PLEASE COMPLETE BOTH SECTIONS; DO NOT SEPARATE AND PLEASE PRINT CLEARLY.

Bus Services into Bohunt School Season Ticket Registration

TO BE COMPLETED BY THE PERSON TO WHOM ALL CORRESPONDENCE SHOULD BE ADDRESSED:

NAME: (Mr / Mrs / Miss / Ms)...... PHONE NO:......

ADDRESS:...... ……

...... POST CODE:......

I will require (a) season ticket(s) for the child(ren) listed below

(PLEASE GIVE SURNAME IF DIFFERENT FROM ABOVE AND PREFERRED CHRISTIAN NAME TO BE USED ON SEASON TICKET).

CHILD (1):...... DATE OF BIRTH......

CHILD (2):...... DATE OF BIRTH......

CHILD (3): ...... DATE OF BIRTH......

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STANDING ORDER MANDATE

To (Name of your Bank)…………………………..……The Manager of…………..…………………… (Branch)

Postal Address of your Bank: …………………………………………………………………………………………

……………………………………………………………………………………………… Post Code:……………….

Please make the following payments from my (our) account.

Account to be debited:………………………………………………(Account Holders Name)

Sort Code:[ ] [ ] – [ ] [ ] – [ ] [ ] Account Number:[ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ]

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Account to be credited: RICHARDSON TRAVEL LTD Account No: 00813190

Bank: Lloyds Bank PLCBranch: PetersfieldSort Code: 30 - 96 – 61

PLEASE APPLY PAYEE REFERENCE NUMBER …………(FOR BANK USE ONLY)

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FILL IN AMOUNT IN NUMBERS AND IN WORDS

Payment Schedule:TEN EQUAL PAYMENTS OF: £………………

…………………………………………………………… (amount in words).

FIRST payment on SEPTEMBER 5th 2017, and on the 5th of each month following

FINAL payment to be made on JUNE 5th 2018.

Please debit my / our account accordingly.

Signature(s) …………………………………………………………. Date:………………………

………………………………………………………….

I ENCLOSE A CHEQUE DATED JULY 31st FOR REGISTRATION PAYMENT

I ACCEPT THAT ONCE PRESENTED, IF PLACES ARE NOT TAKEN UP, A REFUND WILL BE LESS A £25:00 ADMINISTRATION FEE

PLEASE RETURN THIS FORM BY THE LAST FRIDAY IN JUNE: THE DECISION TO RUN A COMMERCIAL SERVICE (OR NOT) ON A PARTICULAR ROUTE, OR PART THEREOF, DEPENDS ENTIRELY ON PARENTAL COMMITMENT BY THE END OF JUNE. THERE IS NO COUNTY OR SCHOOL SUBSIDY FOR THESE SERVICES.

RICHARDSON TRAVEL WILL POST THIS MANDATE TO YOUR BANK IN AUGUST, IF WE ARE ABLE TO OFFER YOUR CHILD(REN) A PLACE ON THE SERVICE; OTHERWISE IT WILL BE RETURNED TO YOU