If you need to change any information at a later date, please contact us on southeast@DofE.org or 01753 727450.

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* 1. Prospective DLC Name

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* 2. Proposed start date (must be the first day of a month):

Date

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* 3. Registered address

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* 4. Invoicing address:

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* 5. Proposed DLC Licence Holder (must be senior level e.g. Headteacher)

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* 6. Proposed DofE Manager

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* 7. Has the DLC ever offered DofE before, e.g. under a Local Authority Licence?

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* 8. Form completed by

T