The personal information requested on this form is collected under the authority of and will be used for the purpose
of administering the Employment and Assistance Act and the Employment and Assistance for Persons with Disabilities Act.
The collection, use, and disclosure of personal information is subject to the provisions of the Freedom of Information
and Protection of Privacy Act. Questions regarding the collection, use, and disclosure of personal information can be
directed to an Employment and Assistance Worker of The British Columbia Bus Pass Program by email: visit
, by phone: 1-866-866-0800
or by mail: PO Box 9985, Stn Prov Gov't, Victoria BC V8W 9R6.