Application form - Clare's Law Domestic Violence Disclosure Scheme

About the applicant

Your details

Please include your full address and postcode
Please include a telephone number and email address
Please choose one of the options

if you are making this application for your own safety select the first option. If you are making the application with concern from someone else please choose one of the options to describe your relationship with them.

What happens next

To find out what we do with the information we collect from this form please visit GDPR form responses.