Skin Treatments (Licensing and Control) Regulations

Application for the Licensing of Premises to be used for the Business of Skin Piercing, Electrolysis, Acupuncture or Tattooing

In pursuance of Regulation 3 of the Skin Treatments (Licensing and Control) Regulations, I hereby apply for a licence for the following premises to be used for the business of: *

skin piercing

electrolysis

tattooing

acupuncture

Address

Name of Business (if any)

Name of occupier of premises *

Address of occupier of premises *

Address of occupier of premises

City

State/Province

Zip/Postal

Country

Date *

Additional information

Email Address

I declare that the above particulars are true in every respect. *

Yes

Applicant will be required to sign application form prior to document being issued by the Agency.

* obligatory fields

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