APPLICATION FOR BUS PASS ACADEMIC YEAR 2016-2017 YOUR DETAILS: Surname: First Name: Date of Birth: Age at 31/8/16: Address: Post Code: Contact No: Email Address: DETAILS OF TRAVEL (outward journey only) Please state precisely the BUS STOP you will use. (Please see time tables on reverse. Times overleaf are approximate and will be confirmed before the start of your course). Bus Route: COL04 please circle COL01 COL03 COL05 (see over) Nantwich/ SHUTTLE Holmes Maccles/ Chapel/ Crewe/ Winsford/Hartford Middlewich/ Knutsford Tarporley Sandbach Winsford Bus Stop: YOUR COURSE: Title of course: Duration of 1 year or 2 years course: Days in College if Mon Tue Wed Thurs Fri known (please circle) PLEASE READ AND SIGN HERE The College will provide a bus pass to Further Education Students on a full time course, subject to the availability of seats. The cost to be confirmed for 2016-17, but you will have the option to pay termly. Bus passes will be available for collection at enrolment or during the first weeks of each term. I declare that it is necessary for me to travel in accordance with the details given and that to the best of my knowledge and belief, these details are correct in every respect. I undertake to return the bus pass to the College, if I withdraw from my course before the end of the academic year, or otherwise become ineligible to receive assisted travel. Signed: Date:………………………………………………… Please return this form to: Student Services, Mid-Cheshire College, Hartford Campus, Northwich, Cheshire, CW8 1LJ. Tel: 01606 720 649 APPLICATION FOR BUS PASS ACADEMIC YEAR 2016-2017 COL01 Holmes Chapel AM /Middlewich/Winsford Holmes Chapel Shops 0725 Middlewich, The Bull Ring Opposite B&W Tyres Wharton Road Crook Lane, Christ Church Winsford, High Street, Guildhall Swanlow Lane, Crossfields Avenue Durham Drive, Bedford Rise Wharton Road, Wesley Court Mount Pleasant Drive Playing Fields Mid Cheshire College COL03 Macclesfield/Knutsford AM Macclesfield Railway Station 0735 Broken Cross, The Cross Potato Chelford Railway Station Ollerton Crossroads Longridge, St Johns Wood School Mobberley Rd Nr. Cheshire East Compound AM ONLY Opposite BP Petrol Station PM ONLY Mobberley Rd Fire Station Knutsford, Knutsford Bus Station AM ONLY Northwich Rd Heathfield Square PM ONLY King Edward Road, Church Hill PM only Arrival at Sir John Deanes Mid Cheshire College COL04 Crewe/Sandbach AM London Road/Nantwich, The Leopard 0740 Crewe, Bus Station Middlewich Road Dental Surgery, Sandbach Co-op Middlewich Road, Elworth The Bull Ring, Middlewich Mid Cheshire College COL05 Tarporley/Cotebrook AM Opp Windsor Ave on Eaton Rd, 0825 Tarporley Eaton Royal/Lower Lane Corner Cotebrook Utkinton/Stable Lane Corner Please return this form to: Student Services, Mid-Cheshire College, Hartford Campus, Northwich, Cheshire, CW8 1LJ. Tel: 01606 720 649 .