3 Distance to nearest school by the shortest trafficable route Please tick (ü) what type of school/s the student/s attend and complete the appropriate - PDF

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Bus Travel Assistance Application School Transport Assistance Scheme DTMR Code BTA The information on the tear off page must be read before completing this form. Office Use Only STIMS: Section A - to be

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Bus Travel Assistance Application School Transport Assistance Scheme DTMR Code BTA The information on the tear off page must be read before completing this form. Office Use Only STIMS: Section A - to be completed by parent/guardian 1 Parent/guardian details Title Surname Given name/s Your principal place of residence (include property name and rural number if applicable) Postcode Please also provide your registered plan and lot number. This information is needed to assess eligibility. Lot number Registered Plan/Survey Plan number The above information is needed to assess eligibility for assistance. If you do not provide all information, it may delay approval for transport assistance. Your registered plan and lot number can be found on your rates notice. Alternatively you can phone your local council and ask for this information or log onto For more information on this website please refer to the tear off page of this application under Applying for bus travel assistance. Postal address Please tick if the same as above Home telephone number Work telephone number Mobile telephone number 2 IMPORTANT: For fast processing, these details should be the same as those held by the student s school. Reason for making this application New application Change of school Change of address Name of previous school attended Previous residential address Last date of enrolment Last date at that address Other Please provide details of change It is important to notify the school of any address change and the bus company of any change to travel patterns. If you don t it may affect your assistance. Please continue overleaf... 3 Distance to nearest school by the shortest trafficable route Please tick (ü) what type of school/s the student/s attend and complete the appropriate section/s below State primary Non-state primary State secondary Non-state secondary Section Type of school Please complete section A below Please complete section A and B below Please complete section C below (include any state senior colleges) Office Use Only Please complete section C and D below Verification Initials Name of nearest school to your house Distance (one way) Map Info On Road A Nearest state primary B Nearest non-state primary* C Nearest state secondary D Nearest non-state secondary* * of type attended 4 Names of student/s applying for bus travel assistance Family name Given name Other initials Male/ Female (M/F) Year (grade) of birth 5 School details of student/s applying for assistance Student s given name (as shown above) Exchange/ overseas student^ (Y/N) Name of school they attend Distance to this school* *refer to point 4 under Eligibility on tear off page for details on measuring. ^refer to point 7 under Eligibility on tear off page 6 On what days will the service be used? Please specify a start date for travel and tick (ü) the days travelled specifying am/pm - actual times are not needed Student s given name (as shown above) First date of travel on this bus this year Monday Tuesday Wednesday Thursday Friday am pm am pm am pm am pm am pm Total number of days (am) Total number of days (pm) Is more than one service used to get to school? 7 Names of other students already receiving, or applying for transport assistance Do not include students listed at question 4 Other Family name Given name Name of school they attend of birth initials Type of assistance you get for this student or type applied for 8 Certification by parent/guardian I certify that the information provided is true and correct and I have read and agree to the conditions of travel as listed on the attachment of this application. I understand that I am required to complete within seven (7) days a new application should there be any change in the information contained in this application. It is further understood that the Department of Transport and Main Roads reserves the right to withdraw travel assistance and recover monies paid if investigations show the student/s to be ineligible. I understand that persons who intentionally provide false information to obtain a benefit may be liable to a $6,000 fine under Section 149(3) of the Transport Operations (Passenger Transport) Act 199 In order to assess an applicant's ongoing entitlement to assistance, the Department of Transport and Main Roads will verify student's personal details with the school attended and schools will disclose to the Department of Transport and Main Roads updated information for that purpose. By signing the certification below I am authorising this exchange of personal information between the Department of Transport and Main Roads and schools. Signature Privacy Disclaimer: The Department of Transport and Main Roads collects the information on this form as authorised under the Transport Operations (Passenger Transport) Act 199 When submitted to the bus operator, these details will be used to provide a preliminary assessment of your eligibility for school transport assistance before being forwarded to the Department of Transport and Main Roads. These details are accessible by authorised Department of Transport and Main Roads staff and may also be provided to the local conveyance committee and the Department of Education and Training staff as required. You and your child s personal details will not be disclosed by the Department of Transport and Main