Fillable Diamond Travelcard Application Form (PDF, 90.97 KB) (North Somerset Council)

Fill Online, Printable, Fillable, Blank Diamond Travelcard Application Form (PDF, 90.97 KB) (North Somerset Council) Form

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Diamond Travelcard Application Form (PDF, 90.97 KB) (North Somerset Council)

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The Diamond Travelcard Application Form (PDF, 90.97 KB) (North Somerset Council) form is 2 pages long and contains:

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  • 25 check-boxes
  • 10 other fields

Country of origin: UK
File type: PDF

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Personal details
Title: � Mr � Mrs � Miss � Ms
� Other please state
First name:
Middle name(s):
Surname:
Date of birth:
Gender: � female � male
� prefer not to say
Address:
Telephone number:
Email:
Eligibility
I confirm that I am applying under the following
category (please tick):
� Pensionable age – apply online at:
www.n-somerset.gov.uk/diamondtravelcard
� In receipt of automatically qualifying benefits
– apply online at:
www.n-somerset.gov.uk/diamondtravelcard
� Disabled person – please read the guidance
notes carefully before applying. You can
apply online at:
www.n-somerset.gov.uk/diamondtravelcard
or by completing this form – tick the category
that most appropriately describes your
disability:
� Registered blind or partially sighted
� Profoundly or severely deaf
� Without speech
� Severely disabled and unable to walk
� Severe disability in both arms
� Significant learning disability
� Have been refused a driving licence due
to physical or mental incapacity:
� I am applying to renew my Disabled Person
pass (no photograph needed)
� I would like to apply for a Companion
Travelcard as I need the assistance of a
companion at all times when travelling
on buses.
Further details on eligibility under any of the
above criteria, and how to prove it, are included
within the guidance notes.
Application for a
Diamond Travelcard
Please note: it is your responsibility to prove your entitlement
Please complete this form in BLOCK CAPITALS
Photograph
Please attach a recent passport
sized photograph in this box.
The photograph should include
your head and shoulders with no
headgear.
Returning your application form
Please return your completed application form to
the following address:
Diamond Travelcard Team
North Somerset Council
Town Hall
Weston-super-Mare BS23 1UJ
Please tick to confirm you have enclosed:
� A recent passport sized photograph
To apply you will also need to send the following
with your application form:
� Proof of your address
• driving licence
• utility bill
• council tax bill
� Proof of your age
• Birth certificate
• Passport
• Driving licence
• Entitlement to a pension
� Proof of your automatically qualifying
benefits
� Proof of your disability
We accept photocopies.
Where to apply:
Applicants should apply online at:
www.n-somerset.gov.uk/diamondtravelcard
Or send your completed application form, a
current photograph and proof of your address
and disability to:
Travelcard Office
North Somerset Council
Town Hall
Weston-super-Mare BS23 1UJ
Alternatively, you can hand in your application
form at one of our council gateways or libraries.
All Diamond Travelcards will be posted out
to applicants. Some may be asked for more
information.
For general enquiries, please contact the
Travelcard Office on 01934 426 426 or email
diamond.travelcard@n-somerset.gov.uk
Where to use your
Diamond Travelcard:
The Diamond Travelcard area covers the council
areas of North Somerset, Bristol, Bath and
North East Somerset and South Gloucestershire.
This includes Park and Ride services within the
Diamond Travelcard area. Premium airport
services are excluded from the scheme.
Cardholders can travel for free on local bus
services throughout England. However, there
may time restrictions outside of the Diamond
Travelcard area (see below).
When you can use your
Diamond Travelcard:
In the Diamond Travelcard area, cardholders can
travel from 9am to 4am the following day and all
day on weekends. In the rest of England, times
are generally 9.30am to 11pm.
Please print
name on
reverse of
photograph in
case it becomes
detached.
27808 1217
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Diamond Travelcard Application Form (PDF, 90.97 KB) (North Somerset Council)

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Completed 15 July 2020

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