Door to door / Dial-a-Ride registration

  • If you wish to use the Door to door / Dial-a-Ride Service, please complete the form below. All information will be treated in the strictest confidence.
  • If you live in a rural area or are difficult to find, please give directions and a brief description of the location
  • I am applying for membership to bact’s Dial-a-Ride Service on the following grounds.
    Please tick all that apply.
  • Please tick all that apply
  • If you have ticked anything with a **, please give us more details.

    If you use a wheelchair, please say whether it is manual or powered and give details, size, wheels etc.

    If you prefer to transfer out of the wheelchair once on the bus, please say if you can do this unaided or only with help.