Fillable Printable Disabled Persons Railcard Application Form
Fillable Printable Disabled Persons Railcard Application Form
Disabled Persons Railcard Application Form
Disabled Persons Railcard
If you have a disability that makes travelling by train
difficult you might qualify for the Disabled Persons
Railcard. The Railcard allows you - and one adult
travelling with you - to get 1/3 off most rail fares
throughout Great Britain.
A one-year card is £20. Use it for a journey that costs £60
and you will save £20, meaning that the card has paid for
itself! A three-year Railcard is also available for £54.
You must provide proof that you are eligible for a Railcard.
You might qualify if you have: a visual impairment, a
hearing impairment, epilepsy, or are in receipt of a
disability-related benefit. The back of the form in this
leaflet gives details of the evidence you must send in.
You can use your Railcard at any time of the day. Some
tickets are subject to availability and may have time
restrictions, so to avoid any confusion please check
before booking.
Children and teenagers
Five to 15-year-olds who have a disability listed on the form
at the back of this leaflet also qualify for a Railcard. This
enables them to pay the usual child fare but also gives 1/3
off most fares to one adult travelling with them.
What discounts do I get?
You can use your Disabled Persons Railcard to get
1/3 off ALL Standard and First Class Anytime, Off-Peak
and Advance fares across the National Rail network.
You can also get:
• 1/3 off London Zones 1-6 Off-Peak Day Travelcards
• 1/3 off Anytime Day Travelcards, when bought as
part of your ticket to London from outside London
Zones 1-9
• 1/3 off Oyster pay as you go single fares and daily
caps (Railcard holder only)
Minimum fares apply to Anytime Day and Off-Peak Day
Travelcards. See disabledpersons-railcard.co.uk for
further details.
Travel Assistance
Rail services are now far more accessible than they were
in the past and many disabled people are able to use the
rail network without assistance.
We will always do our best to help disabled passengers
that need assistance. If you need help when travelling by
rail, it is best to book assistance in advance so that we
can ensure that any help you may need is provided.
In particular, we would recommend that you book
assistance if you:
• Have a mobility or other disability that means you find
getting on and off trains difficult;
• Are a wheelchair user – on most services you will
need to use a boarding ramp and, on some services,
reserve a wheelchair space;
• Are a mobility scooter user – there are restrictions
on different train operators which need to be
checked, a boarding ramp will be required and
possibly a reservation for a space onboard;
• Have a sight impairment and need guiding around a
station or help boarding and alighting from your train;
• Have difficulty walking long distances – at some
stations we can provide a station wheelchair or, at
some larger stations, access to an electric buggy.
We recommend that you book help 24 hours before you
travel. This enables us to:
• give you as much information as possible before your
travel;
• make alternative arrangements for you if the station is
not step free or not staffed at the time you wish to
travel; and
• ensure that there are enough staff for all the
assistance requests at a station.
Overall, this allows us to provide you with the best
possible assistance on the day.
For more information and to book assistance:
nationalrail.co.uk/assisted-travel
08457 48 49 50*
0845 60 50 600 textphone/minicom
* Calls to National Rail Enquiries from landlines are charged at the local rate and may be recorded.
Applying for your Railcard
The fastest and easiest way to apply for your Disabled
Persons Railcard is online.
Online at disabledpersons-railcard.co.uk
Applying online is easy and secure. You will need
to be able to scan the required proof of disability
to upload with your application.
Please allow 5 working days for your Railcard to
reach you.
By post
Complete the application form in this leaflet and
send it with payment and the required proof of
disability to:
Disabled Persons Railcard Office
PO Box 6613, Arbroath DD11 9AN
Please allow 10 working days for your Railcard to
reach you.
Please note, Disabled Persons Railcards are not available
to purchase at stations.
For more information about the Railcard:
disabledpersons-railcard.co.uk
0345 605 0525
0345 601 0132 textphone/minicom
Renewing your Railcard
You can renew your Railcard up to one month in advance of
its expiry date, providing there is no break in continuity. You
can do this online, by phone or by post (see details above).
www
www
www
www
www
www
www
www
www
✂
DISABLED PERSONS RAILCARD APPLICATION FORM
Please complete the appropriate sections in BLOCK CAPITALS
Buying your Railcard
You must complete both sides of this form and send it in with the stated evidence of your disability
to be able to purchase a Disabled Persons Railcard.
I would like a: (please tick) One-year Railcard (price £20) Three-year Railcard (price £54)
Title Mr Mrs Miss Ms Other Date of Birth
First Name
Surname
Home address
Town
Postcode
Telephone
Email
Payment method (please tick)
Cheques must be made payable to “Disabled Persons Railcard”
Rail Warrant Postal Order
Visa Delta Mastercard Electron Solo Maestro
Name on card
Card number
Valid from Valid to Issue number
Last three digits of security code on card signature strip
Declaration
Before signing this declaration, it is important that you have read, understood and agree to the terms & conditions shown
in this leafl et.
