Organisation Blue Badge Application - Croydon Council

State the make, model and registration number ofthe main vehicle in which this badge will be usedWhat features or modifications, if any, does thisvehicle have that address the needs of disabledpassengers? (eg tail lift platform, wheelchair anchorpoints etc)Who owns the vehicle? (if it does not belong to theorganisation, give the name of the vehicle owner)What is the seating capacity if this vehicleincluding the driver?What is the minimum staffing escort (including thedriver) that accompanies the clients when the vehicleis full?Do you have business motor vehicle insurancethat includes cover for conveying clients?Is the vehicle that you intend to use this badgeIn licensed under the Disabled Passenger Vehicle(DPV) taxation class?NO YES If yes, attach a photocopy of the tax disc tothis applicationBesides this badge (if granted), how many otherorganisational blue badges issued by <strong>Croydon</strong> councildoes this organisation currently hold?Please use the space below to provide a brief outline of why your organisation is now applying for anorganisational blue badge. If the organisation already has one or more badges, please explain why anadditional badge is being sought.

The <strong>Organisation</strong>al <strong>Blue</strong> <strong>Badge</strong>The organisational blue badge is issued to organisations that have responsibilityfor the continuous care of a number of disabled people who individually meet thequalifying criteria explained overleaf. The organisation would normally be expectedto cater for five or more such persons. Those organisations with less than fivequalifying individuals are advised to assist such clients to apply for their ownpersonal blue badges.The organisational blue badge can be used in any vehicle belonging to theorganisation, when conveying qualifying clients; however in most cases it will be usedin larger vehicles designed for transporting a number of disabled persons in comfortand safety. In the main, the organisational blue badge will only be issued for use in aprivate motor car if there are exceptional circumstances.When an organisational badge is issued, a copy of the Department for Transportbooklet “Your rights and responsibilities” is also issued. All staff members whoare to use the badge must be made aware of the correct manner to use and displaythe badge.As the badge requires a stamp or logo of the organisation, please impress a sampleof this in the box below, or affix a copy of the logo, eg if incorporated into a businesscard or letterhead, please attach a copy.91184

The <strong>Blue</strong> <strong>Badge</strong> SchemeThe blue badge is an EU-wide scheme which is regulated in England by the Department forTransport granting on-street parking concessions in all EU member states to the following:1) A person who is more than two years old who receives the higher rate of the mobilitycomponent of Disability Living Allowance (DLA);2) A person who is more than two years old who is registered blind;3) A person who is more than two years old who has a permanent and substantial disabilitythat means that they are unable to walk or have very considerable difficulty in walking;4) A person who receives a War Pensioners’ Mobility Supplement;5) A person who drives a vehicle regularly, has a severe disability in both arms and is unableto operate, or has considerable difficulty in operating, all or some types of parking meter;6) A child under the age of two years who, on account of a condition, must always beaccompanied by bulky medical equipment *which cannot be carried around with the childwithout great difficulty;7) A child under the age of two years who, on account of a condition, must always be keptnear a motor vehicle so that, if necessary, treatment for that condition can be given inthe vehicle or the child can be taken quickly in the vehicle to a place where such treatmentcan be given.*bulky medical equipment includes in particular any of the following –i. Ventilators;ii. Suction machines;iii. Feed pumps;iv. Parenteral equipment;v. Syringe drivers;vi. Oxygen administration equipment;vii. Continual oxygen saturation monitoring equipment; andviii. Casts and associated medical equipment for the correction of hip dysplasia.

Conditions of use and declaration• I am authorised to make this application on behalf of the organisation detailed on page1, and to agree to the conditions of the scheme. If a badge is granted I undertake toensure other members of staff are aware of these conditions and comply with them.• I confirm that the organisation is willing to entertain a visit by an assessing officer from<strong>Croydon</strong> council to verify the qualifying conditions are met.• I confirm that if granted an organisational badge it will only be used – ie displayed in thevehicle – when disabled people who would individually be eligible for a blue badge arebeing transported in that vehicle.• Any badge issued to this organisation will not be used for any other purpose, eg fortransporting staff, shopping by staff on behalf of the organisation or themselves etc,or otherwise used to obtain a parking concession when no disabled clients are beingtransported.• If granted, the badge will not be left on display in the vehicle when not being specificallyused to gain a parking concession for the disabled clients.• I have enclosed the £2.00 fee. (cheque or postal order payable to London boroughof <strong>Croydon</strong>.• I have enclosed a photocopy of the tax disc to confirm that the vehicle is licensed underthe Disabled Passenger Vehicle taxation class.• I have enclosed an impression of the logo of this organisation, or provided an image eg alogo incorporated into a letterhead to be used to make the badge.• I understand the organisational blue badge remains the property of <strong>Croydon</strong> council andI agree it will be surrendered to the council on demand.I declare that to the best of my belief all the statements I have made on this formare true.Signature:Signature:Name:Name:Date:Date:91184