Signup for 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: Location: 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. 1st Selection Car Service Inc. 28 Express Inc. 2s Luxury Inc. 7 Ways Transportation Corp. 786 Transportation Rides, Inc. 811 Transit Corp. A List Luxury Services LLC (dba Leading Black A&$ Limousine Service Corp. A&A Amazoon Transportation Inc. A&J Car Service Corp. A&M Ikea Inc. A&S Limousine Service Corp. A&Z Luxury Limousine Transportation Inc. A1 Accessible Transportation LLC AAA Family Limousine Service, Inc. ABA Luxury Car, Inc. Abel Black Car Inc. Abi Group Luxury Inc. Abian Transportation Inc. Abiel Transportation Corp. Absolute Car Service Corp. Ace Car & Limousine Service, Inc. ACK Transportation Corp. Adara NEMT Corp. Admire LLP. Adris Transportation Inc. Advance Luxury Limo Svc Inc. Aero Limo Inc. Agape Luxury Corp. Aguila Car & Limo Corporation. Alcon Express Inc. Alfred Holdings Inc. Alianza Transportation Service Inc. All City Corporate Transportation, Inc. Allstate Private Car & Limo. Alpaca Transportation Corp. Alpha Express Ride Corp. Ambar Transportation, Inc. American Limousine LLC. Amerikanisch Services Corp. Amino, Inc. (dba Chris Limousine U.S.A.) Anytime Forsyth Transport Corp. AP Luxury Limousine Inc. Apex Car & Limo Service, Inc. Approach Quality Transportation LLC Aristacar & Limousine Ltd. Armony Transportation Inc. ASAP Luxe Inc. Asiana Limousine, Inc. Atlantis Transportation Services Inc. Atlas Travel & Limousine Inc. Aureus LLC. Auto Group Inc. Automotive Service Systems, Inc. Avalon Corporate Car, Inc. Avenue O Car Service. Balayira LLC. Baronas Luxury II Inc. Bayridge Express Luxury Inc. Bee Bee Luxury Service Inc. Bell LX, Inc. Bell Radio, Inc. Ben's Luxury Car & Limousine Service, Inc. Best Choice Car Service Corporation. Best Deal Black Inc. Big O Limo Corp. Big Apple Car, Inc. Blackbird Worldwide Corp. Blade Urban Ground Mobility Blessing Transportation Group, Inc. Blue Eagle Transportation Service Corp. BQN Voucher Inc., Brisk Car Service Inc. Brooklyn Ride Corp. BSZ Luxury Black Car Buffalo GCB Transportation and Touring Inc. Buffalo Liberty Communications, Inc. Buffalo Liberty Medicar Inc. Buraq-NY, LLC BWJ Group Inc. C&A Black Car, Corp. Cabot Limo NY Corp. Caprice Car Service Corp. Caprice Car Service No. 2, Inc. Car Line Transportation Corp. Carey Limousine NY, Inc. Carlux Limo Inc. Cartel New York Inc. Castillo Car & Limo Inc. Castleton Black Car Service Inc. Cavalier Car and Limousine, Inc. Celebrity Luxury Inc. CEO Chaffeured Services Corp. CET Group, Inc. Cha Cha Transportation Corp. Charge & Ride Luxury, Inc. Charge & Ride, Inc. Charlie Black Car Inc. Chauffeured Executive Transportation, LLC. Cherry Transportation NY Inc. Chico Express Service Corp. China Transit, LLC. Choice Transportation Corp. Cibao 2 Inc. City WAV Corp. CJ Limousine LLC Clay Transportation Inc. CMS Limo, Inc. Commack Trawell Inc. Commonwealth Worldwide Chauffeured Transporta Communicar, Inc. Compass Transportation Group Worldwide Inc. Concord Limousine, Inc. Continental Ride, Inc. d/b/a I & I Transporta Convenience Ride Transportation Services Inc. Coop Car Care Inc. Corporate Car Ltd. Cozy Ride Limousine, Inc. Crescent Luxury CLS, Inc Crestwood Car & Limousine Services, Ltd. CSL Manhattitude Executive Transportation LLC Curb Transportation Services, LLC D Manny Safe Ride Corp. DAG Network Transportation Dahlia Transportation Corp. Dallas Limo Inc. DAT Transportation Inc. DD & Son, LLC Dial Car, Inc. Diane Car Service, Inc. Discover Limo, Inc. d/b/a Infinity Limo DLS Car & Limousine Service Corp DBA All Tran DLS Transportation Corp. Dreams Luxury Services Inc. Dunamis Care Car Service Corp. DV Luxury Transportation Corp. E Cars & Limo Service, Inc. Eastland Black Cars Corp. Eckford Lite Car & Limo Inc. EDL Transportation Services LLC Electric Peppers LLC dba Revel Transit Inc. Elite Coach Inc. Elite Limousine Plus, Inc. Empire International, Ltd. (dba EmpireCLS Wor Epic Car Service Inc. Ernest Schwarz, Inc. Europe Limo Svc Inc d/b/a Blink Limo Company Europe Limousine Service Inc. Every Where