Application for copy of premises licence or summary

SSDC - Privacy Statement on Handling of Personal Information

I/We
Full name of prospective premises supervisor(s): *
being the holder(s) of a Premises Licence dated: *
Show Calendar
in respect of premises known as: *
hereby apply for: *

Which has been: *



The circumstances of which are as follows: *
A copy of this form will be sent to you by e-mail. Please provide an e-mail address for this below:
E-mail Address: *