Roads to any other third party without your consent unless required to do so by law or for the purpose of the Information Privacy Act Some of the student s personal information including name, school and current year level may appear on a bus pass created and issued at the request and discretion of the relevant bus operator. Please submit completed form with the operator providing the transport within 7 days Section B - to be completed by the bus operator Operator s name Route number/s Kilometre operators to note An increase in payment category will only be considered after an Increase in Payment Category Application (form F3731) has been completed. These forms are available from your nearest Department of Transport and Main Roads office. Fares-based operators to complete* Note - excess fares are to be paid directly to the operator Student s given name (from previous page) government funded travel began on this service/section Section number Description Fare to the nearest school Single Weekly TransLink Top Up Code Level Application ID *Notes section provided on back of form for any additional information or attach documentation if required Operator s certification I certify I have assessed this/these student/s as eligible under the School Transport Assistance Scheme and have issued interim approval based on the information provided. I agree to advise the Department of Transport and Main Roads of any local circumstances which may affect the eligibility of the/these student/s. I understand that this approval is subject to final approval of the Department of Transport and Main Roads. It is further understood that if I wrongfully certify a student/s as being eligible, I will have no entitlement whatsoever to payment for transporting the student/s. I understand that persons who intentionally provide false information to obtain a benefit may be liable to a $6,000 fine under Section 149 (3) of the Transport Operations (Passenger Transport) Act 199 Signature Student s name Approval Yes No Data entry details Travel % Office Use Only Initials Notes Approving officer s certification I have assessed this application in accordance with the approved school transport policies and procedures and certify that the student/s is/are entitled to the level of assistance granted. Officer s signature Input officer s certification I have reviewed travel details on this application with details recorded in STIMS and confirm the student/s is/are not receiving assistance for the same journey/s approved on this application. Appropriate details have been accurately recorded in accordance with the STIMS user manual. Officer s signature SSA MSU Form F2208 ES V01 Oct 2010 Notes Conditions of travel Bus Travel Assistance Application School Transport Assistance Scheme These instructions must be read before completing this form. Please remove this page and keep it for your records. The School Transport Assistance Scheme provides assistance to enable eligible school students to attend education facilities. Travel on school transport services is subject to requirements of the Transport Operations (Passenger Transport) Act 199 Parents are asked to note the following conditions and ensure their children are also made aware of these conditions. Further information on the School Transport Assistance Scheme and additional application forms are available on the Department of Transport and Main Roads website at Applying for bus travel assistance Complete this form if you wish to apply for distance-based travel assistance. Fill in all questions on the form. If you do not it may delay the processing of your form. You can log onto and click on start mapping here to access your lot number and registered plan number. To do this click on property under area of interest and then type in your address. Once you have located your residence, click on identify and it will give you the lot and plan number. Alternatively, look at your rates notice or contact your local council to get your lot and plan number. Return the completed form to your local bus operator. This must be done within 7 days of the student starting to travel on the bus. Applications can only be accepted for the current school year. If the student catches more than one bus to get to school, an application form must be completed for each bus service. If the student changes school or address during the year you will need to reapply for assistance. You must also tell the Department of Transport and Main Roads if the number of times the student catches the bus each week changes. The bus operator will issue interim approval only. Final approval for assistance can only be granted by the Department of Transport and Main Roads. The Department of Transport and Main Roads will advise successful applicants in writing. If your application is unsuccessful, you will be advised by your local bus operator. Eligibility This is only a brief summary. Contact your nearest office or go to for full details.. To be eligible for travel assistance, students must meet the criteria detailed below. Students must be enrolled at an approved school. State primary school students (years prep-7) must live more than 2 kilometres by the shortest trafficable route from the nearest state primary school. Non-state primary students (years prep-7) must live more than 2 kilometres from both the nearest state school and non-state school of the type attended. State secondary school students (years 8-12) must live more than 8 kilometres by the shortest trafficable route from the nearest state secondary school. Non-state secondary students (years 8-12) must live more than 8 kilometres from both the nearest state school and non-state school of the type attended. Measuring: The distance from your residential property to the school is measured by the shortest trafficable route over roads open for public use. Distances are measured from the vehicle access point of your residential property alignment nearest to the school to the closest entrance to the school. No measurements are made on private property. In calculating this distance, the single journey is used. However, in cases where the distance to and from school varies because of different routes (e.g. one way roads), the average distance is taken. 