New Dependant Season Ticket Application

Please complete all relevant fields and submit at least 2 days in advance.
RST will issue a season ticket approval for your Dependant according to their eligibility, status and requirements.
The season ticket will be issued exactly as defined on the form including start and end date. If something different is required, you must let RST know immediately and a new form will need to be sent.

* - Mandatory Field

Employee Details

Title*

First Name*

Last Name*

NI Number*

Date of Birth*

Address 1*

Address 2

Town*

County

Postcode*

Home Phone

Mobile No

Email*

Work Email

Dependant Details

Title*

First Name*

Last Name*

Dependant Type

Date of Birth*

Season Ticket Requested*

Please complete the journey details and reason for the application in this section.

Note:

Dependants of Non-Safeguarded (NSG) staff are NOT eligible for ANY travel on ANY LUL or DLR services
Requests can be for a minimum of a month and a maximum of a year

Nature of Application:

Season Ticket Start Date*

Season Ticket End Date*

From:*

To:*

Via

Class*

Name of College/School/Uni

Application Reason

Attached Proof Document
(as required)

Notes On Completion of this Form
Based upon the Nature of Application specified above, the following additional information must be supplied to RST before eligibility to the journey can be considered: School - please complete the School Name in the "Name of School/College/Uni" field. If your Dependant is 16 years or under then no further documentation is required Full-Time College/University - please complete the College or University Name in the "Name of School/College/Uni" field. You will also need to attach proof of enrolment to this application. Full-Time Advanced Educational Establishment - please complete the Education Establishment Name in the "Name of School/College/Uni" field. You will also need to attach proof of enrolment to this application. Apprenticeship - please complete the Application Reason field with the name and address of the Employer and the gross weekly salary. You will also need to attach evidence of salary either as payslips or the apprenticeship contract to this application. RST may require further supporting documentation to establish eligibility.

Notes On Completion of this Form

Based upon the Nature of Application specified above, the following additional information must be supplied to RST before eligibility to the journey can be considered:

School - please complete the School Name in the "Name of School/College/Uni" field.
If your Dependant is 16 years or under then no further documentation is required
Full-Time College/University - please complete the College or University Name in the "Name of School/College/Uni" field.
You will also need to attach proof of enrolment to this application.
Full-Time Advanced Educational Establishment - please complete the Education Establishment Name in the "Name of School/College/Uni" field.
You will also need to attach proof of enrolment to this application.
Apprenticeship - please complete the Application Reason field with the name and address of the Employer and the gross weekly salary.
You will also need to attach evidence of salary either as payslips or the apprenticeship contract to this application.

RST may require further supporting documentation to establish eligibility.

Declaration*

By checking this box:By submitting this form:

I confirm that all details provided are correct.
I apply for residential travel for my Dependant for the requested journey. I confirm that no travel grant is provided for the specified journey.
I understand that I am responsible for the correct use of my (and any dependant's) rail staff travel facilities and understand that such use is subject to the Conditions of Issue and Use which can be found at www.raildeliverygroup.com/rst/conditions-of-issue-and-use.
I further understand that Rail Staff Travel’s privacy information is available online at www.raildeliverygroup.com/rst/rst-privacy and that I have read it and have made my dependant(s) aware of it.
If I am in any doubt about eligibility, I understand that I MUST check and that any attempt to obtain or use rail staff travel facilities fraudulently may result in disciplinary action and/or legal proceedings and/or permanent withdrawal of all rail staff travel facilities for myself and all of my dependants.

Signed by Employee:

Date:

Form - Season Ticket - Dep - XX31 - This form is not valid for use after 31/03/2021

Once completed save the form with a filename of “YourLastname_YourFirstname_XX31_ddmmyyyy” – where ddmmyyyy is the date that you send the form to RST). Then submit via email to rst@raildeliverygroup.com or your normal rail staff travel facilities contact point