FA5 Travel Assistance Application Form Please read the information for Parents / Carers above before you complete this form All sections must be completed If we do agree to provide transport it can take up to 10 days to put the necessary arrangements in place SECTION 1: Student Details First Name Surname Date of Birth Age Address Postcode Mobile number (If over 16) Email (if over 16) Does the student have a statement of special educational needs? Does the student have a Section 139a Learning Difficulties Assessment? Does the student have an Education, Health and Care Plan (EHCP)? Is the student entitled to Free School Meals under the national criteria?* Does the student receive Disability Living Allowance** (DLA)? Does the student receive the mobility element of DLA? If YES which level of mobility support do you receive? How does your currently travel to their school or setting? * This is based on as assessment of your income and any benefits you receive. ** The Local Authority may take into account receipt of Disability Living Allowance (DLA) for the student when assessing what support might be needed by the student (i.e. as a proxy of the severity of a disability) but may not require the student to use this to support their transport costs to learning.
FA5 Travel Assistance Application Form Please read the information for Parents / Carers above before you complete this form All sections must be completed If we do agree to provide transport it can take up to 10 days to put the necessary arrangements in place SECTION 1: Student Details First Name Surname Date of Birth Age Address Postcode Mobile number (If over 16) Email (if over 16) Does the student have a statement of special educational needs? Does the student have a Section 139a Learning Difficulties Assessment? Does the student have an Education, Health and Care Plan (EHCP)? Is the student entitled to Free School Meals under the national criteria?* Does the student receive Disability Living Allowance** (DLA)? Does the student receive the mobility element of DLA? If YES which level of mobility support do you receive? How does your currently travel to their school or setting? * This is based on as assessment of your income and any benefits you receive. ** The Local Authority may take into account receipt of Disability Living Allowance (DLA) for the student when assessing what support might be needed by the student (i.e. as a proxy of the severity of a disability) but may not require the student to use this to support their transport costs to learning.
travel_assistance_application_form_fa5.docx