ࡱ> 13*+,-./0 ebjbjVV 7<<xb-77777KKK8\KVu!B"C"CCCGI$Jssssssswy*s 7QKFGQKQKs77CCuMMMQK*7C7CsMQKsMM o0rCK{L9p$r&u0Vu]p@yL"yHry7rPQKQKMQKQKQKQKQKssMQKQKQKVuQKQKQKQKyQKQKQKQKQKQKQKQKQK : Application for a club premises certificate to be granted under the Licensing Act 2003 PLEASE READ THE FOLLOWING INSTRUCTIONS BEFORE COMPLETING APPLICATION Before completing this form please read the guidance notes at the end of the form. If you are completing this form by hand please write legibly in block capitals. In all cases ensure that your answers are inside the boxes and written in black ink. Use additional sheets if necessary. You may wish to keep a copy of the completed form for your records.  FORMTEXT  (Insert name of club) club applies for a club premises certificate under section 71 of the Licensing Act 2003 for the premises described in Part 1 below (the club premises) The club is making this application to you as the relevant licensing authority in accordance with section 68 of the Licensing Act 2003 Part 1 Club premises details Name of club  FORMTEXT      Postal address of premises or, if none, ordnance survey map reference or description  FORMTEXT      Post Town FORMTEXT      Postcode FORMTEXT      Telephone number (if any) FORMTEXT      E-mail address (optional) FORMTEXT       Name of person performing duties of a secretary to the club  FORMTEXT      Address of person performing duties of a secretary to the club  FORMTEXT      Post Town FORMTEXT      Postcode FORMTEXT      Daytime contact telephone number (if any) FORMTEXT      E-mail address (optional) FORMTEXT       Non-domestic rateable value of premises FORMTEXT       Are the club premises occupied and habitually used by the clubYes FORMCHECKBOX No FORMCHECKBOX  Part 2  Club Operating Schedule When do you want the club premises certificate to start?Day Month Year  FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT   If you wish the certificate to be valid only for a limited period, when do you want it to end?Day Month Year  FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    General description of club (please read guidance note 1)  FORMTEXT       If 5,000 or more people are expected to attend the premises at any one time, please state the number expected to attend FORMTEXT        What qualifying club activities do you intend to conduct on the club premises? Provision of regulated entertainmentPlease tick yes a)plays (if ticking yes, fill in box A) FORMCHECKBOX b)films (if ticking yes, fill in box B) FORMCHECKBOX c)indoor sporting events (if ticking yes, fill in box C) FORMCHECKBOX d)boxing or wrestling entertainment (if ticking yes, fill in box D) FORMCHECKBOX e)live music (if ticking yes, fill in box E) FORMCHECKBOX f)recorded music (if ticking yes, fill in box F) FORMCHECKBOX g)performances of dance (if ticking yes, fill in box G) FORMCHECKBOX h)anything of a similar description to that falling within (e), (f) or (g) (if ticking yes, fill in box H) FORMCHECKBOX  Provision of entertainment facilities for:i)making music (if ticking yes, fill in box I) FORMCHECKBOX j)dancing (if ticking yes, fill in box J) FORMCHECKBOX k)entertainment of a similar description to that falling within (i) or (j) (if ticking yes, fill in box K) FORMCHECKBOX The supply of alcohol by or on behalf of a club to, or to the order of, a member of the club (if ticking yes, fill in box L) FORMCHECKBOX The sale by retail of alcohol by or on behalf of a club to a guest of a member of the club for consumption on the premises where the sale takes place (if ticking yes, fill in box L) FORMCHECKBOX  In all cases complete boxes M, N, and O A Plays Standard days and timings (please read guidance note 6)Will the performance of a play take place indoors or outdoors or both please tick (please read guidance note 2) Indoors FORMCHECKBOX Outdoors FORMCHECKBOX DayStartFinishBoth FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT      State any seasonal variations for performing plays (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT      Non standard timings. Where the club intends to use the premises for the performance of a play at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       B Films Standard days and timings (please read guidance note 6)Will the exhibition of films take place indoors or outdoors or both  please tick (please read guidance note 2) Indoors FORMCHECKBOX Outdoors FORMCHECKBOX DayStartFinishBoth FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT      State any seasonal variations for the exhibition of film (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT      Non standard timings. Where the club intends to use the premises for the exhibition of film at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       C Indoor sporting events Standard days and timings (please read guidance note 6)Please give further details here (please read guidance note 3)  FORMTEXT      DayStartFinishMon FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT      State any seasonal variations for indoor sporting events (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for indoor sporting events at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       D Boxing or wrestling entertainments Standard days and timings (please read guidance note 6)Will the boxing or wrestling entertainment take place indoors or outdoors or both  please tick (please read guidance note 2) Indoors FORMCHECKBOX Outdoors FORMCHECKBOX DayStartFinishBoth FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT      State any seasonal variations for boxing or wrestling entertainment (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for the boxing or wrestling entertainment at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       E Live music Standard days and timings (please read guidance note 6)Will the performance of live music take place indoors or outdoors or both  please tick (please read guidance note 2) Indoors FORMCHECKBOX Outdoors FORMCHECKBOX DayStartFinishBoth FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT      State any seasonal variations for the performance of live music (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for the performance of live music at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       F Recorded music Standard days and timings (please read guidance note 6)Will the playing of recorded music take place indoors or outdoors or both  please tick (please read guidance note 2) Indoors FORMCHECKBOX Outdoors FORMCHECKBOX DayStartFinishBoth FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT      State any seasonal variations for the playing of recorded music (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for the playing of recorded music at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       G Performances of dance Standard days and timings (please read guidance