All fields marked with a * are required entries
Permit Application
Please Note:
This form can be submitted online
YOU MUST BE LOGGED IN TO SAVE AND SUBMIT THIS FORM
You are not currently logged in to My Profile, however you may
Complete the form and obtain a printout at the end
If you log in you may
Pre-populate certain details from your profile account
Save your form at any time and complete it later
Submit your form online.
New users click here to
, existing users click here to
Application For A Street Collection Permit
*
Applications for a permit must be made no later than one month before the date on which it is proposed to make the collection
Please read the
Terms and Conditions
and the help file.
You may be requested to provide the following documents as applicable:
1. A copy of any agreement or particulars of any contract with any Registered Charity/individual
benefiting from this collection.
2. A copy of the current published accounts for any Registered Charity and/or any Registered Company
undertaking or involved with this collection.
3. Copies of any literature about organisations or individuals who will benefit.
Please tick this box to confirm you have read and accept the terms and conditions
Personal Details
*
Title
---
Mrs
Mr
Miss
Ms
Sir
Lord
Lady
Dr
Prof
Rev
Other
other title
(please specify)
*
Forename
Middle name/Initials
*
Surname
*
Date of birth
----
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Year
---
Jan
Feb
March
April
May
June
July
Aug
Sep
Oct
Nov
Dec
Month
----
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
*
Place of birth
*
Occupation
*
Do you represent a company?
Yes
No
(If yes) Company House Reg. No
Personal Address Details
*
Building/house name/number
*
Street
*
Town
*
County
*
Postcode
Home telephone number
(include area code)
Work telephone number
(include area code)
Mobile number
Email address
Fields marked '*' are required entries.
Page 1 of 7
1
Print blank form
Clear all
Help
P12266
Close Window