Change of Contact Details

* - 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

Pass No (Staff Travel Card or Rail Staff Leisure Card)*

Declaration*

By checking this box:By submitting this form:

I confirm that all details provided are correct.
I understand that I am responsible for the correct use of my (and any 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 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(s) 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 - Change of Contact Details - XX21 - This form is not valid for use after 31/03/2025

Once completed save the form with a filename of “YourLastname_Your Firstname_XX21_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