Solihull Council

Application for Travel Assistance Pre-16 (Secondary)

Please complete this form and print it off, then sign and send to: School Asset Support Team,
PO Box 20, Education and Children's Services, Council House, Solihull,
B91 3QU 

Data Protection

The personal information that you provide will be used to assess entitlement to travel assistance. It will be shared with the school that your child/children attend. We may check information provided by you, or information about you provided by a third party, with other information held by us. We may also share this information with other public bodies to prevent or detect crime or to protect public funds as permitted by law. These public bodies include government departments and other Council departments and West Midlands Travel. It will also be shared with other Council services and partner organisations to ensure our records are kept accurate and help us to identify services you may be entitled to or interested in. For further information about transport and appeals please contact the School Transport Officer tel: 0121 704 6698. For enquiries about bus passes please telephone 0121 704 6610.

Further details on how we will use your information

Full name of parent/person with parental responsibility	Mr  Mrs Miss Ms Other
Full Address
Post Code
Telephone (home)
Telephone (work)
Telephone (mobile)
Email

Child's first name	Surname	Date of birth
		-- dd-mm-yy
School  to be attended	Applying on denominational or benefit grounds?
	No Yes
Previous school	School Start date	Year 11 leaving date
	--	--
Is pupil in receipt of Free School Meals?
No Yes
Are you in receipt of Working Tax Credit?
No Yes

*If you are applying on denominational or benefit grounds please attach a copy of either your own or your child's baptism certificate or confirmation from your clergyman that you regularly attend church or a copy of your TC602.

I understand that assistance is granted on the condition that I fulfill all of the criteria as laid down in the Pre-16 Transport Policy. I agree to return any pass issued as soon as I cease to be eligible for assistance and understand that if I fail to do so I will be liable for a charge from the date eligibility ceased.

I have read the above and agree to the terms and conditions

Signature..................................................................... 

The personal information that you provide will be held by Solihull Council in accordance with the Data Protection Act. We may check information provided by you , or information about you provided by a third party with other information held by us. We may also share this information with other public bodies to prevent or detect crime or to protect public funds as permitted by law. These public bodies include government departments and other local authority departments.