I have read, understood and agree to the terms & conditions of the Disabled Persons Railcard shown in this leafl et.
I confi rm that the details I have provided are correct and that I can provide evidence that I meet the qualifying criteria for
a Disabled Persons Railcard.
Signature Date
FOR OFFICE USE ONLY
Renewals: If you already have a Railcard and want to renew it, you can do this by phoning the Disabled Persons
Railcard Offi ce or quickly and easily online at disabledpersons-railcard.co.uk. Alternatively you can renew by
post using this form. You do not need to re-submit evidence of your disability when renewing your Railcard, unless you
have been specifi cally asked to do so.
Please enter your existing Railcard number here:
e.g Dr day / month / year
DPRC15A
(inc code)
(if applicable)
Don’t forget that a three-year Railcard for £54
will save you £6 compared to buying three
one-year Railcards!
DPRC 12pp DL - DPRC15A.indd 2 17/03/2015 16:09
✂
DPRC15A
Discounted fares for disabled people
who do not have a Railcard
Blind or partially sighted customers
travelling with a companion
If you are registered as blind or partially sighted and you
are travelling with another person, the concessionary
discounts below apply to adult fares only for both you
and your companion. You cannot get a discount if you
are travelling on your own. You must show a document
confirming your disability when you buy your ticket
and when travelling. It must be either a CVI/BP1/BD8
certificate or documentation from a recognised institution,
for example, Social Services, your Local Authority or Blind
Veterans UK. Tickets can be purchased from staffed
National Rail station ticket offices.
People who stay in their own wheelchair
for a rail journey
If you need to stay in your own wheelchair during a
journey and you do not have a Railcard, you are eligible
for the concessionary discounts below on both adult and
child fares.
The discounts below apply if you are travelling alone.
They are also available to one adult travelling with you.
Tickets can be purchased from staffed National Rail
station ticket offices.
Season tickets
If you are blind or partially sighted you can buy one adult
Season ticket that enables a companion to travel with
you on National Rail services only at no extra cost (so two
people travel for the price of one). It doesn’t have to be the
same person travelling with you on every journey. Please
take evidence of your visual impairment (as described
in ‘Blind or partially sighted customers travelling with a
companion’ above) with you to prove your eligibility. These
tickets can be purchased from staffed National Rail station
ticket offices.
First Class/Standard Anytime Singles or Returns 34% off
First Class/Standard Anytime Day Single 34% off
First Class/Standard Anytime Day Return 50% off
You
Please send in one of the following with your application
(Photocopies and printed scans are acceptable - original documents will not be returned)
Please
tick
Receive Disability Living Allowance
(DLA) at either:
• the higher rate or lower rate for
getting around (mobility); or
• the higher or middle rate for help
with personal care
A copy of your award letter showing receipt of Disability Living Allowance
in the past 12 months
Receive Personal Independence
Payments (PIP):
• all rates
A copy of your award letter
Are registered as having a visual
impairment
Social Services offi cial stamp in the space below this table
A copy of your Certifi cate of Visual Impairment (CVI), BP1 Certifi cate
(Scotland) or BD8 certifi cate for being registered blind or partially-sighted
Are registered as deaf or
use a hearing aid
Social Services offi cial stamp in the space below this table
A copy of the front page of your NHS battery book, a copy of your
dispensing prescription or other evidence that you are deaf or use a
hearing aid from an offi cial health provider or local authority.
Have epilepsy and either:
• have repeated attacks even
though you receive drug
treatment; or
• are currently prohibited from
driving because of your epilepsy
A copy of your Exemption Certifi cate for epilepsy medication and a copy
of your prescription for drugs in line with the National Society for Epilepsy
Guidelines (on www.epilepsysociety.org.uk)
A copy of your Exemption Certifi cate for epilepsy medication and a copy
of your letter from the DVLA telling you that you are unable to drive
Receive Attendance Allowance A copy of your award letter
Receive Severe Disablement
Allowance
A copy of your award letter
Receive War Pensioner’s Mobility
Supplement
A copy of your award letter
Receive War or Service Disablement
Pension for 80% or more disability
A copy of your award letter
Are buying or leasing a vehicle
through the Motability scheme
A copy of the leasing or hire-purchase agreement, dated within the past
12 months
Please send this completed form together with payment and the required proof of disability to:
Disabled Persons Railcard Offi ce, PO Box 6613, Arbroath DD11 9AN
Please allow 10 working days for your Railcard to reach you.
Renewal notices
We will send you a reminder to renew your Railcard before it runs out. Please tick your
preferred way of receiving this reminder.
