Become a Member

If you would like to download a printable form, please click here

Personal Information

Your Name: (required)
Address:
Email Address:
Home Phone Number:
Mobile Number:
Date of Birth:
Gender:
Illness / Disabilities / Mobility Aids:
Essential EscortYesNo

* Essential Escorts are free of charge but they must be provided by the passenger as we do not provide essential escorts ourselves

Other Information

Are you registered disabled?YesNo
What is the reason for your application? Rural AreaAgeDisabilityTax CreditsJobseekers
Other
What is the main reason for using the service?

Emergency Contacts

Emergency Contact 1
Emergency Contact 2

If you are in a wheelchair, you can travel sat in the chair, however if you are in a scooter, you will need to be able to transfer onto a bus seat once in the vehicle. There is also a yearly membership fee of £10.00 upon registering to become a member.

Enter your name below to electronically sign the form:

How would you like to pay your membership fee
CashChequeBACS

Please make all cheque payments out to: CT Sussex

Please return this form and any cash payments to: Crawley Community Transport, Middle Yard, James Place, Southgate, Crawley, RH10 6GA.

Bank Details: Account Name: CT Sussex | Account No: 00029230 | Sort Code: 40-52-40

SUBSCRIBE

Subscribe to our mailing list to keep up-to-date with our services.
Email address:
Charity number: 1165527

Registration No. 247816186

Tweets by ct_sussex

CONTACT US

See below for all of our departments and locations and their contact details:
Crawley: 01293 523764 enquiry@crawleyct.org.uk
Horsham: 01403 754206 hdctinfo@gmail.com
Mid Sussex: 01444 417919 enquiry@ctsussex.org.uk