Limo Service, Inc. Excelsior Car & Limo. ExecTransport, Inc. Executive Town Car & Limo Corp. Exit Luxury Inc. Explorer Express Inc. Extra Car Service LLC EzCar.com LLC d/b/a Easy Car Face Limo, Inc. Fanny Radio Dispatch Service 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 Radio Dispatch Corporation d/b/a Minute Flex Express Corp. Flushing Limousine Transportation Service Cor Flyte Line Transportation, LLC Fone-A-Car, Inc. Forever Blue Car Service G&J Luxury Transportation, Inc. Gallant Luxury Service Corp. Ganix Transportation Inc Genesis Luxury Transportation Corp. Get Better Transportation LLC. Gewesen Transportation Corp. Gigi NYC Inc. Glide Luxury Transportation, Inc Global Executive Limousine Corp. Global Limousine Service Go My Sedan LLC Golden Carriage Limousine, Inc. Golden One Transportation Inc. Good Day Transportation Inc. Good Friends Car Service Inc. Graceful Transportation Inc. Grafe Street Service Corp. Gravitas Primo, LLC Greenlight Transportation Service LLC Greenpoint Transit LLC Groundlink Holdings, LLC d/b/a Groundlink You Group Americar GSL Limousines Corporation Guadalupana II Car & Limo, Inc. Guest Travel Service Inc. Guillen Transportation Services Inc. Gulf Luxury Inc. Gypsy Transportation Corp. Harrison Car Service Inc. Health Black Car Services, Corp. d/b/a Adon Heisenberg-Esser Corp. Hermany Limo Transportation, LLC HH Car Service Inc. Hinter, LLC.(Uber) Holy Transportation Corp. Hudson Heights Transportation Inc. Hybrid Limo Express, Inc. Hytch Holding LLC Iffy Towncar Service, Inc. d/b/a Roslyn Limou Inta-Boro Acres, Inc. International Luxury Transportation Inc. IOT Services LLC. Iwagami Limousine, Inc. Jarocho Car Service Inc. Jarpa Transportation Corp. JBK New York Inc. d/b/a Comfort Limo NYC JD Xpress Inc. Jetset Transportation Corp. JFK Luxury Limo, Inc. Joy Luxury, Inc. Juniors Luxury Inc. Jupiter Select LLC. Just a Moment Car Service Inc. Kairon LLC. Kaluma Transportation Group Inc. Kayl Inc. Kid Car NY, LLC. Kidault Kar LLC. Kidmoto Technologies LLC Kirin Transportation, Inc. Kismet International, Inc. Kiss Luxury Transportation Inc. Kyoei Limousine, Inc. L&J Logistics, Corp. La Legenda Corp. La Mexicana Express 2 Inc. La Nortena Car & Limo Inc. Lanas Limo, Inc. Last Modified: 11/02/2021 Last Radio Group Latino Executive Inc. Legend Luxury Limo Inc. Legend Luxury Limo Inc. Leopard Inc. Level Limo, Inc. LFS Limo Corp. Li Yang Limousine, Inc. Limo 360 Inc. Limo Tribe Inc. Long Island City Car & Limo Inc. Los Paisanos Luxury Car Service, Inc. Love Corporate Car, Inc. Love Limousine NYC Ltd. Low Touch Luxury Inc. Luxe Riders Corp Luxoride Inc. Luxury Worldwide Transportation, LLC. M.L. Trips Corp. Macombs Transportation Corp. Malibu Car Service Inc. Mama Mia Transportation Corporation. Mana Transportation Inc. Manga Transportation Corp. Manhattan International Limousine Network, LL Mariachi Car Service Inc. Marr Limo LLC Matthew's Limo Inc. Mavrik Trans, Inc. Mavros Transportation Inc. Maxi Luxury Cars Corp Mazna Transportation Corporation. MBS Limos LTD MDM Transportation II Medrock Car Service, Inc. Meem Services Inc. Metro Luxury Inc. MGL Transportation01, Inc. Mike's VIP Transportation, Inc. Milky Way Limo Corp. Mineola Transportation, Inc Mirage Limousine Service, Inc. Mizuma International, Inc. MJ Luxury Inc. Morelos Car Service Inc. Mota Luxury Corp. My Sedan, LLC. Myle Worldwide Inc. N.Y Car & Limo Services, Inc N.Y. One Corporate Car, Inc. Nassau For All Seasons Limousine Network, Ltd Nassau1 Arrow Island Limousine Service Inc. d Nassau2 Delux Taxi of Long Island Inc. d/b/a Nassau3 Port Conveyance Inc. dba Delux Transp Navi Transportation Inc. ND Line Inc. Nesh Limousine Service LLC (dba NLS NYC) New Apple Trans, Inc. New Bell Luxury Corp. New Black Luxury Cars Corp. New Bushwick Luxury, Inc. New Generation Black Car Transportation Corp. New Heaven Luxury Inc New Technology Transportation Inc. New York Apple V.I.P., Corp. Newport Corporate Car Neza Express Inc. Northside BK LLC. Norwood Car & Limo Inc. Norwood Transportation, Inc. NY Merengue Transportation, Inc. NYC 2 Way International Ltd. NYM