Home to College Transport Application Form

Section 1: Details of student and course
Name
First Last
Gender
- Male
- Female
Date of Birth
DD slash MM slash YYYY
Address
Find addressSelected address
Enter your postcode in Redbrige to select your address
Address*
Street Address Address Line 2 City County Postcode
Age (in September; at start of college)
Student Mobile No:
If you do not wish for the student to be contacted directly with transport updates, please leave blank
Details of the college attending in September:
College name:
College address
Street Address Address Line 2 City County Postcode
Course Studying:
Course duration:
College Contact Name:
College Contact Number:
Date course starts:
DD slash MM slash YYYY

Once supporting documents have been received it takes 4 weeks to process an application

Section 2: Details of parent/carer
Are you in receipt of higher rate mobility component (HRMC) of the Disability Living Allowance(DLA) for your young person?*
- Yes
- No
Does your young person have a mobility vehicle?*
- Yes
- No
Please explain why it is not possible to use the vehicle to transport your young person to college?*
Title:
Name:
First Last
Address
Find addressSelected address
Enter your postcode in Redbrige to select your address
(if same as child, leave blank)
Address
Street Address Address Line 2 City County Postcode
Home telephone number:
Work telephone number:
Mobile telephone number:*
* A mobile number must be provided as transport updates are sent by text message.
Do you want a copy of this application details to be sent to you?*
- Yes
- No
If yes, an email address must be provided on the email field below
Email:*
Enter Email Confirm Email
Email:

Section 3: Details of college times
Please indicate days and times transport will be required:
Monday start time
Monday finish time
Tuesday start time
Tuesday finish time
Wednesday start time
Wednesday finish time
Thursday start time
Thursday finish time
Friday start time
Friday finish time
Please indicate in the box below if college times are different (provide as much details as possible)

Section 1: Details of student and course