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Home > Environment > Environmental Health

Application Registration Form For Acupuncture, Tattooing, Semi-Permanent Skin Colouring, Cosmetic Piercing Or Electrolysis

Local Government (Miscellaneous Provisions) Act 1982 Application For Registration To Carry On The Practice Of Acupuncture Or The Business Of Tattooing; Of Cosmetic Piercing; Of Semi-Permanent Skin Colouring Or Of Electrolysis
Please enter full name & address of applicant
Title *Entries with a red asterick must be filled in
 
Address of premises required to be registered
Have you ever been convicted of an offence under Section 16 of the above Act? If 'Yes', give details
*
 

Type of registration required

Where more than one activity is to be undertaken the sum total of each registration is the fee to be enclosed.
Please select the relevant box(es). *










 
Please enter details of qualifications and experience
I apply for registration to carry out the practice/business specified above.

I understand that the registration permits me to operate within the area of North East Lincolnshire Council on premises which are duly registered for that purpose.

I enclose a cheque/postal order made payable to 'North East Lincolnshire Council' for
£
 
Is a receipt required?
If Yes, to which address?
Signed DatedDay

Please use the Submit button to generate the PDF and then print out the form. Sign the form and return together with said fee to the following address;

Environmental Services, Origin One, Origin Way, Genesis Europarc, Grimsby, North East Lincolnshire, DN37 9TZ

For any queries please telephone (01472) 324500 or e-mail to CustomerRequests@nelincs.gov.uk

 

DATA PROTECTION NOTICE
North East Lincolnshire Council is a Data Controller for the purposes of the Data Protection Act 1998. Any personal information supplied on this form will be processed in accordance with the principles of the Act. If you want to find out more about your rights under the Act, you can contact the Office of the Information Commissioner (tel: 01625 545 700 / http://www.dataprotection.gov.uk) or the Director of Law and Democratic Services on 01472 313131.


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Created by   :   Environmental Services - Licensing Officer
Last Updated   :   30 March 2007
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