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1. The applicant’s full name, date of birth, address and telephone number.
2. Details of the applicant’s professional or technical qualifications, and experience of managing an establishment or agency, so far as such qualifications and experience are relevant to providing services for persons for whom services are to be provided at the establishment or by the agency.
3. Details of the applicant’s professional training relevant to carrying on or managing an establishment or agency.
4. Details of the applicant’s employment history, including the name and address of his present employer and of any previous employers.
5. Details of any business the applicant carries on or manages or has carried on or managed.
6. The name and addresses of two referees –
(a)who are not relatives of the applicant;
(b)each of whom is able to provide a reference as to the applicant’s competence to carry on an establishment or agency of the same description as the establishment or agency; and
(c)one of whom has employed the applicant for a period of at least 3 months,
but the requirement for the name and address of a referee who has employed the applicant for a period of at least 3 months in the last five years, shall not apply where it is impracticable to obtain a reference from a person who fulfils that requirement.
7. The name, address, telephone number, facsimile number, and electronic mail address (if any) of the establishment or agency.
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