5. Financial assistance may be available under the provisions of the safety-net scheme for financially disadvantaged students residing close to their nearest school. 6. Financial assistance may also be available for those parents who choose to transport their children by private motor vehicle. Conveyance allowance may also be available to parents who drive their child/children to the bus service. 7. Students from overseas, interstate or on student exchange programs are not eligible to receive travel assistance. 8. Students attending TAFE colleges are not eligible to receive transport assistance. 9. Students are only eligible to receive assistance on the designated bus service for their area. Students living in an area serviced by a kilometre-based school bus service are not eligible for assistance on fares-based services. 10. Travel assistance is not available for travel to alternative addresses or for travel to more than one school facility. 1 In assessing eligibility of students, the minimum frequency of travel is 20%, that is, 2 trips per week. 1 In some circumstances, eligible students who do not attend their nearest state school may receive assistance to the value of travel to the nearest state school. Parents are then responsible for payment of any excess fares. The Department of Education and Training is responsible for transport assistance for students with disabilities. Please discuss eligibility requirements and assistance types for these students with the school attended. ** Please read and remove this tear off page (not to be returned with this application) ** Bus Passes If bus passes are issued to students, these passes must be produced to the driver upon request. Passes are not transferable. Bus passes must be returned to the bus company immediately upon the students ceasing to use the bus. A replacement fee will be charged for all lost passes. Damaged passes will be replaced at a nominal fee provided the damaged pass is produced and identifiable. Any excess fares for a student s travel are to be paid directly to the bus operator. Code of Conduct for school bus travel ** Please read and remove this tear off page (not to be returned with this application) ** The Department of Transport and Main Roads has in place a Code of Conduct for School Students Travelling on Buses. The Code applies to all students attending primary and secondary school in Queensland who use buses either to travel to and from school or for other school-related activities such as excursions. The Code sets out prescribed standards of behaviour and examples of how your child can meet these standards. A brochure outlining the Code of Conduct and detailing students and parents responsibilities is available from your local bus operator or nearest Department of Transport and Main Roads office. Change of circumstances It is a parental/guardian responsibility to advise the Department of Transport and Main Roads within 7 days when there is a change to a student s personal circumstances that would affect their eligibility for school transport assistance. Parents must: Complete and submit a new application form when a student changes school or address. Complete and submit a new application form when a student goes from primary level (year prep-7) to secondary level (year 8-12), even if the student is remaining at the same school. Notify the Department of Transport and Main Roads if the number of times the student uses the bus service changes during the year. Advise the bus company and the Department of Transport and Main Roads when a student no longer travels on a particular service. Circumstances may also change during a student s schooling which make a student ineligible to continue to receive assistance. These can include, but are not limited to, a new school built in a local area, or a new road network. The Department of Transport and Main Roads reserves the right to withdraw travel assistance and recover monies paid if investigations show the student to be ineligible. Persons who intentionally provide false information to obtain a benefit may be liable to a $6,000 fine under Section 149 (3) of the Transport Operations (Passenger Transport) Act 199 Department of Transport and Main Roads offices Please contact your nearest office for further information on the School Transport Assistance Scheme or log onto Brisbane Ipswich Rockhampton Toowoomba (Brisbane Northside) (including Brisbane South & Passenger Transport Unit Passenger Transport Unit Passenger Transport Unit West) PO Box 5096 PO Box 645 PO Box 156 Passenger Transport Unit Red Hill Rockhampton Qld 4701 Toowoomba Qld 4350 Zillmere Qld 4034 PO Box 631 Phone (07) Phone (07) Phone (07) Ipswich Qld 4305 Phone (07) Cairns Mackay Roma Townsville Passenger Transport Unit Passenger Transport Unit Passenger Transport Unit Passenger Transport Unit PO Box 6542 PO Box 62 PO Box 126 PO Box 7466 Cairns Qld 4870 Mackay Qld 4740 Roma Qld 4455 Garbutt BC Qld 4814 Phone (07) Phone (07) Phone (07) Phone (07) Gold Coast Maryborough Sunshine Coast (including Brisbane South- Passenger Transport Unit Passenger Transport Unit East) PO Box 371 PO Box 111 Passenger Transport Unit Maryborough Qld 4650 Mooloolaba Qld 4557 PO Box Phone (07) Phone (07) Southport BC Qld 4215 Phone (07)
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