Forms home Apply for a disabled parking bay Step 1 of 5 20% Your detailsFirst name(Required) Last name(Required) Address(Required) Address Line 1 Address Line 2 City Postcode Email(Required) Date of birth(Required) Day Month Year Your detailsBlue badge issuing authority(Required) Blue badge number(Required) Please provide a copy of the blue badge(Required)Max. file size: 10 MB.Do you receive the Disabled Living Allowance?(Required) Yes No What rate of the Disabled Living allowance do you receive?(Required) Higher rate Lower rate Other Provide the latest award letter if you receive the higher rate disabled living allowance(Required)Max. file size: 10 MB.If the above does not apply to you, what type of allowance are you entitled to?(Required) Driver detailsIs the badge holder the driver?(Required) Yes No What is the full name of the driver?(Required) Does the driver live at the address above?(Required) Yes No What is your relationship of applicant and driver?(Required) Does the badge holder use a wheel chair?(Required) Yes No Please provide medical evidence e.g. Letter from doctor or hospital stating wheelchair usage(Required)Max. file size: 10 MB.Is there an off street parking facility or garage at or near the home?(Required) Yes No Please give details(Required) Vehicle detailsWhat is the make and model of the vehicle?(Required) Where is the vehicle normally parked?(Required) Please provide a copy of the named driver's driving licence and car registration(Required)Max. file size: 10 MB.Is there any further relevant information you need to tell us??(Required) Consent(Required) I agree that I have answered all the questions correctlyEnter your name(Required) Date(Required) Day Month Year
