Thank you for your interest in a Community Car membership. Please complete all required fields in the application form below.

Before submitting your application:
1. Review our eligibility requirements
2. Choose a rate plan

Application Fee:
When you submit your application, a $25 Application Fee will be charged to your credit or debit card. This non-refundable fee covers the cost of checking your driving record and processing your application.

Member Renewal:
At the end of each year of membership, a $35 Annual Fee will be charged to your credit or debit card, unless you notify Community Car in advance that you do not wish to renew.

Fees may vary based on promotion codes and membership plans.

If you have any questions, call our office at 608.204.0000.

* indicates a required field. The application will not be processed without this information.

New Applicant - Member Application Form

Thursday, September 3, 2015
UW Intro
Choose a Password

Please select a password to be used for online reservations.

Personal Contact Information
Emergency Contact Information
Payment Information
Credit Card Information

Payment Method: Credit Card

Card Number:    *
Check this box if your Credit Card Address is different from your Primary Address
Driver Record Information

A routine check of your driving record will be made with your application.

For more details on eligibility requirements, click here.

 *How many moving violations have you had in the past 3 years?
 *How many at fault accidents have you had in the past 3 years?
YesNo * Have you had any alcohol related violations in the past 7 years?
Current License

You must be at least 21 years of age and have had a driver's license for at least 3 years to qualify for membership.
Under 21 or have questions? Click here for more details on eligibility requirements.

Choose Date  Blank for licenses without a date of issue.
Choose Date   *
Have you had a license from another state or country in the past three years?
Promotion: UW Intro
Referrals and Promotions
Existing Membership
Do you have a key fob already? If so, please enter your Community Car Member ID.
University of Wisconsin
How are you associated with the University of Wisconsin, Madison? *
What department, facility or program are you a part of?
By submitting this application,
  1. I am certifying that everything stated in this application is true to the best of my knowledge.
  2. I understand that CommunityCar is authorized to retain this information whether or not my application is approved.
  3. I understand that CommunityCar is authorized to check my driving record and insurance score.
  4. I understand that this application and all of the above consumer reports will be used to determine my acceptance for membership.
  5. I agree to pay a non-refundable application fee and the non-refundable annual membership fee.
  6. I agree to be bound by this application and understand that failure to disclose my violations or accidents will cause automatic rejection of this application.

I understand and accept

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