Pupil details

Customer name



Pupil eligibility

Is your child receiving Free School Meals?

Are you in receipt of maximum working tax credit?
Please upload the most recent evidence.



Have you previously applied for travel assistance for your child's journey between home and the school named on this application?

Parent/Carer contact details


Current address

Customer address

Have you moved in the last 3 months?
Is your current address temporary?
This must be a scanned or digital copy. We cannot accept photographs. The document must be a current Council Tax bill, a recent utility bill (e.g. gas, electricity) or a signed and dated Tenancy Agreement from the last three months.
Have you moved house since your child has started school?
Previous Address

School details

Does your child attend an Infant/Junior/Primary school or Secondary school?
Junior/Infant/Primary
Secondary school

Additional information

Does your child have a statement of Special Educational Needs or Education Health Care Plan?

Parents/Guardian Declaration

I, the Parent/Carer of the above-named child, testify that the information given is correct. I agree that you will use the information I have provided to process my claim for travel assistance and will contact other sources as allowed by law to verify my entitlement. I agree to notify the Director for Education immediately of any change to the above details. I agree to return any travel pass if my claim is re-assessed and I no longer qualify for free travel assistance for the above-named child.
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