Shropshire Council

SEN Transport Application – Ages 0-18

To qualify for any travel assistance, an application must be submitted for each individual applicant. Once a placement at an education facility has been secured for any age, an application will need to be assessed by the specialist travel team.

We understand that any information shared is confidential and we will only share this information with those who need to know. This form asks for information which in our experience can have an impact on an individual's journey.

For further information please see Education travel assistance - SEN pupils.

Data Protection

Shropshire Council will use the information you provide for the purpose of processing your child's transport entitlement request. It will be retained for a maximum of 6 years, from the receipt of this application.

Consent for storing submitted data (you must tick yes to complete the form) *

Parent/Guardian/Carer details

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Pupil Details

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Gender: *        

School / College details

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Student age range: *        

Special Educational Needs & Mobility Information

In order to assess your travel application, we need to fully understand the needs and requirements of the student applying. Every child / young adult is unique and should your application be successful we would wish to meet those needs to ensure a safe and comfortable journey. Please complete the details below with as much information as possible. We understand that the information you give us is confidential and we will only share relevant information with those who need to know.
Please tick all that apply
Do they have any other conditions or requirements: *
Does the passenger have epilepsy: *
Is the passenger a wheelchair user: *
Passenger:

Passenger has an understanding of road safety: *
Passenger is: *

Emergency contacts

Please provide details of two contacts that you would like us to call in the event of an emergency.
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Changes to transport

Is there anything more we need to know?
Declaration

I confirm that the information I have provided is correct to the best of my knowledge. I understand that if any information I have supplied is found to be intentionally false in order to gain travel assistance, that travel assistance may be revoked.