Dial-A-Bus Scheduling Order

ALL (*) FIELDS MUST BE FILLED IN COMPLETELY FOR YOUR ORDER TO BE PROCESSED PROPERLY.

Please note, you must be registered in our system to use the Dial-A-Bus Online Scheduling.
If you are unsure if you are currently registered, please call our office at 845-692-7852.
Customer Name
(Please use letters only)(*)
Please add your name.

Email(*)
Please enter your email address.

Primary Phone Number(*)
Please enter your phone number.

Alternative Phone Number
Please enter your phone number.

Date of Ride(*)

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Multiple Dates
Invalid Input

Pickup Address and/or Business(*)
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Destination Address and/or Business(*)
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Arrival at destination by a certain time?
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If yes, please choose time required at destination.(*)
Invalid Input

If no, please choose requested pickup time.(*)
Invalid Input

Number of Passengers(*)
Invalid Input

Return Trip Required?(*)
Invalid Input

Return Pickup Address and/or Business
Invalid Input

Return Destination Address and/or Business
Invalid Input

Time of Return
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Number of Passengers
Invalid Input

Special Notes
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