APPLICATION FOR TRANSPORT – LOW INCOME FAMILIES

POST-16 STUDENTS (SCHOOL OR COLLEGE) - 2017/2018 ACADEMIC YEAR

Post-16 students from ‘low income’ families can apply for free discretionary transport through the Student Support Fund if they fulfil the eligibility criteria and their parents/carers can provide evidence that they are in receipt of one of the benefits (as listed on the Post-16 Transport Low Income Families Criteria sheet).  Evidence should be relevant to the current financial year, 2018/2019.  If you consider yourself eligible for free transport on ‘low income’ grounds and have been offered a place on a full time course (a minimum of 17 hours per week attendance) please complete the details below as appropriate.  Before doing so you are advised to read the Post-16 Transport Policy Statement 2018/19 which can be downloaded from the website (contact details are at the bottom of this form) or requested by contacting us on 01228 226428 or 01228 226427.

DETAILS OF STUDENT

SURNAME					 	   DATE OF BIRTH

FORENAME(S)

HOME ADDRESS

POST CODE					  	     TEL NO

E-MAIL ADDRESS           ________________________________________________________________________

NAME OF SIXTH FORM OR COLLEGE to be attended:  _______________________________________________

COURSE TITLE/SUBJECTS TAKEN;________________________________________________________________

If this is not your nearest or catchment school are you attending due to subject choice?  Yes/No
Full Time (17 hours or more per week)     	                                                                                                                    
Part Time (less than 17 hours per week)                                    

DATE FROM WHICH TRANSPORT IS REQUIRED __________________________________________________
(Please note: Completed application forms must be received by 31 May to ensure transport is in place (where applicable) by the start of the academic year).
EVIDENCE ENCLOSED (photocopies only)   YES  

SIGNATURE OF PARENT/CARER						      DATE

PLEASE PRINT NAME			_______________________________________________________

Please return this form to: Commissioning, Procurement & Contract Management Team, Cumbria House, 107-117 Botchergate, Carlisle, CA1 1RD
FOR OFFICE USE ONLY	
Catchment
School	Nearest College	Assessment Outcome	Date for    Reassessment	Reason	Route    Number(s)	Other	

					

		
ASSESSED BY:	DATE: