NEW CHILD DEPENDANT
Initial Application for Leisure Travel Facilities

All appropriate cards will be issued according to eligibility

* - Mandatory Field

Employee details

Title

First Name*

Last Name*

NI Number*

Date of Birth*

Address 1*

Address 2

Town*

County

Postcode*

Home Phone

Mobile No

Email*

Work Email

Child Details

Title*

First Name*

Last Name*

Child Relationship

Date of Birth*

Attachment Type

Does he/she already hold Rail Staff Travel facilities?

Notes On Documents to Attach
A passport style photo must be attached. Full UK Birth Certificates showing the parents names and details Applications with a Short Birth Certificate must also be supported by a scan of a stamped and signed Declaration Form XX04 Applications in respect of a Child who is the subject of a Residency Order or Foster Order must use the Adoption/Guardian attachment type category RST may require further supporting documentation to establish eligibility. Non-UK documents will usually require an official English language translation. Note - For Children aged 18 or above you must also submit a Child Declaration Form - XX05.

Notes On Documents to Attach

A passport style photo must be attached.
Full UK Birth Certificates showing the parents names and details
Applications with a Short Birth Certificate must also be supported by a scan of a stamped and signed Declaration Form XX04
Applications in respect of a Child who is the subject of a Residency Order or Foster Order must use the Adoption/Guardian attachment type category
RST may require further supporting documentation to establish eligibility.
Non-UK documents will usually require an official English language translation.
Note - For Children aged 18 or above you must also submit a Child Declaration Form - XX05.

Declaration*

By checking this box:By submitting this form:

I confirm that all details provided are correct.
I apply for continued rail staff travel facilities for my dependant and have supplied any required evidence.
I understand that I am responsible for the correct use of my dependant's rail staff travel facilities and understand that such use is subject to the Conditions of Issue and Use which can be found at www.raildeliverygroup.com/rst/conditions-of-issue-and-use.
I understand that as soon as my dependant child is no longer eligible for rail staff travel facilities, I must inform Rail Staff Travel and return all of their staff travel facilities.
I further understand that Rail Staff Travel’s privacy information is available online at www.raildeliverygroup.com/rst/rst-privacy and that I have read it and have made my dependant aware of it.
If I am in any doubt about eligibility, I understand that I MUST check and that any attempt to obtain or use rail staff travel facilities fraudulently may result in disciplinary action and/or legal proceedings and/or permanent withdrawal of all rail staff travel facilities for myself and all of my dependants.

Signed by Employee:

Date:

Form - Add Child - XX02b - This form is not valid for use after 31/03/2021

Once completed save the form with a filename of “YourLastname_Your Firstname_XX02b_ddmmyyyy” – where ddmmyyyy is the date that you send the form to RST). Then submit via email to rst@raildeliverygroup.com or your normal rail staff travel facilities contact point

NEW CHILD DEPENDANT Initial Application for Leisure Travel Facilities

Notes On Documents to Attach

NEW CHILD DEPENDANT
Initial Application for Leisure Travel Facilities