PVG - New member form

A guide to completing the form

“Application to join PVG Scheme”

Designed for

organisations

enrolled with CRBS

Use BLUE or BLACK ink

Use BLUE or BLACK ink

Stay within the boxes

Use BLUE or BLACK ink

Stay within the boxes

Do not use any stamps or stickers

Guidance on completing form

X

X

X

X

Note : the red circles are for illustration purposes only!

X

X

5 year h

istory

required

SCWIS (Care Inspectorate) 101

General Chiropractic Council 102

General Dental Council 103

General Medical Council 104

General Optical Council 105

General Osteopathic Council 106

General Teaching Council for Scotland 107

Health Professions Council 108

Nursing and Midwifery Council 109

General Pharmaceutical Council 110

Scottish Social Services Council 111

Applicant 9 9 9 9 9 9 9 9

For a free disclosure application

X

X

X

For a free disclosure application

X

? ? ? ?? ? ? ? ?

For a paid disclosure application

X

A G R E E D P O S I T I O N

For CRBS only

Do NOT sign at F1/F2

Do NOT sign at F1/F2

Leave page 6 blank

The endinfo@crbs.org.uk

01786 849777