Expression of Interest

Name of Organisation/Community Group or Individual

Contact Person

Address

Telephone Number

Email address

Outline the transport need (i.e. Shopping, work,training, social etc...)

Outline how the transport needs were identified (Please provide needs analyse is supporting information)

Outline any specific accessibility requirements

Are there passengers who need to be collected at their home address?

How many passengers do you estimate will use the proposed service?

What is the proposed monthly cost?

How is the transport need being met at present?

Do you receive funding for transport services from any other agency?

Is there potential to link the proposed service with existing transport services? If yes, please give details

Please give details of the proposed routes (If the pickup points proposed are from passengers homes please provide eircodes)

Please give details of the proposed start time for the return journey.

Outline the frequency of service required (daily, weekly, monthly) If weekly specify days