Street Collection Licence Application Form

Your E-mail Address: ^*

Name and address of person, Society, Committee

Names and addresses of the applicant(s) for the permit who will be (jointly) responsible for the collection of sale: ^*

Name of the Charity or Fund which is to benefit: ^*

Address and telephone number of the Administrative Centre of the Fund and the name of the Secretary: ^*

Object of the Charity or Fund: ^*

Date upon which it is desired to make the collection or sale: ^*

Locality within which it is desired to make the collection or sale

The method to be adopted in making the collection or sale: ^*

Are the whole of the receipts to be paid over for the benefit of the Charity or Fund, or will any deductions be made for expenses or other purposes? (including payment to collectors). If any deduction is made state for what purpose and give an estimate of the sum which will be deducted.

Disposal of the receipts ^*

* Required Fields

NOTES:

This application should be submitted as soon as practicable and in any event not later than the first day of the month proceeding the month in which it is proposed to hold the collection or sale.

If any of the questions in this form have not been answered fully, this application will not be processed and will be returned to the applicant for its correct completion.


We will only use personal information you send to us for the purposes for which you provide it. We will only hold your information for as long as necessary for these purposes and will not pass it to any other parties unless this is made clear to you. All employees who have access to your personal data or are associated with the handling of that data are obliged to respect the confidentiality of your personal data.

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Street Collection Licence Application Form

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