On behalf of the Train Companies, ATOC Ltd collects and processes personal information for the
purpose of sales analysis and market research. ATOC Ltd is registered in the UK under the Data
Protection Act 1998 as a Data Controller. We will contact you when your card is close to expiry*.
From time to time your personal details may be used to send you relevant information as
described below.
If you do NOT wish to be contacted for other marketing purposes please tick the relevant boxes below.
I do NOT want to receive: by Mail by Email by SMS
Railcard information and offers
Train Company offers and other rail-related services
We would also like to share your information with third parties so that they may send you information about
their products and services. If you do NOT want to receive this information by post, please tick here If you
do want to receive this information by email or SMS, please tick here
*Provided we hold valid contact details
Please tick if you would like a Braille sticker on your Railcard:
Social Services Stamp here:
for applicants with visual impairments
or hearing impairments only
Email Letter Large Print
Conditions of issue and use of the Disabled Persons
Railcard and reduced priced tickets (ʻdiscounted ticketsʼ)
bought with a Disabled Persons Railcard.
1. ATOC Ltd enters into the contract for the issue and use of Disabled
Persons Railcard on behalf of the Train Companies. Reference to a
‘Train Company’ or the ‘Train Companies’ means those Train Companies
which, pursuant to a franchise agreement, operate Passenger Railway
Services in Great Britain. Any other licensed passenger train operators
that may join the arrangement will accept the Disabled Persons Railcard
for travel on their services.
2. Your Railcard must be signed on the back as soon as you receive it to
show that you agree to these conditions. You can then use your
Railcard.
3. Your Railcard is owned by the Train Companies and, if you are asked,
you must hand it to a representative of any Train Company.
4. The Railcard and tickets bought with it are not transferable and must
not be given, loaned, or resold to anyone else. Only the named
cardholder can use the Railcard.
5. The conditions of issue and use, and the Railcard prices shown, apply
at 17 May 2015 and are subject to change. However, we will
endeavour to give you three months’ notice of any changes to the
conditions of issue and use before they come into effect. For the most
up-to-date information, please check disabledpersons-railcard.co.uk
before you travel.
6. Tickets for your journey should be purchased before boarding the
train. When buying tickets in person from a member of staff, you
must show your valid Railcard. If you are buying online or from a ticket
machine you must declare that you have a valid Railcard by selecting
the Disabled Persons Railcard option. If you fail to do so, you and,
where appropriate, the adult travelling with you will be required to
pay the full price Standard Single fare for your journey as if no tickets
were purchased before starting the journey and in some cases a
Penalty Fare. This does not apply if:
• there was no ticket office at the station at which you began the
journey or if the ticket office was closed, and
• there was no working ticket machine from which you could buy
discounted tickets
• you have a disability which prevented you accessing ticket
retailing facilities
In these cases you will be able to use your Railcard on train or at your
destination.
7. You must carry your Railcard with you on your journey and when
asked by rail staff, you must show a valid ticket and a valid Railcard. If
you fail to do so, you will be required to pay the full price Single fare for
your journey as if no tickets were purchased before starting the
journey and in some cases a Penalty Fare.
8. Only you and, where appropriate, the adult travelling with you, can use
these tickets. The accompanying passenger for whom a discounted
ticket is purchased must travel with the Railcard holder throughout the
journey.
9. The Railcard and all tickets issued at a Railcard discount are issued
subject to the National Rail Conditions of Carriage and the conditions
listed in this leaflet. Copies of the National Rail Conditions of Carriage
are available online at nationalrail.co.uk/nrcc or contact enquiry@atoc.org
for a copy in an alternative format.
10. Disabled Persons Railcard discounts cannot be used in conjunction
with any other discount.
11. The Train Companies do not undertake to replace damaged, lost, or
stolen Railcards, to issue refunds on unused/unwanted Railcards, or
to extend their validity.
12. The Railcard will not be valid if it is damaged or defaced. You should
not laminate your Railcard as this is deemed as defacing it.
13. If your Railcard is stolen, you can apply for a replacement online
at disabledpersons-railcard.co.uk or in writing to the Disabled Persons
Railcard Office quoting a police crime reference number. When we
receive this, we will consider issuing a free replacement.
14. If your Railcard is lost or damaged, you can apply for a replacement
online at disabledpersons-railcard.co.uk or in writing to the Disabled
Persons Railcard Office. A £5 administration fee will be payable for a
one-year Railcard and a £10 administration fee will be payable for a three-
year Railcard. We reserve the right to refuse to issue a replacement
Railcard.
15. When you renew your Railcard we may ask you for current evidence
of your entitlement to it – if we do, your renewal might take longer to
process.
Fraudulent use of Railcards and Railcard discounted tickets may
lead to criminal prosecution.
This leaflet is valid up to and including 14 May 2016.
DPRC15A
DPRC 12pp DL - DPRC15A.indd 1 17/03/2015 16:09
