School Bus Pass Application Form Student Details Firstname: Surname: School: Route: School Year: Please Select.. Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Year 12 Year 13 Bus Stop: Please Select.. Hugglescote - Hugglescote: Station Road, The green Op Cemetery Ashby - Ashby Ivanhoe Ashby - Ashby School Lount - Outside Ted’s End Worthington - Opposite Church Street Bus stop Worthington - Opposite The Malt Shovel Newbold Coleorton - Layby opposite Vicarage Close Coleorton - Lower Moor Road 140yd sign prior Rempstone Road Coleorton - Lower Moor Road Bus stop prior to Outwoods Lane Coleorton - Lower Moor Road, Post Office Coleorton Moor - Opposite The Angel Coleorton Moor - Opposite Kings Arms Coleorton Moor - Moorlands Bus stop at Forrester Close Whitwick - Brooks Lane, 1st Bus stop outside No’s 47/49 Whitwick - Market Place Bus stop Whitwick - Hall Lane Bus stop opposite Lady Jane pub Coalville - Hall Lane Post Office Coalville - Broomleys Road opposite Buckingham Road Coalville - Long Lane Surgery Bus stop Coalville - London Road opposite Scotlands Industrial Estate Coalville - Memorial Square, Red House Bus stop Hugglescote - Depot Mobile Phone: Authorise sending of SMS to Student Tick if disabled access to school transport is required Address Address 1: Address 2: Village: County: Postcode: Parent/Guardian Details Full Name: Relationship: Please Select.. Parent Guardian Phone 1: Phone 2: Email: Payment Scheme: Please Select.. Payment in full (1 x £236.00 Total £236.00) 3 Payments (3 x £236.50 Total £709.50) 8 Payments (8 x £91.25 Total £730.00) LCC Entitled (1 x £0.00 Total £0.00) Authorise sending of SMS to Parent Photograph of Student Upload a photograph to appear on the pass -head and shoulders - Must be taken in portrait mode. Format required JPG, BMP or PNG. You will need to complete one application form per student * Please ensue the photograph is a high resolution portrait Notes (Add any additional comments here): Part Time Options I Agree to Roberts Travel Group Terms & Conditions (You must agree to these terms in order to proceed) View T&Cs Proceed to payment Part time options × Please select your part time travel options, You will only be allowed to create a travel pass for the current or next term period Select Term Please School Term.. Start Date End Date Day of Week AM Travel PM Travel Monday UNKNOWN DAT101 No Travel UNKNOWN DAT101 No Travel Tuesday UNKNOWN DAT101 No Travel UNKNOWN DAT101 No Travel Wednesday UNKNOWN DAT101 No Travel UNKNOWN DAT101 No Travel Thursday UNKNOWN DAT101 No Travel UNKNOWN DAT101 No Travel Friday UNKNOWN DAT101 No Travel UNKNOWN DAT101 No Travel Alternative Route: Please Select..