Community bus application - 19 and 21 seater bus

Use this form to submit a booking for the 19 and 21 seat community bus.

Note: Buses are not equipped to transport wheelchair users who are not ambulatory.

1. Group details

Is this a booking for an internal Inner West Council activity?*

If yes, what account number should it be charged to?

If you are an internal Inner West Council booker, skip to section 2. Otherwise, please continue completing section 1.

Is this booking for a non-profit and non-government organisation/group?

Is the group based in the Inner West Council local government area (LGA)?

What is the purpose of the booking?

Please tell us about your group/booking, including if you work with culturally and linguistically diverse (CALD) communities, Aboriginal and Torres Strait Islander people, older adults, LGBTQ+ people, people living with a disability, children, youth, or people experiencing some form of disadvantage, e.g. boarding house residents.

2. Booking details

Actvity name for which you are requesting use of the community bus*

Name of trip coordinator*

Phone number of trip coordinator*

Email address of trip coordinator*

Will the coordinator be accompanying the group on the bus?* - required

Yes

If no, who will be the staff person accompanying the group?

Please include their name, role/title, phone and/or email.

3. Bus details

Which bus would you like to hire?*

The 21 seat bus is available as Option A (21 passengers and 1 driver), or option B (17 passengers, space for cargo, and 1 driver). The 19 seat bus is available as Option A (19 passengers and 1 driver), or option B (14 passengers, space for cargo, and 1 driver).

3a. Bus configuration

Hiring time starts from the Balmain Depot (Llewellyn Street), where a 30 minute bus safety check is undertaken prior to the bus trip. Hiring time finishes when the bus returns to the Balmain Depot.

How would you like the bus configured?*

Will your group require use of the bus hoist?*

The hoist is suitable for people with access needs or for loading cargo. If you have access needs, please discuss with Council staff. Buses cannot accommodate wheelchairs or mobility aids that cannot be folded and stored.

3b. Additional info (19 seat bus only)

Hiring time starts from the Balmain Depot (Llewellyn Street) - where a 30 minute bus safety check is undertaken prior to the bus trip. Hiring time finishes when the bus returns to the Balmain Depot.

How many people will be transported on the community bus?

Will you be transporting children aged 4 to under 7 years on the community bus?

Yes

If yes, please indicate the number of children in this age range

Will you be transporting children aged 7 years and over on the community bus?

Yes

If yes, please indicate the number of children in this age range

NOTE: The minimum height for children to be well protected by a lap sash seatbelt alone without a booster seat is 145cm tall. Council buses are not currently equipped for booster seats.

Which type of hire are you applying for? (Please refer to the applicable fees and charges for each type of hire)

For wet hire, please continue to Section 4.

For dry hire, please complete a Dry Hire Application Form, attach it below, then continue to Section 4.

Please attach a completed dry hire application form here

4. Booking details

Please note: The minimum hire period is 3 hours.

Activity date(s)*

Please include a list of specific dates and times if required.

Pick up location*

Pick up time (am/pm)*

Destination for trip*

Drop off location (if different to pick up)*

Drop off time (am/pm)*

Date exclusions (i.e. public holidays, school holidays)

Bus bookings are not available for Public Holidays and there is restricted bus availability during school holiday periods.

5. Contact details

Organisaton or hirer's name*

ABN

Contact name*

Street address*

Suburb*

Post code*

Postal address (if different to street address)

Phone*

Mobile

Email*

6. Invoicing details

Only complete if different to contact details.

Organisaton or hirer

Contact name

Street address

Suburb

Post code

Postal address (if different to street address)

7. Particpants' details

Proportion of participants that live in the Inner West Council area*

The Inner West Council area includes the suburbs of Annandale, Ashfield, Balmain (including Balmain East), Birchgrove, Dobroyd Point, Dulwich Hill, Enmore, Haberfield, Leichhardt, Lewisham, Lilyfield, Marrickville, South Marrickville, Petersham, Rozelle, Stanmore, St Peters, Summer Hill, Sydenham, Tempe. Inner West Council also includes parts of Ashbury, Camperdown, Croydon, Croydon Park, Hurlstone Park and Newtown.

Is the activity free to particpants?*

If you answered "No" to the above question, what is the cost per person per session?

If you selected

Approximately what proportion of your participants hold low-income or pensioner Health Care Cards?*

Do you offer concessional/lower fees for people with a Health Care Card?*

8. Declaration

I have read and understand the Inner West Council - 19 and 21 Seat Bus Conditions of Hire and Community Bus Fees and Charges. I understand that information provided with this application (including the application form) and any subsequent information submitted as part of this application, may be disclosed under the provisions of the Government Information (Public Access) Act 2009 and correspondence from Council may be made available for viewing by the general public.**

9. Privacy statement

Application forms and/or names and addresses of people making an application is information that is publicly available. In accordance with section 18(1)(b) of the Privacy and Personal Information Protection Act 1998 (NSW), you are advised that all application forms received by Council will be placed on the appropriate Council file and may be disclosed to Councillors, Council officers, consultants to Council or members of the public. Pursuant to the provisions of the Government Information (Public Access) Act 2009, Council is obliged to allow inspection of its documents, including any application you make. However, should you wish for your contact details to be suppressed, please indicate such on the application form.

After you press submit a pop up box will appear stating that your form has been submitted successfully. If you do not see this pop up box please check the form to ensure you have completed all the mandatory fields, update any missing information and press submit again.

Mandatory field(s) marked with *