Disclosures Online Form


Disclosure form

STEP 1: Your group needs to download and complete a PVG Contract with LAYC

STEP 2: The individual person should complete the application filling in the Disclosures Online Form below using BLOCK CAPITAL letters (we suggest pressing the CAPS LOCK key on your keyboard).

STEP 3: This information is entered onto a PVG Scheme Application form by LAYC . The individual person needs to contact LAYC to arrange ...

STEP 4: To come in to the LAYC Offices to check and sign the application.They will also have to produce at least three forms of identity (one of them should be photographic and there should be two recent proofs of address, such as a utility bill and a bank statement).

If you have any enquiries relating to the information requested below please do not hesitate to contact us at LAYC on 0131 667 1828 or email enquiries@layc.org.uk

All fields should be filled in unless indicated otherwise.


PVG Membership

I am already a PVG member

If you are already a PVG member have any of your details changed since your last PVG?

Has your name changed?

Has your address changed?

Has your SSSC/GTC Registration Number changed?

Are you applying for a
Scheme Record
Scheme Update

(In each case you will receive a copy of the certificate as will LAYC on behalf of the organisation you will be working for.)


Details of Group

Group name

Is the Club/Group/Organisation a voluntary sector charitable body?

Position applied for

Is the position paid?

Is the position 'regulated work'


Name(s)

Title

Present surname

Present forenames (please include all middle names)

Name at birth (if different)

Birth surname

Birth forenames (please include all middle names)

Any other names known by or previously known by?

Other surname

Other forenames (please include all middle names)

Mother's family/maiden name


Birth details

Date of birth DD/MM/YY

Gender

Town of birth

Country of birth

Nationality


Contact information

Telephone number (including STD code)

Email address


Additional Information

Do you have a UK National Insurance Number

If yes, what is it?

Do you have a Passport

If yes, what number is it?

And what is the country of issue?

Do you have a Driving License

If yes, what number is it?

And what is the country of issue?


Are you now or have you ever been

A member of the PVG scheme?

If yes, what is your PVG scheme number?

Registered with ISA / DBS?

If yes, what is your ISA or DBS number?


Current home address

Address (number, street)

Post town

County/Region

Country (leave blank if UK)

Post code

Resident from (DD/MM/YY)


Home address history

If you have not lived at your current home address for FIVE years then please provide your previous addresses covering this period, with the most recent first.

Previous address #1

Address (number, street)

Post town

County/Region

Country (leave blank if UK)

Post code

Resident from (MM-YYYY)

Previous address #2

Address (number, street)

Post town

County/Region

Country (leave blank if UK)

Post code

Resident from (MM-YYYY)

Previous address #3

Address (number, street)

Post town

County/Region

Country (leave blank if UK)

Post code

Resident from (MM-YYYY)


SSSC GTC

If you are registered with the SSSC or GTC for Scotland you can have a duplicate copy sent to them too.

SSSC registered?

SSSC registration number is

GTC registered?

GTC registration number is


Indentification

I am aware that I am required to provide a minimum of three forms of identification, one of them being photographic. These forms of ID should confirm my name and date of birth and my recent home address (within the past three months).

The forms of ID I will be presenting will be:

If other ID type please specify - e.g Official Correspondence; Bank Statement; Utility Bill etc.)