You are on page 1of 4

Social Club License Application Form

1. PROPOSED NAME OF THE SOCIAL CLUB

First Choice

Second Choice

Third Choice

2. PROPOSED TYPE OF ACTIVITY

Non-Profit Profit

3. RESPONSIBLE CONTACT PERSON

Full Name:

Position at the proposed entity:

Mobile No: Email Address:

4. PROPOSED ACTIVITIES

Notes:
 If you require additional space for the activities, a separate sheet must be attached to this application

Page 1
SRL – SCL V1.0
5. PROPOSED LOCATION

6. FOUNDER(S)INFORMATION (IF INDIVIDUAL)

Name Nationality Passport Paid-up Capital Resident of Board


(As per passport) Number (AED) UAE? (Y/N) Member?
(Y/N)

7. FOUNDER(S) (IF ENTITY)

Company Name (As per the Registration Country & Date of Paid-up Capital (AED)
Document) Incorporation

8. PROPOSED BOARD OF DIRECTORS

Director 1 Director 2
Name
Address:
Nationality:
Place of residence:
Occupation:

Page 2
SRL – SCL V1.0
Director 3 Director 4
Name
Address:
Nationality:
Place of residence:
Occupation:

Director 5 Appointed Manager


Name
Address:
Nationality:
Place of residence:
Occupation:

Notes:
 If you require additional space for the names and details of Directors, a separate sheet must be attached to this
application

9. DOCUMENTATION CHECKLIST (PLEASE CHECK THE FOLLOWING)

Completed Application Form (All information should be furnished)

List of Activities proposed to be provided at the club

Vision, Mission and Objectives of establishing the proposed social club

Proposed Location Map

List of Board Members/Board of Directors

Passport copies and CV’s of all Board Members/Board of Directors

Attested copy of constitution in both Arabic and English

Financial plan for next 2 years

Letter of recommendation from one supporting organization

Meeting minutes signed by the Board assigning the Manager of the Social Club to take care of application
and other communication with CDA

Page 3
SRL – SCL V1.0
Signature Sheet below to be completed by ALL Applicants

By signing below, I/we, hereby certify that, I/we am an authorized party who has the capacity and authority to
make this application to CDA. I/we accept to settle all fee(s) that are applicable as a result of this application.
I/we also certify that all information provided is correct to the best of my knowledge. I/we agree to abide by the
laws, rules and regulations of CDA applicable in the Emirates of Dubai.

Name of Applicant: Position:

Address: Date & Signature:

Phone:

Fax:

Mobile:
E-mail:

Notes:

 Once completed, please submit this form to CDA Social Regulatory& Licensing.
 All fields are mandatory and subject to verification by CDA.
 Incomplete applications will not be accepted.
 CDA reserves the right to request any additional information.
 CDA reserves the right to inactivate the application if requested information is not furnished within 30 days from the
date of communication sent by CDA.
 CDA reserves the right to request attestation of legal documents from any Embassy or Consulate.
 False statements/information may result in de licensure of the entity, office closure, and/or legal proceedings.
 Please contact CDA's Facility & Society Licensing department in the event of any clarification.

FOR CDA OFFICIAL USE ONLY

Application/ Documentation Approval Licensure Approval


Name: Name:

Signature: Signature:

Date: Date:

Page 4
SRL – SCL V1.0