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All fields marked with a * are required entries
APPLICATION FOR  LICENCE

Please Note:
This form can be submitted online with a card payment
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Application for Grant/ Renewal/ Transfer/ Variation of Licence for a Sex Establishment
Please click here for a Notice of Application and here for a Certificate of Publication of Notice
of Application.
* The giving of false information may result in registration being refused or revoked, and the local authority reserve the right to make such further enquiries arising out of this application as they may consider desirable.

This application fee is not refundable in the event of the application being refused or otherwise.

I declare that I have completed a Notice of Application for a Licence, one copy of which is displayed at the premises for 28 days, the other copy which is displayed at the premises which has been sent to the County Press. I understand that I will also need to complete a 'Certificate of Publication of Notice of Application for a Licence' and return it to the Licencing Authority following the expiry of the notice period.
Applicants Details
The Licence fee of    will be required when submitting this application
* Is the application on behalf of an individual or a corporate  or unincorporated body?
If individual, please provide:
Title Other title
(please specify)
Forename
Middle name/Initials
Surname
Building/house name/number
Street address
Town name
County
Postcode
 Tel number
(include area code)
Email address  
Fax
Age
Date of birth

Year
Month
Day

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