Application for MyWay Student Concession Card - Transport for ...

Application for MyWay StudentConcession CardFor Tertiary students that do not possessa current valid photographic student ID cardMyWayNumber(if applicable)Effective: 01/01/11F00618(02/12)Please attach a passport sized photo and a copy of a drivers licence or passport to support theapplication and provide proof of identity.1. Student’s Personal DetailsSurname/Family name:Given names:Date of birth: / /2. Student’s Enrolment DetailsInstitution where enrolled:Student number (if applicable):3. Evidence of EnrolmentPlease have your institution complete the course completiondate, sign and stamp this application to confirm your full-timeenrolment status. If your institution is not able to complete thisform for you, you MUST attach a letter from the institutionconfirming your enrolment, full-time study status and expectedcourse completion date.Affix institution stamp here:Sign:Name:Date: / /Daytime Contact Number:Course completion date: / /4. Student’s AddressAddress:Suburb: State: Postcode:Phone Number (home):Phone Number (mobile):5. Declaration and ConsentI have read and understand the terms and conditions outlined on this application for a MyWay Student Concession Card. Iunderstand that the MyWay Student Concession Card must be presented when purchasing cash fares on ACTION buses orwhen requesting to access concession entitlements for bus trips using a MyWay card.MyWay Student Concession Cards are only valid up to and including the date stamped on the card. I understand that Iwill need to renew the application prior to the expiry date of the MyWay Student Concession card to continue to accessconcession travel on ACTION buses.Name:Signature: Date: / /Office use onlyProcessing officerDate / /

MyWay Card Conditions of UseThe MyWay card is issued subject to the conditions of the RoadTransport (Public Passenger Services) Act 2001, Road Transport(Public Passenger Services) Regulations 2002 and the conditionsand notes set out below.The MyWay card may be used for travel on designated ACTIONservices, provided that:• the card has a positive balance;• the card is not damaged, or expired, and has not beencancelled or blocked/hot-listed; and• the MyWay card must be touched to a card reader at thestart and finish of travel (known as tagging on and taggingoff ) on an ACTION service to obtain a response fromthe card reader indicating that the card has been readsuccessfully. For more information on the tag on tag offservice, please refer to the MyWay user guide.ConditionsI understand that:• A MyWay card registered to a person granted a fareexemption or concession may only be used by that person.Unauthorised use of that card by another person mayresult in the withdrawal of the exemption or concession;andNotes• Registered cards that are lost, damaged or faulty can bereplaced with a new card;• Replacement of registered cards will permit the transfer ofany concession entitlements and stored value that remainsagainst the previous registered card;• The MyWay Card stored value balance is non refundableand cannot be transferred to another persons’ MyWay card;• The minimum value that can be credited to a smartcardaccount is $5 cash or $20 via EFTPOS or credit card;• The maximum balance that can be credited to a smartcardaccount is $190;• From 1 January 2012, a default fare will be applied ifpassengers fail to tag off when using a MyWay Card onACTION bus services; and• MyWay cards remain valid for two years from the date ofthe last transaction (a transaction could either be travel orrecharge).These Conditions of Use, and related materials, are subject tochange at the discretion of the ACT Government. These termsand conditions are also available by calling 13 17 10.• In the event that a registered MyWay card is lost or stolen,the cardholder will be liable for all fares, fees and chargesincurred through the use of the smartcard by any personuntil the card is reported missing by calling 13 17 10 orvisiting a MyWay Centre or Canberra Connect Shopfrontand the card is frozen.