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Bus and Financial Assistance Application Form

Bus Service and/or Financial Assistance Application - 2019/20

Apply for bus service and/or financial assistance

1 Initial Assessment

2 Personal Details

3 Financial Checks

4 Bank Details

5 Bus Details

This application process allows you to reserve a place on the College bus service and/or to apply for financial assistance towards transport and other costs associated with being a student at QE.

The College Bus pass costs £596 for the year and can be paid for in monthly instalments.

We will ask you some initial questions about what you are applying for to ensure we collect the right information from you.

Deadline for bus applications is 1st August 2019 to guarantee a place on the bus

Deadline for Financial Support applications is 24th September 2019 - applications after this date will NOT be backdated to the start of the College year.
If your total household income (including all benefits) is less than £35,000 per year you may be eligible for assistance towards College transport and other costs. Please select the appropriate option below:
Total household income*
including salary, all benefits, Universal Credit and any other income
As your income is greater than £35,000, you are not eligible for financial assistance. If you would like to apply to use the College Bus Service then please select from the options below. If not, this application process is complete and you can close this page.
Would you like to apply for a bus pass?*
Would you like to apply for financial assistance?*
Would you like to apply for a pass to use a College bus?*
You can now close this page.

Student Details
Student Surname*
Student Forename(s)*
Student Date of Birth*
Date Format: DD slash MM slash YYYY
Student Reference Number
If you don't know your reference number you can leave it blank and submit the form.
Parent/Carer Details
Parent/Carer Title (Mr, Mrs, Ms etc.)*
First Name of Parent/Carer*
Surname of Parent/Carer*
Home Telephone Number
Mobile Telephone Number
Email Address for correspondence*
Enter Email Confirm Email

Correspondence regarding this application will be emailed to this address
Address
Parent/Carer
Address Line 1*
Address Line 2
Town/City*
County
Postcode*

Financial Assessment
Please ensure you submit all the required information. Incomplete applications will not be processed until all evidence is received.
Which of these items or services would you like to apply for?
- Free College meals for household incomes less than £16,190 per year
- Student Bursary for household incomes less than £25,000 per year
- Transport Bursary for students living more than 2 miles from College and household income less than £35,000 per year
Trip/Visit/Examination re-sit details
If you're applying for financial help towards the cost of a College trip or exam re-sits, you must provide details and cost.
Household Income*
Please provide household income for tax period 6th April 2018 - 5th April 2019.
You will need to attach evidence of your household income below.
Please include ALL pages when providing evidence

Proof of income includes:
- TC602 Tax Credit Award Notice dated after 1st April 2019
- P60 dated after 1st April 2019
- Universal Credit Statements- 3 consecutive months, showing the amount received and how the award is made up
- Proof of benefit dated within the last 3 months, showing the amount received
Don't worry if you don't have electronic copies of your evidence, you can use your mobile phone or tablet to take photos and upload these.
Drop files here or
Proof of income must be submitted before 20th September 2019 to be eligible to payment from the start of your course. Late applications will not be backdated.
Are you or your parent(s)/guardian(s) in receipt of Social Security or other means tested benefits?*
Please upload evidence of above benefits
Drop files here or
Are you or your parent(s)/guardian(s) in receipt of any other type of financial support, i.e., maintenance/CSA payments?*
Please upload evidence of above financial support
Drop files here or
Are you in local authority care, a care leaver or living with foster parents?*
Please upload a letter from your local authority to confirm your care status.
Have you been resident in the UK for the last 3 years?*
Country of origin*
Date of entry to the UK*
Date Format: MM slash DD slash YYYY
Are you an asylum seeker?*
Country of origin*
Date of entry to the UK*
Date Format: MM slash DD slash YYYY
Do you live within North Yorkshire?*
If you live in North Yorkshire you must apply to your Local Authority for financial assistance with travel costs, and if you are eligible, a bus pass may be available at a reduced rate. If NYCC refuses your application for support, you can apply to the College for assistance. Please provide proof of NYCC’s refusal or if you don't have this, contact NYCC to apply for assistance.
NYCC Refusal Evidence
Please see the following link to our 2019-20 Financial Assistance Terms and Conditions:
College 2019-20 Financial Assistance Terms and Conditions
Please check the box below to confirm you have read these terms and conditions
- I have read and fully understand the above terms and conditions for financial support

Student Bank Details
Financial assistance payments must be paid into a bank account in the STUDENT'S NAME. If a student does not have a bank account they will need to open one first and then provide us with the information detailed below. Make sure the bank account can accept BACS direct credits. You can check this with your bank or building society. Sorry, but we can’t pay into Post Office Card accounts.
Account Holder
Name of bank/building society
Sort Code
Account No.
Building society roll number (if applicable)
Bank/Building Society evidence
You must enclose an account statement, letter or form from your bank or building society that shows your name, sort code, account number, roll number (if applicable) and home address. We are unable to make bursary payments without proof of the students bank account.
Drop files here or

Bus Details
Please fill in the following details to reserve a place on one of the College buses. Please note that you will not be required to pay for anything at this stage but we will email you with details on how to pay for your bus pass in due course.
Please see the following link to our 2019-20 College Bus Timetable:
College 2019-20 Bus Timetable
Select a bus route*
Select your Bedale Pick-up point*
Select your Sedgefield Pick-up point*
Select your Stockton Pick-up point*
Select your Richmond Pick-up point*
Select your Bishop Auckland Pick-up point*
Select your Ferryhill Pick-up point*
There is not a College bus planned for the Ferryhill route for 2019/20. The route will instead be covered by Arriva buses which will require you to buy an Arriva bus pass. The College has made arrangements with Arriva to ensure that students from these areas are able to travel to College. We have also ensured that the pass from Arriva offers value for money and flexibility. Please still submit this form otherwise you may miss out on discounts available through the College. We will then contact you shortly to give guidance on how to purchase a pass from Arriva.
Select your Teesdale Pick-up point*
If you have selected to apply for financial assistance and are successful in securing a free pass you will not be charged the following fees, but we still need you to select payment options below to allow the assessment to take place.
Payment Details

You can either:

· pay in full (£596.00 x 1) or

· pay a deposit of £36 followed by 7 instalments of £80 which will be debited from your account on the 8^th of each month from October 2019 to April 2020
Payment choice*
Are you sure you want to pay in one single installment in September? If not, please select to pay in 8 installments
Please read the College’s Bus Details and Conditions of Use for the bus service and confirm acceptance with the check-box below before proceeding.
I have read and accept the College conditions of use for the bus service.*
- Accepted (YOU MUST ACCEPT BEFORE SUBMITTING)

Students

Staff

Parents

Bus and Financial Assistance Application Form

Bus Service and/or Financial Assistance Application - 2019/20

Student Details

Parent/Carer Details

Address

Financial Assessment

Student Bank Details

Bus Details

Payment Details

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