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Phone Us On: 01761 417504 Registration Form Can you help us? We’re seeking volunteer bus & car drivers to cover otherwise unachievable transport, such as journeys to and from medical appointments. All mileage will be reimbursed - Midsomer Norton, Radstock and surrounding Districts if you can spare a few hours each week, please get in touch to volunteer. CONTACT US Midsomer Norton & Radstock Dial a Ride The Hollies, High Street Group travel Midsomer Norton BA3 2DP We run seasonal daytrips, but members may also use our e: [email protected] service for group travel. t: 01761 417504 Please contact our office to discuss your journey details. Charity No: 1109319 For Door-to-Door Financially supported by: Community Transport Plus several Town & Parish Councils Phone us on: 01761 417504 Registration form Rural East Service DIal a Ride areas All information is treated confidentially Rural West Service of operation: Town Service Title: Whitchurch Keynsham Destination Only Hartclie First Name: Saltford Park & Ride Surname: Norton D.O.B: Malreward Newbridge Corston Compton Publow Dando Twerton Address: & Newton Chew Pensford St. Loe Magna Southdown Stanton Odd Combe Down Drew Marksbury Down Englishcombe Monkton Chew Combe Stoke Chelwood Southstoke Postcode: Priston Farmborough Combe Nempnett Hay Freshford Telephone No: Thrubwell Stowey-Sutton Clutton Dunkerton Hinton Diamond Travelcard/Bus Pass Number: Timsbury Charterhouse Ubley Compton Martin West Cameley Peasedown Wellow Harptree High Camerton St. John Littleton Please tick the following applicable to you: Paulton Hinton Shoscombe Blewett Farrington Limited Mobility ¨ Visually Impaired ¨ East Gurney Harptree Midsomer Norton, Hearing Problems ¨ Special Needs ¨ Ston Radstock Easton Clapton & Westeld Kilmersdon Other (please specify): Chewton Mendip Chilcompton Please retain this page Holcombe Stratton-on-the-Fosse for information! Will you travel with any of the following? What is the Dial a Ride? Who can use this service? Wheelchair: Manual ¨ Electric/Scooter ¨ Shopping Trolley ¨ Walking Aid ¨ We offer a pre-booked door-to-door transport Those living in the areas shown above who Escort/Carer ¨ Other (specify): service, using vehicles specially adapted for cannot easily access public transport are eligible wheelchair passengers and improved accessibility. for membership. This includes the elderly, disabled, parents with small children, Do you have alternative transport Mon- Fri? Our drivers are always willing to help! plus people of any age living in rural isolation. Yes ¨ No ¨ Please provide an emergency contact: When I can use it? How much does it cost? Contact Name: Telephone No: This service operates: There is a small annual membership fee, and journey fares are calculated by distance. Relationship: 08:00 - 16:00 See insert for details. Monday to Friday Diamond Travelcard holders are entitled to Signed: (excludes Bank Holidays) concessionary fares within B&NES by minibus..
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