Essential Companion Scheme - individual membership application

  1. 1) Details of the person with the disability

  2. Label
    1. Will the person with the disability, listed above, be booking the tickets? *
    2. You can provide contact details for the personal representative on the next page.

    3. 2) Type of application

    4. Application type: *
    5. 3) Evidence of entitlement

      Please include a scanned copy of the letter from the Department of Work and Pensions confirming DLA / Attendance Allowance status or Certificate of Visual Impairment. You may cross out any monetary amounts.