Application for replacement bus pass
Items marked * must be completed
To apply for a replacement bus pass due to a pass being lost, damaged or stolen, please complete and submit this form. The current cost of a replacement pass is £10.00.
If the pupil has changed address or school
you cannot use this form for a pass replacement, instead you'll need to have their
transport entitlement re-assessed.
For a change of stop please contact us directly at
student.transport@staffordshire.gov.uk or by ringing 01785 895024.
About the pupil
1. Name of Pupil
2. Pupil's address
3. Pupil's date of birth:*
(Day / / )
Details of the bus pass
4.
5. Operator and route information
6.
Do not use this form if replacement due to change of school, address or pickup point, instead see contact details above.
About you
7. Name of person completing the form
8.
9. Your contact details
Is your address the same as the pupil's?:*