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Bus and Financial Assistance Application Form

Bus Service and Financial Assistance Application - 2019/20

Apply for bus service and 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 one of our College buses and also apply for financial assistance towards this and other costs associated with coming to QE. We will ask you some initial questions about what you are applying for to ensure we collect the right information from you.
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, CSA payments and any other income
You have told us that your income is greater than £35,000, this means you are not eligible for financial assistance. If you would like to apply for transport assistance then please select to do this in the box below, if not, this application process is complete and you can simply close this page.
Would you like to apply for a bus pass?*
Your income suggests you may be eligible for financial assistance. Would you like to apply for this?*
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*
Student Reference Number
this six digit number can be found on emails and letters sent to you from the College
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
Detail and evidence
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
- Education Trips and Visits
- Examination Re-sit Fees
Trip/Visit/Examination re-sit details
Please include costs
Household Income*
Please provide household income for tax period April 2017 - April 2018. You can find this on your TC602 - Tax Credit Award Notice dated after 1st April 2018.
Tax Credit or P60
Please upload a copy of your TC602 Tax Credit Award Notice from HMRC dated after 1st April 2018. If you do not have this please upload your household's P60's for that period.
Please note that we need this evidence of household income before we can agree your financial assistance award.
Are you or your parent(s)/guardian(s) in receipt of Social Security or other means tested benefits?*
Please upload evidence of above benefits
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
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*
Are you an asylum seeker?*
Country of origin*
Date*
Do you travel or intend to travel to/from College on a College operated bus service?*

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

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.
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*
Select your Teesdale Pick-up point*
Payment Details:

Remember you can either:

· pay in full (£596.00 x 1) which will be debited from your account on 8^th September 2017; or

· pay in 8 instalments (£74.50 x 8) which will be debited from your account on the 8^th of each month from September 2017 to April 2018
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 Financial Assistance Application - 2019/20

Student Details

Parent/Carer Details

Address

Financial Assessment

Student Bank Details

Bus Details

Payment Details:

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Dates for Your Diary

Start of Summer Exams (13 May – 26 June)

Holiday (27 – 31 May)

HE Parents’ Evening (7.00 pm)

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