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Seattle CiviForm
Note: Fields marked with a * are required.
Here are things to consider before you begin: This application may take up to 10 minutes to complete.
If you’d prefer, there are several in-person locations in the community where you can complete your application in person. You can find locations here: http://www.seattle.gov/agefriendly/about/discount-program#goldflash.
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To apply for the FLASH Card, you must meet the following criteria: *
I am 18-59 years old
I have a disability
None of these apply to me
You will be asked to provide proof of your disability. Please have ONE of the following documents ready to upload in order to complete and submit your application.
Current Metro, Regional or other out-of-region ADA Paratransit Card.
Permanent reduced fare permit for disabled persons (only ages 18-59), back & front.
Regional Reduced Fare Permit (RRFP) Certification of Eligibility, signed by approved health care provider.
Award letter or letter of verification of Social Security Disability Income (SSDI), Supplemental Security Income (SSI), Veterans Administration Income or General Assistance Unemployable (GAU/GAX).
Proof of eligibility for Social Security Disability Benefits or Supplemental Security Income Benefits.
Proof of current eligibility by the Veterans Administration as having a disability of at least 30%.
Valid Medicare card issued by the Social Security Administration.
Proof of enrollment in a vocational career program with the WA Individual Education Program (IEP).
I have one or more apparent physical impairments
Certification of Medical Eligibility form signed by Washington State licensed health care provider