NETWORK ONE CORPORATE ANNUAL TICKET APPLICATION FORM
Please ensure you complete the entire form to take advantage of the
travel ticket loan scheme.
Please print in BLOCK CAPITALS.
Title: ..……. First Name:
……………………………………………………
Surname: ………………………………………… Personnel no: …………………
School/Service: ……..…………………………… Job title :……………………
Home Address: ………………………………………………………………….
…………………………………..
Date of birth : ………………………
Post code: ……………………
Telephone ext: …………….
E-mail address: …………………………………..…..
NETWORK ONETICKET DETAILS Tickets commence on the 30th March only
Do you currently hold a Network travel card?
Please state your existing photocard number
Yes


No
 (all boxes must be
completed)
Type of Network Ticket required:
All zones
Two zones
One zone



Please indicate zones required

(Zones 1 to 5)
I hereby apply for a corporate travel loan and give authority below to deduct the
appropriate charge from my salary.
SALARY DEDUCTION AUTHORISATION
Signature
…………………………………
Date ………………………….
Amount
£………………………( please check website for current costs)
If on fixed term contract, please indicate contract end date: ……………………….
Please select preferred payment method from options below

One lump sum payment (deducted from salary)

Monthly instalment
(deducted from salary)
In the event of leaving the University, any outstanding balance on the travel loan
will be deducted from final salary.
Please return completed application to Estate Support Service, 1st floor
Agriculture Building or email ess-helpdesk@ncl.ac.uk.
------------------------------------------------------------------------------------------------------OFFICE USE ONLY
Commencement Date …………………
Renewal Date
…………………
Travel card type:
Cancel Date
…………………