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Rule 6(5)
Rule 4(1)(a)
The following information shall be provided by an applicant to the Council:
(a)his full name;
(b)his former name (if any);
(c)his date of birth;
(d)his nationality;
(e)his home address;
(f)his work address;
(g)his telephone number;
(h)his e-mail address;
(i)the Part of the Register to which his application relates;
(j)details of his education, training, experience and qualifications in reliance upon which the application is made;
(k)whether he has previously been registered by the Council or another health or social care regulatory body, and if he has, details of such registration;
(l)confirmation that he has not been convicted of, or cautioned for, any criminal offence or, if he has, details of the conviction or caution;
(m)confirmation that he has not been disciplined by another health or social care regulatory body or, if he has, details of the disciplinary action; and
(n)a declaration by the applicant as to his good health and good character.”.
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