Kenilworth Community Transport Service registration form Last updated: 27 Sep 2021 Register now to become a passenger by completing the information below. Your application will be forwarded to the Kenilworth Community Transport Service Committee, who will be in contact with you to advise when your application has been processed. To submit this form you need to agree to your details being provided to The Kenilworth Community Transport Service which is supported by council, operated and administrated by the Kenilworth Community Transport Service sub-committee of the Kenilworth Chamber of Commerce. Personal details Given name/s * Surname * Mobile phone * Email Street address * Suburb Belli Park Cambroon Conondale (part) Coolabine Eerwah Vale Gheerulla Kenilworth Kidaman Creek Obi Obi Please note that in order to become a registered user, you must reside in one of these localities. * Use of service What are you likely to use the service for? Health & Medical Services Shopping Access to the train Social Do you require a wheelchair friendly vehicle? Yes No We are committed to providing a transport service that is accessible for all Kenilworth residents. The service is not currently wheelchair accessible, however, the data collected here will inform future service improvements. Declaration of registrant I understand and accept the terms to register for this service. I declare that these details are correct in all respects, at the time of lodgement of this registration with the Sunshine Coast Council. * What day of the week is it? If you have not received a response to your request within 3 days please contact the Kenilworth Community Transport Service via email.