Signup forÂ the 4 Hour Wellness Class Step 2 - Complete all the information below and click on the "Submit Request" button at the end of the form. Date: Class Requested: First Name: Last Name: Social Security Number - - Date of Birth: mm/dd/yyyy Address: NOTE Please enter the address of your current residence. This is the address your check will be mailed to. City: State: NY NJ CT PA Zip: Cell Number: DL Number: TLC Number: NOTE Please select your company base from the list. Company Base: 12th Street Luxury Cars, Inc. 786 Transportation Rides, Inc. 811 Transit Corp. A-Z Access Car Service Inc. A&J Car Service Corp. AAA Family Limousine Service, Inc. ABA Luxury Car, Inc. Abel Black Car Inc. Abiel Transportation Corp. Ace Car & Limousine Service, Inc. Acht-NY, LLC(Uber) Achtzehn-NY,LLC(Uber) Admire LLP. Advance Care Transportation Inc. Advance Luxury Limo Svc Inc. Advantage Limo of NY Inc. Agape Luxury Corp. Aging and Handicap Transportation I A List Luxury Services LLC (dba Lea All City Corporate Transportation, Alliance Limousine Allied Black Car Service LLC Allstate Private Car & Limo. Alphine Limousine Service, Inc. Ambar Transportation Inc., American Limousine LLC. Amino, Inc. (dba Chris Limousine U. AMK Luxury Car & Limo Inc. Anns Car & Limousine Service Anytime Forsyth Transport Corp. Apex Car & Limo Service, Inc. AP Luxury Limousine Inc. Approach Quality Transportation LLC Aristacar & Limousine Ltd. ASAP Luxe Inc. Asiana Limousine, Inc. Atlantis Transportation Services In Atlas Travel & Limousine Inc. Aureus LLC. Automotive Service Systems, Inc. Avalon Corporate Car, Inc. Avenue O Car Service. Axum Corp. d/b/a Central Park Limou Bayridge Express Luxury Inc. Bee Bee Luxury Service Inc. Bejewel US Inc d/b/a Luxcar.limo Bellerose Car & Limo Service Inc Bell LX, Inc. Bell Radio, Inc. Bens Luxury Car & Limousine Service Bernice Services Inc. Best Deal Black Inc. Better Car & Limousine Service Inc. Big Apple Car, Inc. Black Car Express.com Corp Blessing Transportation Group, Inc. Blue Eagle Transportation Service C BQN Voucher Inc., BR-Addo LLC Bridges Limousine Inc d/b/a Excelle British Luxury Transportation, Inc. Brooklyn Ride Corp. BWJ Group Inc. C&A Black Car, Corp. Cabot Limo NY Corp. Carey Limousine NY, Inc. Carey Limousine Stamford, Inc. Car Line Transportation Corp. Carlux Limo Inc. Castillo Car & Limo Inc. Cavalier Car and Limousine, Inc. CCS Group LLC dba Nationwide Transp Celebrity Luxury Inc. CET Group, Inc. Cha Cha Transportation Corp. Chaddher Imports Inc. Charge & Ride Luxury, Inc. Charge & Ride, Inc. Charlie Black Car Inc. Charritos Black Car Inc. Chauffeured Executive Transportatio Chico Express Service Corp. Chief Limo Inc. China Transit, LLC. Chris Limousine U.S.A. Inc. CJ Limousine LLC Clay Transportation Inc. CMS Limo, Inc. Commonwealth Worldwide Chauffeured Communicar, Inc. Concord Limousine, Inc. Continental Ride, Inc. d/b/a I & I Convenience Ride Transportation Ser Cool Way Technology, Inc. Corporate Car Ltd. Cozy Ride Limousine, Inc. Crestwood Car & Limousine Services, CSL Manhattitude Executive Transpor CTG Logistics, Inc D &M Express Inc. DAG Network Transportation Danach-NY, LLC.(Uber) DAT Transportation Inc. Dial Car, Inc. Diane Car Service, Inc. Discover Limo, Inc. d/b/a Infinity Divine Luxury Transportation Inc. DLS Transportation Corp. DMCLS, Inc. Dreist-NY, LLC(Uber) Dreizehn-NY, LLC(Uber) Drinnen-NY, LLC(Uber) DV Luxury Transportation Corp. Eager Limo Service Inc. Eastern Luxury, Inc. Eastland Black Cars Corp. E Cars & Limo Service, Inc. Eckford Lite Car & Limo Inc. Eins-NY, LLC(Uber) Einundzwanzig-NY,LLC(Uber) Elegant Luxury Limo, LLC Elf-NY, LLC(Uber) Elite Coach Inc. Elite Limousine Plus, Inc. Empire International, Ltd. (dba Emp Endor Car & Driver, LLC Entransit, LLC Epic Car Service Inc. Equaltrans LLC Ernest Schwarz, Inc. Europe Limo Svc Inc d/b/a Blink Lim Europe Limousine Service Inc. Every Where Limo Service, Inc. Excelsior Car & Limo. ExecTransport, Inc. Executive Town Car & Limo Corp. Explorer Express Inc. Express Car & Limousine Service EzCar.com LLC d/b/a Easy Car Face Limo, Inc. FC Limousine Inc. Fenix XL Car and Limo Service Corp. Finesse Group Limousine, Inc. First Class Luxury Inc. First Class of New York Inc. Five Star Luxury Flatiron Transit, LLC(Via) Fleet Management d/b/a First Corpor Fleet Radio Dispatch Corporation d/ Flex Express Corp. Flyte Line Transportation, LLC Fone-A-Car, Inc. For All Seasons Limousine Network, Forever Blue Car Service Fourty-Four Car & Limo Inc. Funf-NY, LLC(Uber) Funfzehn-NY, LLC(Uber) Gallant Luxury Service Corp. Gaynor Enterprises, LLC(dba Med Fle Genesis Luxury Transportation Corp. Glide Luxury Transportation, Inc Global Limousine Service Golden Carriage Limousine, Inc. Golden Luxury Transportation, Inc. Go My Sedan LLC Good Day Transportation Inc. Good Friends Car Service Inc. Grafe Street Service Corp. Grand Transportation Services Inc. Gravitas Primo, LLC Great Express Car & Limousine Servi Greenpoint Transit LLC GroundAnywhere, LLC. Groundlink Holdings, LLC d/b/a Grou Ground Travel Services II, LTD / d/ Group Americar Grun, LLC. GSL Limousines Corporation Greenlight Transportation Service Guadalupana II Car & Limo, Inc. Gulf Luxury Inc. Gypsy Transportation Corp. Hamptons Transsportation Service In Harrison Car Service Inc. Hawk Car and Limo Service Health Black Car Services, Corp. d/ Hermany Limo Transportation, LLC Hinomaru Enterprises, Inc. Hinomaruny International Inc. Hinter, LLC.(Uber) Holla Car & Limo, LLC Hollywood Limo Service Inc. Hudson Heights Transportation Inc. Hybrid Limo Express, Inc. Hytch Holding LLC ICS-NY, Inc. Iffy Towncar Service, Inc. d/b/a Ro Immediate Luxury Car & Limo Service InDriver NY LLC Inspiration Group Inc. Inta-Boro Acres, Inc. Interstate Luxury Limousines Inc. Iwagami Limousine, Inc. JBE Limo Inc. JC Luxury Inc. JD Xpress Inc. JFK Luxury Limo, Inc. Joy Luxury, Inc. Juniors Luxury Inc. Just a Moment Car Service Inc. Kalia & Sons Limousine Inc. Kaluma Transportation Group Inc. Keshes, Inc. Kingsmen Limousine Inc. Kirin Transportation, Inc. Kismet International, Inc. Kiss Luxury Transportation Inc. Kyoei Limousine, Inc. L & D Limousine Service Corp. Lanas Limo, Inc. Last Radio Group Legend Luxury Limo Inc. Legend Luxury Limo Inc. Leon Luxury Limo, Inc. Leopard Inc. Level Limo, Inc. LFS Limo Corp. Liberty Communications, Inc. Liberty International Trading, LLC. Liberty Medicar Inc. Limo 360 Inc. Limo Seven Transportation, Inc. Li Yang Limousine, Inc. Lluma Transportation