Travel Buddy Referral

Your contact details

Address *
Address
Address Line 1
Address Line 2
Town/City
County
Postcode

About you

We need this information to make sure you are safe

Travel Questions

Do you have a bus pass? *
Are you aware of dangers and hazards that can arise when travelling? *
Can you learn travel routes and remember directions? *
Do you know how to cross at traffic lights and do you know what green and red indicates? *
Do you know how to use zebra crossings and traffic islands? *
Can you safely cross a road without a traffic crossing? *
At the bus stop, can you read timetables and recognise the bus you need? *
Would you know what to do if you got lost and who to ask for help? *
Are you aware of dangers or hazards that can arise when out in the community? *

Referral

Photo/Film Consent

We often take photos/film as part of the course and use them to help us with publicity and to show the Big Lottery what we have been doing.

Photo/Film Consent

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