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Your Borough Of Poole
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Designated Premises Supervisor

A Designated Premises Supervisor must hold a Personal Licence and is the person specified on the Premises Licence who is responsible for authorising the supply of alcohol. This person must be readily identifiable and will normally be given day-to-day responsibility for running the premises.

You can use this application form to apply to vary the Designated Premises Supervisor of a Premises 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 us the form of consent given by the person who holds the existing premises licence.

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