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Application for a Disabled Person's Parking Bay
Applicant's Name
Title
Title
- None -
Miss
Ms
Mr
Mrs
Dr
Other…
Enter other…
First name
Surname
Address
Address
Address 2
Town
Postal Code
Telephone number
Email address
Do you have a blue badge?
Yes
No
Blue badge details
Serial number
Date of issue
Expiry date
Is a car registered at this address?
Yes
No
Please provide registration number of vehicle
Please upload a copy of vehicle registration document V5
One file only.
8 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.
Do you have a driveway/vehicular access at this address?
Yes
No
Do you have another location where off road parking is available?
Yes
No
Applicable
What are the reasons for your parking difficulty?
Please indicate within this description, the distance from your home which you normally have to park and if there are times when it is particularly difficult e.g. evenings.
Where do you suggest a disabled person's parking bay could be located?
Please upload a simple location sketch
One file only.
8 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx, ppt, pptx, xls, xlsx.
I declare to the best of my belief all the statements I have made on this form are true and I agree to the Local Authority contacting other Agencies when necessary for the purpose of obtaining information to support my application.
I understand that the parking place is not for my exclusive use and can be used by anyone displaying a Blue Badge.
N.B. If signing on behalf of the applicant, please provide a contact number if different from that of the applicant.
Signed
Title
Title
- None -
Miss
Ms
Mr
Mrs
Dr
Other…
Enter other…
First name
Surname
Contact number
If different from the applicant.
Based on your answer you are not eligible for a disabled person's parking bay.
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Too much information
Not enough information to answer my question
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I tried this and it didn't solve the problem
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