Application for a premises licence to be granted under the Licensing Act 2003

Please read the guidance notes

Premises details*
 

Premises name
Telephone number at premises (if any)
Non-domestic rateable value of premises*
Select your property band*
If 5,000 or more people are expected to attend the premises at any one time, please state the number expected to attend*



Applicant details

Please state whether you are applying for a premises licence as:












*If you are applying as a person described in (a) or (b) please confirm:

  I am carrying on or proposing to carry on a business which involves the use of the premises for licensable activities ; or

I am making the application pursuant to a



Applicant details continued
Title*
Surname*
First name*
Are you over 18?*
Country *
Address*
Post town*
Post code*
 

Telephone*
Email*
Nationality : *

Where applicable (if demonstrating a right to work via the Home Office online right to work checking service), the 9-digit ‘share code’ provided to the applicant by that service (Please see note)

Share Code :
Date of Birth : *
Second Applicant
Title
Surname
First name
Are you over 18?
Country
Address
Post town
Post code
 

Telephone
Email
Nationality :

Where applicable (if demonstrating a right to work via the Home Office online right to work checking service), the 9-digit ‘share code’ provided to the applicant by that service (Please see note)

Share Code :
Date of Birth :

If there are more than two applicants please contact Licensing Service on 02083562431.



Applicant details continued

Please provide the name and registered address of the applicant in full. Where appropriate please give any registered number.

Name*
Country *
Address*
Post town*
Post code*
 

Registered number (where applicable)
Telephone*
Email*
Description of applicant(for example, partnership,company,unincorprated association) Max characters: 60

Correspondence address

Please select you correspondence address:



Alternative address

Please provide correspondence name and address in full

Name*
Country *
Address*
Post town*
Post code*
 

Telephone*
Email*