Club Premises Certificate
You can use this application form to apply for the above licence. The application form is available in 2 forms -
- a pdf version to print off and complete or
- a Word version to download and type into which allows you to keep an electronic copy.
You also need to download, complete and send to us the Qualifying Club Status Declaration Form 
.
Note: For all copies sent to Environmental and Consumer Protection Services please clearly mark each envelope with LA2003.
There are fees involved with this application depending on the Non Domestic Rateable Value (NDRV) of the premises. Unless your premises is exempt you will need to pay an application fee and an annual fee . If you allow an occupancy greater than 5,000 persons there are additional fees. There are some other fees which may be applicable.
We are unable to accept this form by email because it must have a signature. Please print the form, sign it and return it to the address below.
Return completed form to:
Environmental and Consumer Protection
Unit 1, Newfields Business Park, 2 Stinsford Road, Poole
BH17 0NF
Directgov