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Change of Designated Premises Supervisor

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 must also download, complete and send to us the Designated Premises Supervisor Consent 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.

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

Tel: 01202 261700
Email: environment@poole.gov.uk

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