Monthly Ticket Application Form Tick Passenger Category Adult School Travel (QR Citytrain ONLY) Concession* Child (5–14 years inclusive) *Australian Pensioner; Queensland Senior; Full time Student Ticket Details From Suburb / Station Zone (enter station or suburb name and circle ‘suburb’ or ‘station’) To Suburb / Station Zone (enter station or suburb name and circle ‘suburb’ or ‘station’) Note: It is important to indicate whether your journey starts or finishes at a rail station or if you are travelling further, so the correct ticket can be issued. If you know the zones in which you will start and finish your journey, please include them. Passenger Details Ms/Mrs/Miss/Mr Surname (select) Given Names Address Suburb Postcode Ph: (W) (H) PH: (Mobile) Personal information contained on this application form is obtained for the purpose of issuing a ticket and to be used to enable the issue of a replacement ticket should the original ticket be lost or stolen. It will not be disclosed to any other entity. OFFICE USE ONLY: Date of Issue Ticket No. $ Method of Payment Cash Debit Card Credit Card If Credit Card: Charge Bankcard Visa Mastercard Other Credit Card Number Cardholder Name Expiry Date / Conditions of Purchase and Travel Passenger Category The correct passenger category must be selected. Proof of entitlement to concession (PCC Card, Qld Senior Card, Approved Student Identification Card) must be presented, when submitting the application, if ‘Concession’ or ‘School Travel’ category is selected. Ticket Details To ensure the correct ticket is issued, exact journey information must be supplied. Please indicate whether you are travelling to and/or from a rail station or whether your journey starts and/or finishes elsewhere in a suburb. If you know the zones in which you will start and finish your journey please include them in the space provided. Passenger Details Passenger details, name and address, are obtained on application so a replacement ticket can be issued in the event that the original ticket is lost/stolen or destroyed. If details are not supplied, the ticket will not be refunded or replaced. These details are obtained for the purpose of issuing and possibly replacing a ticket only. They will not be disclosed to any other entity. Purchase and Renewal A Monthly ticket cannot be issued (for the first time) in advance, but it can be renewed up to 9 days prior to expiry. Days remaining on the current ticket will be added to the new ticket. Validity A TransLink Monthly Ticket entitles the holder to unlimited travel on TransLink services, within the zones printed on the ticket, for one calendar month – for example, from the 3rd of one month to the 2nd of the next. Refund or Replacement Pro-rata refunds will be made by the issuing operator, on completion of a refund application form, on valid monthly tickets. Tickets will be replaced if lost or stolen. An Administration Fee will be charged. Conditions apply. Helpful Hints To save time when purchasing a Monthly Ticket, complete the application in advance. You can also check the ticket price (if zones are known) on a TransLink brochure or by calling a TransInfo Operator. Phone 13 12 30.
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