The Ponders End Community Development Trust (PECDT)
Due Diligence Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Back
Next
Tick All Applicable Boxes
Photographic ID verified (Passport / Driving Licence)
Proof of address verified (Utility Bill / Bank Statement – dated within last 3 months)
Please verify you have the Right-to-work in the UK (for staff/volunteers where applicable)
Disclosure and Barring Service (DBS) Checks. Insert your DBS Certificate Number
Date Of Issue
Safeguarding Policies in place
Children safeguarding policy
Adult safeguarding policy
Please provide copies of the relevant safeguarding policies mentioned above
Type a question
Public Liability Insurance in place (minimum £5 million cover)
Employer’s Liability Insurance in place (if applicable)
Professional Indemnity Insurance in place (if applicable)
Insurer Name:
Policy Number:
Expiry Date:
Declaration
I confirm that all the information provided above is true and accurate. I agree to comply with PECDT’s safeguarding policies, health & safety procedures. I understand that failure to do so may result intermination of my bookings.
Signature:
Name:
Date:
Submit
Should be Empty: