Wheels to Work West
Applications

Applications

If you’re looking to apply to a Wheels to Work West offer, or are a partner organisation applying on behalf of someone else, please use the below forms or get in touch.

Bristol North Somerset South Gloucestershire

Bristol

If you are seeking Wheels to Work support, please fill out the form below.

If you are a partner organisation referring a client for support, please also fill out the form below. You can also use this form to let us know if you have given out support (e.g. bus tickets).

Before completing the referral form please take note of our Privacy Notice.

Step 1 of 5 – Support needed

What Wheels to Work support are you/your client interested in?(Required)

Free adult cycle training

Free bike service (up to £80)

£150 discount on a refurbished bike

1 day bike maintenance training course

First Bus mTickets for smartphone (emailed to you)

First Bus printed tickets (posted to you)

Multi-operator bus vouchers (please only select if you are travelling on a service not provided by First bus)

I have already provided a client with mTickets, paper bus tickets or Voi codes

The ticket codes were:(Required)

Please list the ticket codes that you provided the client here. If you are requesting support then please do not click this box, and instead select which offer(s) you require from the tick boxes, above.

Number of tickets given out(Required)

The ticket type was(Required)

Paper Bristol Rider voucher

Paper Avon Rider Voucher

mTicket Bristol Daily

mTicket Bristol Weekly

mTicket West of England Daily

mTicket West of England Weekly

Voi scooter code

What do you/your client need the support for?(Required)

Starting a new job

Attending a training course

Attending a work placement

Attending job interviews

Other

Other reason support needed (please specify; e.g. ESOL/English classes)(Required)

Partner organisation/Employing company(Required)

This is the organisation that referred you to Wheels to Work or the company which is employing you.

Sponsor/Employer's name(Required)

This is the name of the person who referred you to Wheels to Work or your employer.

Sponsor/Employer email address(Required)

Without a sponsor contact details, you will not receive Wheels to Work support. Do not put your own details.

Sponsor/Employer phone number(Required)

Without a sponsor contact details, you will not receive Wheels to Work support. Do not put your own details.

Your/the client's full name(Required)

If you are a client please put your name. If you are a partner organisation, put the name of your client.

Your/the client's email address(Required)

Enter Email Confirm Email

We need your email to send you most of the offers. If you are a client please put your email address. If you are a partner organisation, put the email address of your client. If you don’t have an email, put your sponsor or employer’s email.

Your/the client's phone number(Required)

If you are a client please put your phone number. If you are a partner organisation, put the phone number of your client.

Your/the client's address(Required)

First line of address Postcode

Please note we will not provide Wheels to Work support to anyone that lives outside of Bristol city.

Where are you/is your client travelling to?(Required)

We need to know if you are travelling within Bristol or to another part of the West of England.

How would you/your client have made the journey without Wheels to Work?

Driving

Getting a lift

Bus

Walking

Cycling

Train

Other (please specify)

I would not be able to make the journey without Wheels to Work support

Other transport mode (please specify)(Required)

Do you/does your client have a driving license?(Required)

Yes

Do you/does your client have a car?(Required)

Yes

Your/your client's date of birth(Required)

Day

Month

Year

Which gender do you/ your client most identify with?(Required)

Female

Male

Not listed (please specify)

Prefer not to say

Gender identity most identified with(Required)

Which ethnicity do you/ your client most identify with?(Required)

Arab/Arab British

Asian/Asian British – Bangladeshi

Asian/Asian British – Indian

Asian/Asian British – Pakistani

Asian/Asian British – Chinese

Asian/Asian British – Not listed (please state)

Black/African/Caribbean/Black British – African

Black/African/Caribbean/Black British – Caribbean

Black/African/Caribbean/Black British – Not listed (please state)

Gypsy or Traveller of Irish Heritage

Mixed/Multiple Ethnic Groups – White & Asian

Mixed/Multiple Ethnic Groups – White & Black African

Mixed/Multiple Ethnic Groups – White & Black Caribbean

Mixed/Multiple Ethnic Groups – Not listed (please state)

White – English/Welsh/Scottish/Northern Irish/British

White – Irish

White – Not listed (please state)

Not listed (please specify)

Prefer not to say

Ethnicity most identified with(Required)

Do you consider yourself/does your client consider themselves to be disabled?(Required)

Yes

Prefer not to say

Please describe your/your client's current employment status(Required)

In permanent employment

In temporary employment

In training

Unemployed

Other (please specify)

Other employment status(Required)

How did you/your client hear about Wheels to Work?(Required)

At one of our partner organisations, e.g. Job Centre

Through a bike shop

Facebook Ad

Facebook post

Google Ad

Bus stop advertising

Word of mouth

Other

Other source(Required)

In order to benefit from the scheme you/your client will need to provide consent for us to process their data(Required)

I have read your privacy policy and agree with you processing my/my client’s data

This website’s privacy policy can be found here, the Wheels to Work Privacy Policy can be found here.

Comments

This field is for validation purposes and should be left unchanged.

If you encounter issues with the form, contact us

If you're based in Bristol:

Wheels to Work (10am – 4pm on business days)

If you're based in Bristol: Email Address: [email protected]

Phone Number for Applications: 0117 357 6241

North Somerset

North Somerset Council

Public Transport team

North Somerset Council Email Address: [email protected]

Phone Number for Applications: 01934 426 715

View website

South Gloucestershire

Wheels to Work is not currently available in South Gloucestershire

If you're based in South Gloucestershire:

Transport Policy

If you're based in South Gloucestershire: Email Address: [email protected]