ATOC logoRSTL name Ticket by MikeJenny

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ATOC logoRSTL name Ticket

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									                                                                                                                         RSTL87151


                                               RAIL STAFF TRAVEL LIMITED
                             APPLICATION FOR REDUCED RATE SEASON TICKET:
                             TOC NEW ENTRANTS – ANY PERIOD UP TO 30 JUNE 2013

This form should be completed by the employee and sent to RSTL at least 15 days before the ticket is required, then taken
to a ticket office once authorised. Use ticks or enter text in boxes as appropriate.

EMPLOYEE DETAILS
Title Mr Ms              Mrs    Miss          NI No                                    Date of birth
First name                                                Last name
Home address
                                                                                       Post code
Tel No                                                  Email
EMPLOYMENT DETAILS
Employer                                             Employed as
Dept                                                 Location
Date ent’d service                                   Grade
TICKET DETAILS
From                                                 To
Route                                                Class of travel         Std    1st
Start date                                           End date
Total period (mths)                                  Collect from stn
IF APPLICATION IS IN RESPECT OF A DEPENDENT, THAT PERSON’S DETAILS:
Title            Mr Ms Mrs Miss                      Status            Partner    Child
First name                                           Last name
IF APPLICATION IS FOR A CHILD, AND/OR FOR EDUCATIONAL PURPOSES:
Date of birth                                        Age now (years)
I certify that the whole cost of travel is paid by me and further, that:
EITHER:       My child is undertaking advanced education and is not in receipt of an allowance towards the
cost of travel for this journey, except any such allowance which may be included in a maintenance grant
OR:      My child attends school and the education authority has declined to make ANY grant in respect
thereof, because:
Reason
Authority name
DECLARATIONS
I hereby apply for the Reduced Rate Season Ticket above, subject to the Conditions of Issue and Use
which can be found at www.atoc.org/rst.
Signed by employee
Date
Once completed (save electronically as “RSTL87151_lastname_NInumber)” and email to rstl@atoc.org; or print then fax to 020 7841
8273, or mail to RSTL, 40 Bernard St, London WC1N 1BY (write employer’s name on outside of envelope)
RSTL APPROVED BY:                                                               Date



                        RAIL STAFF TRAVEL LIMITED (www.atoc.org/rst) is part of:

Issue date 1 December 2010

								
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