Employee Commuter Benefits Enrollment

Employee Commuter Benefits Enrollment — Form Fields

This hr template includes 11 fields. Enrollment form for pre-tax commuter benefits including transit and parking. Free to customize and use on ZenBuild.

• Employee Name (text, required)
• Work Email (email, required)
• Employee ID (text, required)
• Benefit Type (dropdown selection, required) — options: Transit Only, Parking Only, Transit and Parking, Vanpool
• Monthly Transit Amount (dropdown selection, optional) — options: $50, $100, $150, $200, $250, $300 (max)
• Monthly Parking Amount (dropdown selection, optional) — options: $50, $100, $150, $200, $250, $300 (max)
• Transit Type (dropdown selection, required) — options: Subway/Metro, Bus, Commuter Rail, Ferry, Vanpool, Rideshare, Bicycle
• Transit Pass Type or Route (text, optional)
• Parking Facility Name (text, optional)
• Effective Start Month (dropdown selection, required) — options: January, February, March, April, May, June, July, August, September, October, November, December
• Enroll in Auto-Renewal (multiple choice, required) — options: Yes, No