Pittsburgh Regional Transit Kids ConnectCard Application

REDUCED FARE TRANSIT PROGRAM FOR KIDS AGES 6-11

(PRT Electronic Version)

Application Form

Parents / Guardian: Please complete the form below, verify with the "Captcha" and press the submit button to apply for your child's reduced fare ConnectCard.

NOTE: This site only accepts submissions for first-time applicants. Please do not submit a new online application for a lost or stolen card. For a replacement card, please contact Port Authority’s Downtown Service Center at 412-255-1356.

Parent / Guardian Information:
First Name:	Last Name:	MI:

Address 1:	Address 2:

City:	State:	Zip Code:

Phone:	Email:

Child's Information:

First Name:

Last Name:

MI:

Date of Birth (mm/dd/yyyy):

Gender:

Male

Female

Child's Age Documentation:
Please upload documentation confirming the birthdate of the child (example: Birth Certificate, Baptismal Certificate, Statement of Age from US Social Security Administration, etc). This can be as simple as a digital photo of the document taken with your cell phone camera. Once the documentation is verified by Port Authority administration, it will be deleted from our system and not retained for any further use. Note: The document must be less than 50 MB in size.

By checking this box, as parent/guardian of the applicant, I accept full responsibility for the proper use of this card and I verify that the information submitted is true and accurate.