Application for ARB Licence Renewal - Department of Education
Application for ARB Licence Renewal - Department of Education
Application for ARB Licence Renewal - Department of Education
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4.1.6<br />
Licensee Representative 2<br />
Title (e.g.<br />
Mr/Mrs/Ms)<br />
Given name(s)<br />
Family name<br />
Residential street<br />
address<br />
Town/suburb<br />
Postcode<br />
Postal address (if<br />
different from above)<br />
Telephone (work)<br />
Telephone (home)<br />
Facsimile<br />
Mobile<br />
Email<br />
Please tick relevant boxes<br />
4.1.7 Fitness and Propriety Check<br />
Licensee representative 2<br />
Yes<br />
No<br />
Yes<br />
No<br />
I hold a current Tasmanian Working with Children Check (WWCC); or<br />
I hold a valid safety screening clearance, issued by the <strong>Department</strong> <strong>of</strong> <strong>Education</strong>.<br />
Note: If you do not hold either a current WWCC or valid safety screening clearance, be<strong>for</strong>e progressing<br />
you must apply <strong>for</strong> and hold a current WWCC.<br />
4.1.8 Tasmanian Working with Children Check<br />
Identification Number: _________________ Expiry Date: _________________<br />
OR<br />
<br />
<br />
<br />
<br />
Safety Screening Clearance<br />
is attached; or<br />
has already been provided to the <strong>Education</strong> and Care Unit; and<br />
I declare that no changes have occurred since my safety screening application <strong>for</strong>m was submitted; or<br />
changes have occurred since my safety screening clearance was submitted and I have notified the Conduct<br />
and Investigations Unit.<br />
<strong>Application</strong> <strong>for</strong> <strong>ARB</strong> <strong>Licence</strong> <strong>Renewal</strong> – November 2014 Page 12 <strong>of</strong> 20
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