Warwickshire School Transport Application Form

Details of special needs

Please give all information as accurately as possible including any additional information that you think may be useful to us in the additional information box below. If your child has been given a statement or EHCP then it may be helpful to use it to complete this section of the application form.

Please select all that apply and if necessary add additional information below:

Details of Special Needs:

Are there any triggers that may affect your childs behaviour on the journey to/from school:

Yes

Equipment

In order to ensure that we provide the most appropriate transport for your child, we require details of any equipment they may need to travel with.

Will your child be travelling in a car booster seat:*

Yes

Will your child be travelling with a wheelchair or buggy?:*

Yes

Will your child need to travel in their wheelchair or buggy?*

Yes

Please provide wheelchair/buggy details:

Please enter the make and model of the wheelchair/buggy:*

Please enter the length and width of the wheelchair/buggy in centimeters:*

Has the wheelchair / buggy been crash tested?*

Yes

Is your child's wheelchair or buggy fitted with a headrest?:*

Yes

Is your child's wheelchair or buggy:

Manual

Electric

Folding

Please note that in some circumstances the local authority may need to send out an inspector to look at the wheelchair/buggy to assess whether it is safe to transport. You may also be asked to provide proof of crash testing in the form of certification.

Will your child need to travel with a walking frame?*

Yes

Additional information:

Attendance details

Date that transport is required to start (dd/mm/yyyy):*

Payment options

Please do not send payment until we have assessed your eligibility for free transport assistance. If you do not qualify then we may contact you to request payment if you have paid previously.

Students or families who are in receipt of a qualifying benefit are entitled to a reduced charge. The qualifying benefits are:

Income Support, Income based Jobseekers Allowance (or equal based Income based & Contribution based JSA), Universal Credit (with an annual income less than £7,400), The Guarantee Element of State Pension Credit, Income related Employment & Support Allowance (or equal based Income based & Contribution based ESA), the Maximum Level of Working Tax Credit, Child Tax Credit (with an annual income less than £16,190) or a family who receives support under Part VI of the Immigration and Asylum Act 1999.

You must supply proof of entitlement to a relevant benefit with this form.

Benefits:*

Benefits proof uploader (maximum 5 files):
Please note: maximum file size 5mb

Browse Upload proof of income

If you receive one of the qualifying benefits (excluding free school meals) you will need to attach proof. This should be dated within the last 6 months

Additional information:

By clicking submit, you acknowledge that you have read and understood the terms and conditions applicable to you. A full copy of these can be found at www.warwickshire.gov.uk/schooltravel.

Your information rights

To see how we use your personal data and what your information rights are, please read our overall customer privacy notice at www.warwickshire.gov.uk/privacy which includes the contact details if you have a complaint about your information rights. For general enquiries, please contact Warwickshire County Council's customer service centre on 01926 410410.

Application for transport assistance for students aged 19-25 with special educational needs and/or learning difficulties or disabilities attending special schools and colleges

Transportation policies

Academic year

Student details

Photo uploader - student photo

Student address

Parent/carer details

Establishment details

Course Details