(Please complete this box ONLY if you are renewing your membership)
ADDRESS 1 *
DATE OF BIRTH *
CONTACT NAME *
Do you have a Cambridgeshire County Council bus pass? *
BUS PASS NUMBER
BUS PASS EXPIRY DATE:
Tick all that apply
The local bus timetable does not meet my needs
I live too far from the bus stop
I find the local buses physically too difficult to use
No bus service available
I am disabled and cannot use the public bus service
Other reason (please state below)
Folded manual wheelchair
Other (please state below)
I wish to apply for membership of Fenland Association for Community Transport and I agree to abide by the membership terms and conditions. I understand that any breach of these conditions may result in being expelled from membership.
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