Express Inc. Odyssey Transportation, LLC. On Line Limousine LLC. Onix Transportation, Inc. Onyx 1 Inc. OP Car Service, Inc. Optimum Car & Limo, Inc. Orion Luxury Corp. Oscar Limousine Inc. OSO Auto Corp Ottoman Transportation Inc. Paisa Classic Black Inc. Parada Luxury Inc. Paramount Transport Inc. Park West Executive Services d/b/a Town Car Paseo Transportation Inc. Paxxia Luxury Corp PCS Limousine, Inc Peace Transportation Services Inc. Peter Executive Limousine Corp. Phase One Transport Inc. Pibe Transportation Inc. Planet Limousine, LLC. Platinum Car Corporation Plush Services, Corp. Polo Limousine, Corp. Port Richmond Black Car Inc. Praise Ride Inc. Preferred Care Transportation Service, Inc. Primary Transportation Corp. Prime Time Transportation, Inc. Priscilla Black Car Inc. Prospect Luxury Car Service Puebla Luxury Corp. Puerto Rico Express Black Luxury Inc. Q Family Digital Dispatch Corp. Q-First Limousine Corp. Quest International Limousine, Inc. Quick and Luxurious Black Car Corp Quiet Services, Inc. Rain Solution Inc. Ready Go USA, Inc. Reagan Conveyance Corp. (dba Delux Transporta ResQ Ride Corp. Reyno, Inc. Ricky Limousine Services, Inc. Ride FHV Corp. Ride Smart Corp. Ride4NYC Corp. Ridgeway Transit Inc. Rincon Transportation LLC Rise and Shine Transportation Inc. Ritzy Transportation Corp. Riverside Classic, Inc. Road New York Enterprises, Inc. Royal Dispatch Services, Inc. d/b/a Executive Royalty Family Corp. RRD Transportation, Inc. Sabo One, LLC(Gett) Sabo Two, LLC(Gett) Safe Rides Car & Limo Services Inc. Salam Car Service Inc. Sano Car, LLC Saros Transportation Group, Inc. Scarsdale Veterans Car & Limousine Service, L SDR Transportation Corp. Seagull Ride Corp Select Trans, Inc. SempeRide LLC Show Limo Corp. Showtime Transportation, Corp. Skyline Credit Ride, Inc. SpotOn.Pet LLC SS Limousine Service, Inc. StandaradLux Inc. Standard Limousine & Car Service Group, LLC. Staten Island Transportation Services Inc. Stride Transportation Inc. STS Luxury, Inc. Suffolk S Transportation Group Inc. Summit Corporate Car, Inc. Sunny Day Transportation, Corp. (dba Sun Ligh Sunny's Limousine Service, Inc. Super Fast Limousine Service, Inc. Taha Inc. Take Me 2 Inc. Tap & Ride, Inc. Tapmapz LLC Tel-A-Car of NY, LLC. Tempo Transportation Corp. The Best We Can Transportation Inc. The Drivers Cooperative, Inc. The Original Dial Car & Limo, Inc. Times Transportation, Inc. TNC Lyft Healthcare,Inc. TNC170001 Lyft, Inc.(non NYC TLC) Torinko NY, LLC Tower Car and Limo Inc. Tracy Luxury Corp. Trans City Transportation, Inc. Transmedi, LLC Traxline Car Service Inc. Tri-City, LLC(Lyft) Tri-County Black Cars Inc. Tri-State Ground Transportation, LLC. Turing Enterprises Inc. TWR Car & Limo, Inc. U1st Transportation Services LLC. UAS Luxury1 Inc. Uber USA LLC. Ultra Black Car Transportation Corp. Unicar Luxury, Inc. Unik Transportation Inc. USA Limo, Inc. UTOG 2-Way Radio, Inc. V & C, Inc. V.I.P. Connection, Inc. d/b/a Car Link V.I.T. Black Car Transporation Vahana Inc. Valera Global, Inc. Ville De La Liberte Chauffeur Inc., Vital Platinum Services, Inc. Vital Transportation, Inc. VJVM Car Service Inc. Voces Transportation Management Corp. W.K. Express Limo Service Inc. WC Transportation Service Group, Inc. Westchester A&Z II Limousine Transportation Westchester A&Z II Luxury Limousine Transport Westchester Acquisition Corporation d/b/a Fly Westchester Ann's Car & Limousine Service Westchester Asher Transportation Inc. Westchester Axum Corp. d/b/a Central Park Lim Westchester CTG Logistics, Inc Westchester JC and M, Inc. Westchester Liberty International Trading, LL Westchester Sarinas Limo & Car Service Inc. White Top Car Service Inc. WMC Service Inc Woodhaven Limousine, Inc. WST Limousine LLC WTM 365 Inc. X Y Z Two Way Radio Service, Inc. xxxxxx Carey Limousine Stamford, Inc. XYZ Limousine, Inc. Yerz Car Inc. YUR Drivers Network, Inc. Z&T Black Car Inc Zip Connections 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 workers’ 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 (“PPACA”). 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.