Tertiary and post-secondary student
regional concession fare
application/renewal
Apply for concession fares on public transport in regional
Queensland (outside of the go card network)
From January 2016, tertiary and post-secondary students can
complete this application form for concession fares on public
transport in regional Queensland. Before completing this form,
check that you meet all of the eligibility criteria below.
Eligibility criteria
To be eligible for concession fares you must meet all of the
following criteria:
•carry a student ID (issued by an institution registered with the
Department of Transport and Main Roads) as proof of eligibility
•reside in Queensland; and
•be enrolled in and attending a course:
•at a university, higher education provider or other registered
training organisation in Queensland (unless otherwise
approved by the Department of Transport and Main Roads)
that is registered with the department; and
•that has been developed and accredited under the Australian
QualicationsFramework,or
•that is a Course in Core Skills supported by the Queensland
Government’s Skilling Queenslanders for Work Initiative*; and
•be a full time student enrolled on an internal basis. To be
considered full time and internal:
•a university student must be enrolled full time on an internal
basis, as deemed by their university; or
•students attending an institution other than a university
must be enrolled in a course of study requiring attendance
at classes (or unpaid practical requirements) for at least 12
hours per week for a minimum course duration of 12 weeks.
*for details on eligible courses, visit translink.com.au/tertiary
What you need to do
Step 1 - Complete Part A and sign the declaration.
Step 2 - Present your completed form at your educational
institution’sstudentadministrationofce,alongwithyourcurrent
student ID card.
Step 3 -Ifyourinstitutionveriesyoureligibilityforconcession
fares, they will apply a concession sticker to your student ID
card.
You must carry a current student ID card with you at all times as
proof of eligibility to purchase and travel on concession fares in
regional Queensland.
Note: The concession sticker is not valid for travel on public
transport services in South East Queensland (on the go card
network). For details on how to travel in SEQ, visit
translink.com.au/tertiary
Renewal
Your concession sticker is valid until 31 March following the year
of issue.
If your course is longer than 12 months and you are still eligible,
you will need to re-apply each year for the duration of your
course.
Please check the expiry date on your sticker to allow enough
time to re-apply for concession fares in regional Queensland.
It is an offence under the:
•Criminal Code Act 1899 to dishonestly provide information
with the intent to defraud. The maximum penalty may include
10 years imprisonment.
•Transport Operations (Passenger Transport) Act 1994 to
state anything or give a document to an authorised person if
you know it contains false or misleading information.
Continued page 2...
Page 1 of 2 TRB Forms Area Form F5140 CFD V01 Dec 2015
Phone number
Email address
Part A - Applicant details
Please complete the details below.
Alleldsaremandatory.
Title
(e.g. Mr, Mrs, Miss or other, please specify)
Family name
Given name/s
Educational institution name
Student ID card number
(include all letters and numbers as shown on your student ID card)
Residential address
Postcode
Postal address
(if same as residential address, write AS ABOVE)
Postcode
Declaration
I declare that:
•the details provided by me are true and correct
•I authorise the Department of Transport and Main Roads or
its agent to make reasonable enquiries to verify any details
provided in this application.
Date
/ /
Applicant’s signature
(must be handwritten)
Print
Reset
James Cook University (Cairns)
@my.jcu.edu.au
Tertiary and Post-secondary Student Regional Concession Fare Application/Renewal continued... page 2 of 2
Page 2 of 2 TRB Forms Area Form F5140 CFD V01 Dec 2015
Privacystatement
The student’s nominated institution is collecting the information on this form on
behalf of the Department of Transport and Main Roads (TMR) for the purpose
of assessing a student’s eligibility for concession fares on public transport in
regional Queensland. This process is being undertaken in accordance with the
Information Privacy Act 2009 (Queensland). TMR and the nominated institution
will not disclose a student’s personal information to any other third party without
a student’s consent unless authorised or required to do so by law.
Part B - Educational Institution details
To be completed by the educational institution.
Please complete the details below.
Alleldsaremandatory.
Legal entity name
Trading name
Full address of campus student attends
Postcode
New
Renewal
Replacement
(lost/stolen ID card)
Yes
Q2. Does the student meet all of the department’s eligibility
criteria outlined on page one?
No
Not eligible
Eligible - issue concession sticker
Application processed date
/ /
Sticker expiry date
/ /
Declaration
As a representative of (insert educational institution name)
I declare that:
•the details provided by me are true and correct
•I am authorised to process this application
•I authorise the Department of Transport and Main Roads or
its agent to make reasonable enquiries to verify any details
provided in this application.
Date
/ /
Signature
(must be handwritten)
Name
Position
Contact number
Email address
Q1. Tick the category below relevant to the student’s application:
James Cook University
James Cook University
14-88 McGregor Road
James Cook University
Smithfield QLD
31
03
19
James Cook University (Cairns)
Client Service Officer
1800 246 446
enquiries@jcu.edu.au
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