Connect Transit Coupon/Fare Card Purchasing

Please use this form to pay for your bus tickets online in advance.

Once payment is received, coupon books will be mailed out the next business day to the mailing address listed on the form. Thank you for riding Connect Transit.

Personal Information First Name * Last Name * Mailing Address * Mailing Address 2 City * State * Zip Code * Phone Number * Secondary Phone Number

UTMB Employee?
Primary Purpose?	Work Medical Education Other

Coupons

Instructions

Once payment is received, coupon books will be mailed out the next business day to the mailing address listed on the form. Thank you for riding Connect Transit.

Item	Price	Quantity
Demand Response (Galveston and Brazoria Counties) 20 ride Coupon Book	$15.00
Mainland Transit Fixed Route (including Texas City, La Marque, Dickinson and San Leon/Bacliff) 20 ride Coupon book	$15.00
Southern Brazoria County Transit Fixed Route (including Lake Jackson, Angleton, Freeport and Clute) 20 ride Coupon book	$15.00
Mall of Mainland Park and Ride 50 ride Coupon Book	$75.00
Victory Lakes Park and Ride 50 ride Coupon Book	$112.00
Pearland, League City, Friendswood – Fare Card Amount Please enter amount as whole number	$
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You may also make your request

By mail to: 4352 E. F. Lowry Expressway, Texas City, TX 77590
By E-mail to: rideconnect@gulfcoastcenter.org
By fax to: 409-948-6824
In person at: 4352 E. F. Lowry Expressway, Texas City, TX 77590
By phone at: 1-800-266-2320

Community Mental Health, Intellectual & Developmental Disability and Recovery Services Center for Galveston and Brazoria Counties
Administrative Office • 123 Rosenberg, Suite 6 • Galveston, Texas 77550
409.763.2373 • 281.488.2839 • Fax 409.763.5538

24-Hour Crisis Hotline • 866-729-3848