APPLICATION FOR ASSISTANCE WITH HOME TO SCHOOL TRAVELLING EXPENSES PLEASE READ THE ENCLOSED GUIDANCE NOTES BEFORE YOU START TO FILL IN THIS FORM. PLEASE COMPLETE THIS FORM IN BLOCK CAPITALS PLEASE APPLY EARLY – All applications received by the end of July will be guaranteed to be processed for the beginning of term in September. Applications received during the school summer holidays will be looked at in the order of the date received, we cannot guarantee a response by the beginning of term in September. SECTION A: TYPE OF ASSISTANCE REQUIRED PLEASE TICK ZERO FARE BUS PASS CYCLE ALLOWANCE A TfGM bus pass enables the child to travel to and from school for free before 9pm on any Greater Manchester bus, tram or train. The pass is only valid for the journey shown on the pass. Any changes to those journeys must be authorised by the school using a 'Journey Variance Voucher'. This pass is valid for one academic year. A cycle allowance of £30 can be made instead of a bus pass. Please read the attached notes carefully before applying for a cycle allowance. PLEASE TICK THE RELEVANT BOX BELOW THIS IS A NEW APPLICATION DUE TO: CHANGE OF SCHOOL HOUSE MOVE CHANGE IN ELIGIBILITY * Date of Change *i.e. Student has become eligible for Free School Meals or Parent now receiving Maximum Working Tax Credit NO CHANGE IN CIRCUMSTANCES BUT WOULD THIS IS A RENEWAL LIKE TO APPLY FOR PASS APPLICATION SECTION B: CHILD DETAILS CHILD’S SURNAME: CHILD’S FORENAME: DATE OF BIRTH: DD MM YYYY HOME ADDRESS: THIS MUST BE THE CHILD’S PERMANENT RESIDENTIAL ADDRESS POST CODE: DATE MOVED TO THIS ADDRESS: IF YOU HAVE MOVED HOUSE IN THE LAST 12 MONTHS, PLEASE STATE YOUR PREVIOUS ADDRESS POST CODE: SECTION C: PARENT/CARER DETAILS PARENT/CARER SURNAME: PARENT/CARER FORENAME: PARENT NATIONAL INSURANCE (NI) NUMBER: PARENT DATE OF BIRTH: DD HOME TELEPHONE NUMBER: MM EMAIL ADDRESS: SECTION D: TRANSPORT ASSISTANCE ELIGIBILITY YYYY RELATIONSHIP TO CHILD: MOBILE TELEPHONE NUMBER: PLEASE COMPLETE THE QUESTIONS BELOW AND ATTACH FURTHER EVIDENCE AS INDICATED. SEE THE ATTACHED NOTES FOR INFORMATION REGARDING THE ELIGIBILITY CRITERIA. NAME OF PRESENT SCHOOL: NAME OF PRIMARY SCHOOL ATTENDED: HAS YOUR CHILD HAD A FREE TRAVEL PASS FOR THIS SCHOOL/ACADEMY IN THE PAST? YES NO DOES THE CHILD HAVE A STATEMENT OF SPECIAL EDUCATIONAL NEEDS? YES NO IS THE CHILD ELIGIBLE FOR FREE SCHOOL MEALS? YES NO YES NO IS THE PARENT IN RECEIPT OF THE MAXIMUM WORKING TAX CREDIT? IF YES, YOU MUST ENCLOSE A FULL COPY OF YOUR MOST RECENT TAX CREDIT ASSESSMENT NOTICE. PLEASE DO NOT SEND ANY ORIGINAL DOCUMENTS AS THESE CANNOT BE RETURNED. DO NOT SEND A PHOTOGRAPH UNTIL YOU HAVE RECEIVED A LETTER CONFIRMING YOUR ELIGIBILITY FOR A BUS PASS. (PHOTOGRAPHS SENT IN ERROR CANNOT BE RETURNED) SECTION E. DECLARATION I confirm that the information given on this form is correct and that the child lives at the home address stated. I will notify the School Admissions Team if there are any changes to the information provided on this form. I apply for the child named on this application to be considered for assistance with travelling expenses. I understand that assistance with travelling expenses issued on the basis of false or misleading information may result in assistance being withdrawn. I understand that Tameside Council must protect the public funds they handle and may use the information provided on this form to prevent and detect fraud. Tameside Council may also share this information, for the same purposes, with other organisations which handle public funds. I accept that where a cycle allowance is made, Tameside Council is not responsible for the safety of the cyclist or the security of the cycle equipment. I acknowledge a replacement allowance or free bus pass will not be issued in the event of theft or loss of the bicycle or if the child no longer wishes to cycle to school. SIGNED: DATE: PLEASE RETURN THE COMPLETED FORM TO: SCHOOL ADMISSIONS, TAMESIDE MBC, PO BOX 317, ASHTON U LYNE, OL6 0GS GROUP 1 GROUP 2 GROUP 2 FAITH GROUP 3 ISSUED ON APPEAL YES YES YES YES YES / NO / NO / NO / NO / NO OFFICE USE ONLY DISTANCE REASON PASS NUMBER ISSUED BY APPLICATION FOR ASSISTANCE WITH HOME TO SCHOOL TRAVELLING EXPENSES – GUIDANCE NOTES PLEASE READ THESE NOTES CAREFULLY BEFORE YOU START TO FILL IN THE APPLICATION FORM. You may wish to detach these notes and keep them in a safe place so that you can refer to them at a later date. The application form must be complet

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