New bus pass form

    Application for a 6 month* bus pass. Please complete one form for each pass requested.

    I would like a bus pass from one of the following operators:

    NOTE: This application is for a 6-month bus pass only. If your household is entitled to 2 x 6 monthly passes a sperate application will need to be submitted at the point of expiry or for another person who resides at the property.
    Please allow up to 6 weeks from submitting your application to receive your bus pass. Please ensure the form is completed correctly to help us process the application as quickly as possible. Charges may apply if a replacement pass is required.

    Preferred bus pass start date

    Date of birth

    Your name

    Address (including postcode)

    Contact number

    Email address

    From time to time, we would like to send you information about services and ask you to take part in customer surveys.
    Please tick which box applies:

    The data collected is in accordance with the Data Protection Act 2018. Data will only be used for the purpose/s outlined in the fair processing notice available on the Leicestershire County Council website: Please note that the data may be provided to bodies responsible for auditing and administering public funds for the purpose of preventing and detecting fraud.