Is Transport A Problem for You?

1. What town are you travelling from?

2. Do you need pick up at your door or in the town?

3. Which town would you like to go/connect to?

4. If you are connecting to another transport service, what service is it?

5. What is the purpose of your journey?
WorkEducation/TrainingShopping/PensionLeisure/Hobbies/Visiting FriendsLinking to existing transport servicePersonal BusinessSocialOther (please specify)
Other:

6. How are you making that journey at the moment?
I can’t make this trip at allWalkingBicycleBus/CoachTrainCarLift from othersOther (please specify e.g Community Car etc)
Other:

7. What day would you need this service?
MondayTuesdayWednesdayThursdayFridaySaturdaySundayMonday to FridayMonday to Saturday

8. Can your contact details be given to Local Link Limerick Clare to contact you for your transport unmet needs?

Name:
Telephone No:
Email Address:

Any other comments: