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New Locker at Rail Stations Application Form

Please complete the following form in order to renew or update your bicycle locker agreement.

New Rail Station Locker Application Form

* Indicates required information

Customer Details

Name:*

House Number:*

Street Name:*

City:*

Postcode:*

Email address:*

Confirm Email Address:*

Daytime telephone Number:*

Evening telephone number:

Please select the rail station name that you wish to apply for a locker at from the list below:

Station name:*

Making an application does not guarantee a locker will be available for use. Some stations will have all lockers currently rented out to passengers. If this is the case, your name will be added to a waiting list and you will be informed when a locker becomes available.

For security confirmation please supply the following:

Memorable Date:

Memorable Place:

Memorable Name:

I understand that a security deposit of £20 for the use of a cycle locker for twelve months for sole access bicycle locker will be required at the time of my application being accepted.

Tick here to confirm:*

I agree to use the facilities in accordance with the Licence Terms and Conditions** (see below) which may be varied from time to time by Centro without prior notice.*

** Rail Station Locker Terms and Conditions (opens in a new window)

Data Protection Act 1998

The padlock symbol shows that we follow best practice in managing personal information.

We will keep all details secure. We may use the information you provide for administration, to tell you about updates to our products or services, for analysis purposes and to contact you, in line with the Data Protection Act 1998. We want to make sure our services offer equal opportunities to everyone, no matter what their sex, age, race, nationality, ethnic origin, disability or religious belief.

Journey Planner

Network West Midlands is a partnership between Centro and bus, rail and tram operating companies within the West Midlands County to promote increased public transport use. To visit our partners website please click here.