Home to School Travel Assistance Form

This form should be used to apply for SEN Home to School Travel Assistance. This service is for pupils who have special educational needs, disabilities or medical needs. Supporting evidence must be supplied with the application.

Travel Assistance is provided at the department’s discretion and if agreed, could be provided in any of the following ways:

Independent Travel Training
Personal Travel Budget (PTB)
Seat on a Vehicle (Home Collection)
Seat on a Vehicle (Collection Point)

Additional important information

It takes 4 weeks to process a completed application form and during this time it is the responsibility of parents and carers to transport their child to and from school. A completed application includes the supporting evidence. This department may visit applicants to assess their suitability for assistance using a partnership agency. If assistance is provided, please note that it is reviewed regularly and is subject to change.

Name of child

First name(Required)

Last name(Required)

Middle name

Known as (if different from first name):

Details of child

Gender

Male

Female

Date of birth(Required)

Day

Month

Year

Current school

Address of child

Does your child live in Rebridge(Required)

Yes

Current address

Enter your postcode in Redbrige to select your address

Find addressSelected address

Current address(Required)

Address Line 1 Address Line 2 City County Postcode

Details of school that you require transport to

Name of school

Address of school

Street Address Address Line 2 City County Postcode

New year group

Transport details

Please select the days that the transport is required

Monday am

Tuesday am

Wednesday am

Thursday am

Friday am

Monday pm

Tuesday pm

Wednesday pm

Thursday pm

Friday pm

Date which you would like support to commence

We require 4 weeks to process an application

Day

Month

Year

Details of childs needs

Does your child have a Statement of Special Educational Needs or EHC Plan?(Required)

Yes

What do you consider to be your child’s primary need?

Detail’s of Parent/Carer and family component

Please inform this office if any of the information changes, after submission.

Title

First name(Required)

Last name(Required)

Parent/Carer address details

Is your address same as your child's

Yes

Do you live in Redbridge?

Yes

Address

Find addressSelected address

Enter your postcode in Redbrige to select your address

Address

Street Address Address Line 2 City County Postcode

Contact details of parent/carer

Home telephone number

Work telephone number

Mobile(Required)

A mobile number must be provided as transport updates are sent by text message.

Emergency contact details

First name(Required)

Last name(Required)

Relationship to child

Contact number

Sibling details

Please give details of any siblings

First name	Last name	Date of birth	Do they have an EHC/SEN?	School/College attended?	Actions

There are no Entries.

Maximum number of entries reached.

Additional information

Please note any travel assistance provided is at the Special Educational Needs and Inclusion Services discretion and is annually reviewed

Please explain why you think your child needs assistance to and from school and why you cannot make your own arrangements to provide this assistance. To help with the decision, please only include information relating to your child’s needs i.e. why your child is unable to access public transport or travel with a parent in their own vehicle. Please read the entire form prior to completing this information box to avoid duplication of information, as some of the detail maybe asked for in another part of this form.(Required)

Additional information

Have you claimed Disability Living Allowance (DLA) for your child?(Required)

Yes

Please select if the DLA is for care or mobility?(Required)

Care

Mobility

What level of DLA is received for each component (if applicable)

Do you have a mobility vehicle for your child?

Yes

If yes, please explain why you are unable to use the vehicle to transport your child to and from school.

If your child is over 16, please confirm whether your household income is below £16,190 per annum?(Required)

Yes

Please answer the questions below to assist us with transporting your child safely & comfortably.

Does your child travel in a wheelchair (which must be crash tested)?(Required)

Yes

Please provide the wheelchair make and model, whether manual or automatic and if there have been any alterations to meet your child’s needs (please detail)(Required)

Does your child use any other walking aids, e.g. walking frame, sticks, crutches, calipers, etc.?(Required)

Yes

Please give details of other walking aids(Required)

Is your child able to walk a distance for approximately 5 minutes with or without accompaniment?(Required)

Yes

Please give details?(Required)

Transport needs

Does your child need a car seat?(Required)

Yes

Does your child need a booster seat?(Required)

Yes

Transport needs

Does your child require lifting on & off the seat?(Required)

If the answer is yes, parent/carer will be asked to assist their child on and off the vehicle seat.

Yes

Is your child able to fasten & unfasten their own seatbelt?(Required)

Yes

Your child's needs, language and communication

Does your child have hearing difficulties i.e registered deaf or hearing impaired?(Required)

Yes

Does your child have visual impairment, i.e. registered blind or partially sighted?(Required)

Yes

How does your child communicate, i.e. verbally (if so, what language), signing, Makaton etc(Required)

Your child's needs, language and communication

Does your child have emotional and behaviour difficulties?(Required)

Yes

Please explain how these are displayed(Required)

Your child's needs, language and communication

Does your child have any fears that could affect/her on transport i.e. loud noises, colours, smells, Items of clothes, crowds etc.(Required)

Yes

Please give details about your child's fears(Required)

If your child becomes anxious or distressed, what behaviour is displayed and how do you calm him/her?(Required)

Your child's needs, language and communication

Does your child have physical or sensory difficulties?(Required)

Yes

Please give explain how your child displays this.(Required)

Medical Information

Does your child have epilepsy?(Required)

Yes

Does your child have any other medical needs that may affect transport, not previously mentioned e.g. requires oxygen, severe allergies, diabetes, etc. ?(Required)

Yes

If yes to any of the above questions, please give details, e.g. what signs and symptoms do we need to look for or be aware of, and what action we need to take. Please be aware that our staff are not allowed to administer medications. If medications are required to be given we will call the emergency ambulance. Please provide a copy of any medical care plan or protocol that you have.(Required)

Terms and conditions for transport

Theft, loss or damage of personal belongings

We understand that at times, with discussion between the Home to School Travel Assistance Team and parents/carers, an item such as a toy or an iPad might be helpful to assist a young person on their journey. However, this must be with the understanding that the Travel Assistance Team cannot supervise the use of personal items. As such, parents will exercise responsibility in attending to and the safeguarding of all personal belongings placed on any SEND Home to School Transport. Leaving personal belongings such as laptops, iPads, valuables, textbooks, notes unattended even for short period of time, may invite unnecessary damage, thefts or create unnecessary misplacement or losses. The Council will not be held responsible for any personal loss or damage of such items.

Further transport guidance can be found by visiting SEND Home to School Travel Assistance (Redbridge) (opens in new window)

Data protection

Your personal information will be held and used in accordance with the requirements of the Data Protection Act 1998. We have a duty to protect the public funds we administer and may use the information you provide for the prevention and detection of fraud. We may also share this information with other bodies responsible for auditing or administering public funds for these purposes.

Declaration(Required)

I declare that to the best of my knowledge the information I have given is correct and complete. I will inform the Special Educational Needs & Inclusion Services if any details I have given change. I agree that if transport assistance is agreed, the information I have given may be shared with Redbridge Transport Services to provide my child with safe and appropriate transport.