Lisburn City Council

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Please complete the following form:

Name of Organisation (if
applicable):
Address:
Contact Name and Address
(if different):
Telephone Number:
Fax Number:
Does your organisation
have a constitution?:		   Yes
  No
If 'No', enclose details
of members:



Purpose of Journey:
From:
To:
Date(s) Minibus Required:
Pick-up Time:
Pick-up Date:
Return Time:
Return Date:



Please state numbers of previous bookings/days used – year to date:
Details:



Please list Drivers currently holding Council Minibus Driver Permits:
Driver One:
Driver Two:
Driver Three:
Driver Four:



I hereby apply for the use of a Council Community Minibus as detailed above and I understand and accept the General Information, curent Rules and Conditions (012000) concerning the booking of the minibus.



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