Application for concessionary travel smartcard (Disability)

Title: Mr / Mrs / Miss / Ms / Other Initials:

Surname: Date of birth:

Address:

Post code:

Telephone:

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Please select your disability type:

(A) People who are severely sight impaired, or sight impaired
(B) People who are profoundly or severely deaf
(C) People without speech
(D) People who have a disability or have suffered an injury which has a substantial and long-term adverse effect on their ability to walk
(E) People who do not have arms or have long-term loss of use of both arms
(F) People who have a learning disability that is a state of arrested or incomplete development of mind which includes significant impairment of intelligence and social functioning.
(G) People who if they applied for a licence to drive a motor vehicle under part III of the Road Traffic Act 1988, would have their application refused pursuant to section 92 of the Act (physical fitness) otherwise than on the ground of persistent misuse of drugs or alcohol.

You will need to send in:

  • Passport-sized photograph (not required if applying for a replacement card)
  • Proof of your address in Luton (recent utility bill, bank statement, Council tax bill)

and

  • Proof of your disability- This needs to be in writing from a medical specialist (not your G.P (Doctor).Please turn overleaf for details of acceptable proofs.

Please send in original documents (not passport or driving licence) and these will be returned to you.

Please Turn Overleaf for approved documents….

ACCEPTED PROOF OF DISABILITY

  • A recent letter confirming current award of Higher Rate Mobility Component of Disability Living Allowance (HRMCDLA)

or

  • Personal Independence Payment (PIP) award letter showing at least eight points or above for “Moving Around” and/or “communicating verbally”

or

  • A recent letter confirming current award of War Pensioners Mobility Supplement (WPMS)

or

  • A Blue Badge (Parking badge)

or

If you are severely sight impaired or sight impaired :

  • letter from an eye specialist/optometrist or social services registration

or

If you are profoundly or severely deaf:

  • letter from an aural specialist or audiogram report, or acknowledgment from Sensory Team (Clemitson House 44-48 Gordon Street, Luton, LU1 2QP)

or

  • A letter from the DVLA stating that you are unable to drive due to a medical condition

or

  • A letter from Social Services confirming that you have a registered disability

or

  • A letter from your hospital Consultant regarding your disability, which explains how it prevents you from accessing public transport