Will the supply of alcohol be for consumption on premises or off premises or both? (please read guidance note 8)*\nIs the premises used exclusively or primarily for supply of alcohol for consumption on the premises?*\nState any seasonal variations for the supply of alcohol. (please read guidance note 5)\nPlease state any non-standard timings, where you intend to use the premises for the supply of alcohol different times from the Standard days and times listed?(please read guidance note 6) On Premises

Yes

Summer time everyday and Winter months Thursday Friday Saturday Sunday

Designated Premises Supervisor

State the name and details of the individual whom you wish to specify on the licence as designated premises supervisor (Please see declaration about the entitlement to work in the checklist at the end of the form)

Title*

First name*

Surname*

Street address*

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