Apply to Renew a Chaperone Licence

A chaperone is responsible for the supervision of a child who is taking part in entertainment.

1. Friendly Url
2. Friendly Url
4. Unique Reference Number
All information given in this application form will be treated in confidence, other than information relating to criminal offences.
Applicant details
1. Name
  1. Title
  2. Other Title
  3. First Name*
  4. Last Name*
2. 1. Date of Birth*
  2. dd/mm/yyyy
3. 1. Email*
4. 1. Telephone / Mobile
  3. Numbers, spaces, + , ( , and ) are all valid characters
5. 1. Address
    
    Address Postcode
    
    Postcode
    
    Address
    
    Full address*
  3. Date from when renewal is required
    
    dd/mm/yyyy
  4. If for a specific show, please give full details
  5. Which Theatre Group / Dance School are you connected with?
1. * Please correct any of the validation issues highlighted above

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