- Devonport City Council -
https://www.devonport.tas.gov.au
-
Public Health Risk Activity (Premises) Application Form
Posted By
Scott Newman
On
August 30, 2019 @ 5:29 pm
In Businesses & Residents,Business Forms,Forms and Payments |
Comments Disabled
Step 1 of 2
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Public Health Act 1997 Part 5, Division 3 & 4
Select Application Type
*
Application for Health Risk Activity Registration
Application for Health Risk Activity Registration Renewal
Applicants Details
Name of Applicant
*
First
Last
Address
*
Street Address
City
Post Code
Telephone
*
Mobile
Date of Birth
*
Date Format: DD slash MM slash YYYY
Email
*
Premises Details
Trade Name of Premises
*
Address
*
Street Address
City
Post Code
Do you want to receive your correspondence to a different address.
*
Yes
No
Address
*
Street Address
City
Post Code
Telephone
*
Mobile Phone
*
ABN
*
Public Health Risk Activity Details
Please tick the applicable Public Health Risk Activities to be carried out on the premises
*
Body Piercing
Ear Piercing
Tattooing
Semi-Permanent - Permanent Makeup
Acupuncture
Agreement
I
*
First
Last
agree that the information i have provided is truthful and accurate.
Date
*
Date Format: DD slash MM slash YYYY
Consent
*
I agree to the privacy policy of the Devonport City Council.
Click Here to view our Privacy Policy
[1]
Consent
*
I consent to receiving communications about this application in electronic form
