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Your Borough Of Poole
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Qualifying Club Status Declaration

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.

Note: For all copies sent to Environmental 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 Services
Unit 1, Newfields Business Park, 2 Stinsford Road, Poole
BH17 0NF

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

go to 'apply for it' homepage

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Contact us

Telephone
01202 261700

Text Relay
18001 01202 261700

Address
Environmental Services
Unit 1
Newfields Business Park
2 Stinsford Road
Poole
BH17 0NF