Organisation / Individual*
Contact Name
First Last
Email Address*
Contact Tel*
Journey Information
Date & Time vehicle required
Date*
Time*

: Hours

Minutes
Total number of people travelling
Number of manual wheelchairs
Any other mobility aids eg. Walking frames
- Yes
- No
If Yes, please give details
The number of wheel chair users who can transfer to bus seats
Collection Point & Times
Place Time
Destination Address (please include postcode if known)
Street Address City Postcode
Do you require BCT to provide a driver?
- Yes
- No
If no, name of driver (who must hold a current MiDAS certificate & a valid driving licence for the vehicle to be hired)
Any further information
Date form completed

Hiring a Vehicle

Training
Please contact us for more information

Blantyre Community Transport
Blantyre Volunteer Limited
1 Calder Street
Blantyre
G72 0AU
01698 821656
info@bctbus.com
Registered Scottish charity: SC012393 Company Limited by Guarantee No: SC364447

Place	Time