, your
RAM RUSH service will be activated.
£
Cash
£
Credit
£
Check
£
Payroll Deduction
E
RAM RUSH Participation Acknowledgement: To be completed by Employee
I hereby authorize the Auxiliary Services Department to charge my banner account the $35 per semester RAM RUSH
Transportation fee. I understand that I must renew my RAM RUSH Transportation request at the beginning of each semester in
order to continue the RAM RUSH Transportation service. If my request is not renewed at the beginning of any given semester, I
understand that I will not have access to the RAM RUSH service until I submit a new request form and pay the $35 transportation
fee in full. *RAM RUSH transportation fees are non-refundable.
Employee Signature:
Print Name:
Date:
F
Payroll: To be completed by Payroll Administrator
£
Accepted for payroll deduction
Title:
Date:
G
Auxiliary Services ONLY: To be completed by Auxiliary Administrator
Charged to Banner Account:
Date: ________________ Charged by: ___________________________________
Application/Request Status:
¨
Approved
¨
Pending Payment
Auxiliary Services Title:
Print Name:
Auxiliary Services Signature:
Date: