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Where you can get your pass... All the centres below issue passes & can offer further details. Active Trafford Application Booklet Altrincham Leisure Centre Oakfield Road . Altrincham . Cheshire . WA15 8EW T 0161 926 3255 Altrincham Golf Course Stockport Road . Altrincham . Cheshire . WA15 7LP T 0161 928 0761 George H Carnall Leisure Centre Kingsway Park . Davyhulme . Manchester . M41 7FJ T 0161 749 2555 Partington Sports Village Chapel Lane . Partington . Manchester . M31 4ES T 0161 777 4222 Sale Leisure Centre Broad Road . Sale . Cheshire . M33 2AL T 0161 905 5588 Stretford Leisure Centre Greatstone Road . Stretford . Manchester . M32 0ZS T 0161 875 1414 The Grammar Marlborough Road . Bowdon . Cheshire . WA14 2RS T 0161 929 1078 Urmston Leisure Centre Bowfell Road . Flixton . Manchester . M41 5RR T 0161 749 2570 William Wroe Golf Course Pennybridge Lane . Flixton . Manchester . M41 5DX T 0161 748 8680 W: www.traffordleisure.co.uk E: [email protected] Active Trafford.indd 1 28/05/2012 10:11 What is Active Trafford? Employment Status: Please tick the relevant option Active Trafford is a concessionary pass for Trafford Community Leisure Trust centres, golf courses and services. It provides a discount for leisure activities allowing the whole community to access physical activity. Full Time Unemployed Student Part Time Benefit In Education Casual Retired Who can apply? Band 1 Band 2 Unemployed People on Low Income Full Time Carers People with a disability 65+ Forces (Airforce, Army, Marines, Navy, Home Guard & TA) How much does it cost? Yearly Pass = £12.00 Each session: Band 1 Swimming Gym Racquets Exercise classes Golf £1.00 £1.00 £1.00 £1.00 £9.00 Students 16+ Ethnicity: Please circle the relevant option White British / White Irish / other, please specify Indian / Pakistani / Bangladeshi / other, please specify Black Caribbean / Black African / other, please specify Chinese / other, please specify White & Black Caribbean / White & Black African / White & Asian / other, please specify Disability: Please circle the relevant option None / Moderate Learning / Severe Learning / Health Impairment / Visual Impairment / Hearing Impairment / Physical Impairment / other, please specify Band 2 £1.60 £3.20 £3.20 £3.20 £9.00 How do I apply? Fill in the application form attached and take it to your nearest Trafford Community Leisure Trust facility along with proof of eligibility. What proof of eligibility is needed? Please note: All documentation must be current and dated within the last three months. Unemployed and People on Low Income = Proof of residency in Trafford and proof of receiving Jobseekers Allowance, Income Support or Working Tax Credit Full Time Carers = Proof of residency in Trafford for applicant or person caring for and proof of receiving Carers Allowance People with a disability = Proof of residency in Trafford and proof of receiving Disability Living Application Form: Your Details Surname: First Name: Address: Post Code: Telephone No: Mobile No: Email Address DOB: Declaration All information held by Trafford Community Leisure Trust will be processed in compliance with the Data Protection Act 1998. If you do not wish for your personal data to be kept for use on forthcoming services and activities please tick this box I have read and understand the terms and conditions of the Active Trafford concessionary pass Allowance or Employment and Support Allowance Signature 65+ = Proof of residency in Trafford and proof of your date of birth (passport, birth certificate, For Active Trafford terms & conditions log onto our website for details www.traffordleisure.co.uk driver’s license) . Forces (Airforce, Army, Marines, Navy, Home Guard & TA) = Proof of identity (passport, driving licence, military ID card) and proof of employment (military ID card, letter of confirmation on unit’s letter head.) Student 16+ = Proof of your date of birth (passport, birth certificate, driving licence), proof of students status (copy of university or student identity card or a signed and dated letter on official university or school stationery stating you are a full time student.) Active Trafford.indd 2 Date OFFICE USE ONLY: Card issued Yes / No Date entered onto system Card Number Completed by 28/05/2012 10:11