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Hull SmartCommute Card Application Form
Unique ID
Confirmation of employment
(Required)
I confirm I am paid by Hull University Teaching Hospitals NHS Trust
Your ESR Number
(Required)
This is 8 digits long.
Your NHS Email Address
(Required)
Your Name
(Required)
Forename
Surname
Where would you like to collect your card from?
(Required)
Employee Service Centre, Suite 21, CHH
Employee Service Centre Hub, Alderson House, HRI
How do you currently travel to work?
(Required)
Car
Bus
Cycle
On Foot
Terms and Conditions
I agree to the sum of £58.45 being deducted from my net monthly salary for a 12 month period.
I understand that if my card is lost or stolen, I must notify the Transport Manager immediately and a charge of £15 will be deducted from my salary for a replacement card.
I understand that the cost of the card is fixed for 12 months.
I understand that a new 12-month card will be issued automatically unless I request cancellation.
I understand that following the initial 12-month fixed price period, the amount of my monthly salary deduction may increase without notification should the cost of the card increase.
I understand that if my application is processed by Payroll before the 12th of the month, my salary deduction will begin that month, and if it is processed by Payroll after the 12th of the month, my salary deduction will begin the following month.
I agree that I will inform the Transport Manager if I change my name.
I understand that the card cannot be used by any other person and is non-transferable.
I understand that I will be required to show both my Trust ID badge and my Hull SmartCommute Card to the bus driver when travelling.
Terms and Conditions acceptance
(Required)
I confirm that I accept the above Terms and Conditions
Comments
This field is for validation purposes and should be left unchanged.