Corp. Long Island City Car & Limo Inc. Los Paisanos Luxury Car Service, In Love Corporate Car, Inc. Love Limousine NYC Ltd. Low Touch Luxury Inc. Luigi Memo Inc d/b/a View Luxoride Inc. Luxury Worldwide Transportation, LL Lyft, Inc. -- TNC170001 (non NYC TL M.L. Trips Corp. Manhattan International Limousine N Marathon Car &Limousine Service, In Mariachi Car Service Inc. Marr Limo LLC Matthews Limo Inc. Mavrik Trans, Inc. Mavros Transportation Inc. MBS Limos LTD Medrock Car Service, Inc. Meem Services Inc. MGL Transportation01, Inc. Mikes VIP Transportation, Inc. Milky Way Limo Corp. Mineola Transportation, Inc Mirage Limousine Service, Inc. Mizuma International, Inc. MJ Luxury Inc. MLL Limousine Services, Inc. Murray Express Car Service Inc. Murrays Limousine Service, Inc. My Sedan, LLC. N.Y.M Express Inc. N.Y. One Corporate Car, Inc. N.Y Car & Limo Services, Inc Navi Transportation Inc. NBT Transportation, Inc. ND Line Inc. Neun-NY, LLC(Uber) Neunzehn-NY, LLC(Uber) New Apple Trans, Inc. New Bell Luxury Corp. New Black Luxury Cars Corp. New Bushwick Luxury, Inc. New Generation Black Car Transporta New North Side Luxury Corp. Newport Corporate Car New York Apple V.I.P., Corp. New York Finest Luxury Car & Limous Nick Car & Limo Service, Inc. Nuvo Rideshare Inc. NYBC Luxury Limousine LLC NYC 2 Way International Ltd. NYC Middtown Limo Corp. NYM Express Inc. NY Premier & Limousine Inc. Odyssey Transportation, LLC. Omaha LLC One Stop Ride LLC. Onix Transportation, Inc. On Line Limousine LLC. Onyx 1 Inc. OP Car Service, Inc. Optimum Car & Limo, Inc. Orion Luxury Corp. Oscar Limousine Inc. Ottoman Transportation Inc. Paisa Classic Black Inc. Parada Luxury Inc. Park West Executive Services d/b/a Pasha Enterprise Corp PCS Limousine, Inc Persist Corporation Peter Executive Limousine Corp. Planet Limousine, LLC. Platinum Car Corporation Plush Services, Corp. Polo Limousine, Corp. Pratt Luxury Service Inc. Preferred Care Transportation Servi Presidential Luxury Limo, Inc. Prime Time Transportation, Inc. Prince Luxury Corp. Prospect Luxury Car Service Puebla Luxury Corp. Puerto Rico Express Black Luxury In Q-First Limousine Corp. Quality Executive Limousine, LLC. Quest International Limousine, Inc. Quiet Services, Inc. Raiser-NY, LLC. -- TNC170002 (Uber) Reagan Conveyance Corp. (dba Delux Reyno, Inc. Ricky Limousine Services, Inc. Riverside Classic, Inc. Road New York Enterprises, Inc. Rolux Inc. Royal Dispatch Services, Inc. d/b/a Sabo One, LLC(Gett) Sabo Two, LLC(Gett) Safe Rides Car & Limo Services Inc. SAI Executive Limo Corp Sano Car, LLC Sarah Ventures Inc. Sarinas Limo & Car Service Inc. Saros Transportation Group, Inc. Scarsdale Veterans Car & Limousine Schmecken, LLC.(Uber) Scorpio Five Star Car & Limo Servic Seagull Ride Corp Seaman Express Corp Sechs-NY, LLC(Uber) Sechzen-NY, LLC(Uber) Select Trans, Inc. SempeRide LLC Showtime Transportation, Corp. Sieben-NY,LLC(Uber) Siebzehn-NY,LLC(Uber) Skyline Credit Ride, Inc. Skyway Executive Service, Inc. South Bronx Transportation,Inc. SpotOn.Pet LLC SS Limousine Service, Inc. Standard Limousine & Car Service Gr Stride Limo Worldwide, LLC STS Luxury, Inc. Summit Corporate Car, Inc. Sunnys Limousine Service, Inc. Super Fast Limousine Service, Inc. Take Me 2 Inc. Tap & Ride, Inc. Tel-A-Car of NY, LLC. The Maya Car Service Inc. The Original Dial Car & Limo, Inc. Times Transportation, Inc. TLC Limousine Corp. Tokyo Hinomaru Inc. Torinko NY, LLC Transcare Solutions Inc. Transmedi, LLC Trawell Inc. Tri-City, LLC(Lyft) Tri-State Ground Transportation, LL Tristar Services(US), Inc. Truestar Limo Corp TWR Car & Limo, Inc. Ultimate Black Car Corp., Ultra Black Car Transportation Corp Unicar Luxury, Inc. UNLS Corp d/b/a Reliable Car & Limo Unter, LLC. Urban Car Services LLC. Urban Luxury Inc. USA Drivers Group Inc. USA Limo, Inc. UTOG 2-Way Radio, Inc. V.I.P. Connection, Inc. d/b/a Car L V.I.T. Black Car Transporation Vahana Inc. Valera Global, Inc. Vier-NY, LLC(Uber) Vierzehn-NY, LLC(Uber) Ville De La Liberte Chauffeur Inc., Vital Platinum Services, Inc. Vital Transportation, Inc. V R Worldwide, Inc. Vulcan Cars, LLC d/b/a Juno W.K. Express Limo Service Inc. WC Transportation Service Group, In W Diamond Limo Inc. Weiter, LLC.(Uber) Westchester Acquisition Corporation White Glove Associates Inc. WMC Service Inc Woodhaven Limousine, Inc. WST Limousine LLC XYZ Limousine, Inc. X Y Z Two Way Radio Service, Inc. Zehn-NY, LLC(Uber) Zwanzig-NY,LLC(Uber) Zwei-NY, LLC(Uber) Zwolf-NY,LLC(Uber) Zync Inc. ZYT Express Corp. Email Address: As an IDG and Black Car Fund member, you can be automatically enrolled in Drivers Benefits so that you can start using the benefits available to you as a New York Black Car driver. IDG and The Black Car Fund have worked hard to provide you with benefits including telemedicine (free access to a doctor 24/7), prescription discount cards, affordable legal service, and others. Would you like to be enrolled in Drivers Benefits for free? Yes, enroll me in Drivers Benefits so I can start using my free benefits. No, I do not want to use my free benefits right now. Your request may take a few seconds to process - Do Not press the "Submit Request" Button twice! Facts You Should Know As you may know, the Black Car Fund provides drivers in the black car industry with workersâ€™ compensation benefits. In order to help its covered drivers stay healthy and reduce accidents that lead to injuries the Black Car Fund is sponsoring this Program for the purposes of injury and medical claims reduction. The Program is provided to you as a driver covered by the Black Car Fund and is not intended to provide you with any rights of employment or to otherwise affect your status as an independent contractor with respect to the Black Car Fund or with the dispatch base you are affiliated with. While we hope you will participate in the Program, the Program is entirely voluntary and you are not required to participate. If you are an employee driver, this Program is not sponsored or endorsed by your employer. The Program is not intended to be covered by the Employee Retirement Income Security Act (ERISA) or the Patient Protection and Affordable Care Act (â€śPPACAâ€ť). If you register for the telemedicine benefits available under the Program, you may become ineligible to contribute to a health savings account. Consult with your tax advisor for more information. The Black Car Fund reserves the right to revise or terminate this Program in whole or in part at any time, and for any reason.