Regulation 2(1)
1. The full name of the applicant, including (if different) name at birth and any other former names, or where day care is to be provided by a partnership, committee or incorporated or unincorporated body, the full names of the partners, members of the Committee, Board of Directors, or the Board, identifying the Chairman, Secretary and Treasurer.
2. The address at which the children are to be looked after, and the applicant’s address if different.
3. Whether the premises available to the applicant at which the children are to be looked after are domestic premises.
4. In the case of day care, a description of the facilities available to the applicant for day care, including the number of rooms, their functions, the numbers of lavatories and washbasins, any separate facilities for adult workers and access to the premises for cars.
5. Whether the applicant wishes to register as a child minder, or as a provider of day care, and if the latter, whether he will provide full day care or sessional day care.
6. In the case of day care, the proposed hours for which the applicant wishes to provide day care.
7. Relevant experience of the applicant, including any previous work with children or with elderly or disabled people, whether paid or not.
8. The number and ages of any children of the applicant or any children for whom he is to be responsible.
9. Any relevant qualifications (with dates) of the applicant, giving details of the organisation running the course, the subjects studied, the length of the course and the name of the qualification.
10. The names of two referees for the applicant who may be contacted.
11. The name and address of the applicant’s general medical practitioner and whether he may be approached for details concerning the state of health of the applicant, together with details of anything for which he is currently being treated by his general medical practitioner or by a hospital, and details of any hospital admissions during the last 2 years and of any serious illnesses in the last 5 years.
12. Details of any criminal convictions of the applicant, including—
(a)the date of offence;
(b)the nature of offence;
(c)the place where it occurred;
(d)the name of the court which gave the conviction; and
(e)the penalty imposed.