note 6)Will the performance of dance take place indoors or outdoors or both please tick (please read guidance note 2) Indoors FORMCHECKBOX Outdoors FORMCHECKBOX DayStartFinishBoth FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT      State any seasonal variations for the performance of dance (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for the performance of dance at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       H Anything of a similar description to that falling within (e), (f) or (g) Standard days and timings (please read guidance note 6)Please give a description of the type of entertainment that the club will be providing  FORMTEXT      DayStartFinishWill this entertainment take place indoors or outdoors or both  please tick (please read guidance note 2) Indoors FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Outdoors FORMCHECKBOX  FORMTEXT       FORMTEXT      Both FORMCHECKBOX Tue FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT      State any seasonal variations for this entertainment (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT             4 6 t v       2 4 H J L V X \ jEhUUjhUUj5hUUj'hUUjh6/!UmHnHuj hUU h6/!5\ h6/!6]h6/!mHnHujhUUjhUUh6/!mH sH h6/!4:WX     6 U V ]kdv$$If4$$0$4af4 $Ifgd6/!$If$IfV u v   ekd$$Ifs4    @$ 0    44 saf4$If 2 Z $Ifekd$$Ifs4    p$0    44 saf4Z \ e__$Ifkd!$$Ifs    \$ 80    44 sa :<PRT^`dxz02FHJTVZj hUUj hUUjg hUUj hUUjhUUjhUUjhUU h6/!5\h6/!jh6/!UmHnHujhUU9 $Ifvkd$$Ifs4    0 $| 0    44 saf4$Ifvkd $$Ifs4    0 $|  0    44 saf4:bdx-ekde $$Ifs4    p$0    44 saf4$IfekdI$$Ifs4    @$ 0    44 saf4x0X_kd $$Ifs    \$ 80    44 sa$IfXZ$IfvkdC $$Ifs4    0 $| 0    44 saf4 "$&024 RԵ憔vl^jhUhUUjhU@zUjh6/!@zUmHnHuj'hUhUUjhUhUUjhUUjhUU jh6/!5U\mHnHuj[hU5U\jhU5U\ h6/!5\h6/!jhUUjh6/!UmHnHu# 4v $If[$$Ifvkd $$Ifs4    0 $|  0    44 saf4468 ~s~~~  !$If$Ifxkd$$Ifs4    0,$    0    44 saf4 ROMMG< $$Ifa$K$$Ifkd$$Ifs r>!#$?s 0644 sa$Ddqffffffff $$Ifa$K$kdi$IfK$L$4FT 8QS06    4af4$IfK$  "$&:<>@BDFZ\^`bdfz|~sjh6/!@zUmHnHujhUhUUjhUhUUjEhUhUUjhUhUUjqhUhUUjhUhUUjhUhUUh6/!jhU@yUjh6/!@yUmHnHu+  "$&(*>@BDFHJ^`bdfhj~檠檠檠v檠hjhUhUUjhUhUUjIhUhUUjhUhUUjhU@yUjh6/!@yUmHnHujuhUhUUjh6/!@zUmHnHujhUhUUjhUhUUh6/!jhU@zU($Ifkd$IfK$L$ִ8Tp 6666666606    4atll$IfK$ $$Ifa$K$$Ifzkd$$Ifs4B0$ 0644 saf4(Hhynnnnnnnn $$Ifa$K$kdA$IfK$L$4FT 8QS06    4af4 DFZ\^hj`bvxz=Mֺ֙ֆx֑mxf^h6/!5>*\ h6/!>*^Jj!hUUjh6/!UmHnHujhUUjhUU h6/!5\jhU@zUjh6/!@zUmHnHujhUhUUjhUhUUh6/!jhU@yUjh6/!@yUmHnHujhUhUU#$Ifkd[$IfK$L$ִ8Tp 6666666606    4aDl}}$Ifzkdp$$Ifs4B0$ 0644 saf4lnp`$IfK$$Ifbkd$$Ifs $    0[44 sa ukd$$IfH07$ 0644 Ha$Ifckd$IfK$L$s  0 644 sa=NORxxrrr$Ifukd$$Ifs0s$k044 sa $$Ifa$$If MNxyYZhij+,:;<)*+XYj@*hUU h6/!5\j(hUUjX'hUUj,&hUUj%hUUj#hUUj"hUUj|!hUUjP hUUjhUUh6/!h6/!5>*\^J2vppp$Ifkd $$IfsF"$T!0    44 savppp$Ifkd!$$IfsF"$T!0    44 saYkvppp$Ifkd#$$IfsF"$T!0    44 saklovppp$IfkdJ$$$IfsF"$T!0    44 savppp$Ifkdv%$$IfsF"$T!0    44 sa+=vppp$Ifkd&$$IfsF"$T!0    44 sa=>Avppp$Ifkd'$$IfsF"$T!0    44 savpp$Ifkd($$Ifs=F"$T!0    44 sa,$Ifekd)$$Ifs4$044 saf4,-0Xjvppp$Ifkd*$$IfsF"$T!0    44 saYghiGKSfghvwxz/01?@ACmopwXZvxzj1hUUj/hUUh6/!5>*\h6/!5CJ\ h6/!5\j.hUUj-hUUh6/!5>*\^J h6/!^Jh6/!5\^Jj,hUUjhUUjl+hUUh6/!0jknvppp$Ifkd+$$IfsF"$T!0    44 sagyvpp$Ifkd-$$IfsF"$T!0    44 sayz0B$Ifxkd:.$$Ifs4@0"$g!044 saf4BCDlmopwFHX||vvvvv$If$IfxkdV/$$Ifs4@0"$g!044 saf4 |~`ZZZZ$Ifkdp0$$Ifs4    Z\ 6"$`b   `!  "  0    44 saf4 `ZZZZZZ$Ifkd>2$$Ifs4     \ 6"$ b   ! " 0    44 saf4 ,.0:<>@TVXbdf   & ( * 4 6 8 : N P R \ ^ l n 輵j:hUUj8hUUjG8hUUj6hUU h6/!5\h6/!5>*6hUUjh6/!UmHnHuj5hUUh6/!jhUUj3hUU2 >f:4444$Ifkd3$$Ifs4    TֈU 6"$       !   "  0    44 saf4   8 ` b Zkd6$$Ifs4    T\U $`    `&   0    44 saf4$Ifb d l `ZZZZ$Ifkd/9$$Ifs4    T\U $  &  0    44 saf4 !!!!!! !4!6!8!B!D!F!H!\!^!`!j!l!n!!""&"("*"4"6"<">"R"T"V"`"b"d"f"z"|"ڹڮڦڛڐڅj)BhUUjAhUUj?hUUh6/!5>*?hUUj ?hUUj?=hUUj<hUUh6/!jh6/!UmHnHujhUUj:hUU4 !!`ZZZZ$Ifkdq;$$Ifs4    T\U $` &  0    44 saf4!!!F!n!"8"`ZZZZZ$Ifkd=$$Ifs4    T\U $  &  0    44 saf48":"<"d"""`ZZZZ$Ifkdi@$$Ifs4    T\U $` `&   0    44 saf4|"~"""""""""""""""""""## #####.#0#2#<#>#L#N#b#d#f#p#r#t#v#######$0%2%F%H%J%T%V%\%^%jGIhUUh6/!5>*HhUUj_HhUUjFhUUj+FhUUj]DhUUjChUUh6/!jh6/!UmHnHujhUU8""""""`ZZZZ$IfkdB$$Ifs4    T\U $  &  0    44 saf4"""#@#B#`ZZZZ$IfkdD$$Ifs4    T\U $` &  0    44 saf4B#D#L#t##0%X%`ZZZZZ$IfkdG$$Ifs4    T\U $  &  0    44 saf4X%Z%\%%%%`ZZZZ$IfkdI$$Ifs4    T\U $` `&  0    44 saf4^%r%t%v%%%%%%%%%%%%%%%%%%%%%%&&&&$&&&(&2&4&6&8&L&N&P&Z&\&j&l&&&&&&&&&&&&&&&jRhUUjQhUUjOhUUjoOhUUjMhUUj;MhUUj{KhUUjh6/!UmHnHujhUUjKhUUh6/!8%%%%& &`ZZZZ$IfkdK$$Ifs4    T\U $  & 0    44 saf4 & &&6&^&`&`ZZZZ$Ifkd#N$$Ifs4    T\U $` & 0    44 saf4`&b&j&&&&`ZZZZ$IfkdWP$$Ifs4    T\U $  & 0    44 saf4&&&&''`ZZZZ$IfkdR$$Ifs4    T\U $`  & 0    44 saf4&&&&&&&&&'' '''''',''>((((((((((( )")>)@)B)N)P)d)f)h)r)t)v)x)))))xj,\hUUj[hUUjYhUUjWhUUj VhUUh6/!5>*\h6/!5\^Jh6/!5CJ\ h6/!5\jKThUUjh6/!UmHnHujhUUjShUUh6/!/''''',''~(((`^^^XRRRR$If$IfkdT$$Ifs4    T\U $    & 0    44 saf4 (((((((ZkdV$$Ifs4    Z\ 6"$`b   `!  "  0    44 saf4$If((())) )D)`ZZZZZZ$IfkdMX$$Ifs4     \ 6"$ b   ! " 0    44 saf4D)F)N)v))*:4444$Ifkd Z$$Ifs4    TֈS 6"$       !   "  0    44 saf4)))))**2*4*6*@*B*H*J*^*`*b*l*n*p*r**********************++++ +"+$+8+:+<+F+H+V+jNchUUjbhUUj ahUUj`hUUj^hUUjV^hUUjh6/!UmHnHuj\hUU h6/!5\h6/!5>*\h6/!jhUU6*D*F*H*p***Zkd ]$$Ifs4    T\S $`    `&   0    44 saf4$If******`ZZZZ$Ifkd>_$$Ifs4    T\S $  &  0    44 saf4***"+J+L+`ZZZZ$Ifkda$$Ifs4    T\S $` &  0    44 saf4L+N+V+~++T,|,`ZZZZZ$Ifkdc$$Ifs4    T\S $  &  0    44 saf4V+X+l+n+p+z+|+~++++++++,T,V,j,l,n,x,z,,,,,,,,,,,,,,,,,,,,------ -*-,-4-6-J-jzjhUUjjhUUj8hhUUjghUUjfhUUh6/!5>*ehUUjh6/!UmHnHujehUUh6/!jhUU5|,~,,,,,`ZZZZ$Ifkdxf$$Ifs4    T\S $` `&   0    44 saf4,,,-.-0-`ZZZZ$Ifkdh$$Ifs4    T\S $  &  0    44 saf40-2-4-\---`ZZZZ$Ifkdj$$Ifs4    T\S $` &  0    44 saf4J-L-N-X-Z-\-^-r-t-v------------------0/n/p////////////////////// 00ڹڱڦڛڐڅjfshUUjqhUUj2qhUUjrohUUh6/!5>*nhUUjnhUUjlhUUh6/!jh6/!UmHnHujhUUjHlhUU4-----n//`ZZZZZ$Ifkd0m$$Ifs4    T\S $  &  0    44 saf4//////`ZZZZ$Ifkdo$$Ifs4    T\S $` `&  0    44 saf4///0F0H0`ZZZZ$Ifkdr$$Ifs4    T\S $  & 0    44 saf400000 0406080B0D0L0N0b0d0f0p0r0t0v0000000000000000000001111"1$1&1(1<1>1@1J1L1V1Z1\1 h6/!CJjvzhUUjzhUUjBxhUUjwhUUjvhUUjuhUUjshUUh6/!jh6/!UmHnHujhUU7H0J0L0t000`ZZZZ$IfkdNt$$Ifs4    T\S $` & 0    44 saf4000000`ZZZZ$Ifkdv$$Ifs4    T\S $  & 0    44 saf4000&1N1P1`ZZZZ$Ifkdx$$Ifs4    T\S $`  & 0    44 saf4P1R1T1Z1\111z22`^\^VPPP$If$Ifkdz$$Ifs4    T\S $    & 0    44 saf4\111<2>2z2|222222222222233333$3&3.303D3F3H3R3T3V3X3l3n3p3z3|333333333333jhUUj/hUUjahUUjhUUj)hUUjhUUjh6/!UmHnHuj6|hUUjhUU h6/!5\h6/!5>*\h6/!h6/!5\^J22222$Ifxkd|$$Ifs4    Z0 $`b   `&    0    44 saf4222222$Ifxkd}$$Ifs4     0 $ b   &   0    44 saf42223(3*3`ZZZZ$Ifkdn~$$Ifs4    T\S $       &   0    44 saf4*3,3.3V3~33`ZZZZ$Ifkd$$Ifs4    T\S $`     &   0    44 saf43333344`ZZZZZ$IfkdՂ$$Ifs4    T\S $  &   0    44 saf433333J4L444444444444444444445555&5(5*5456585:5N5P5R5\5^5f5h5|5~5555555555jhUUj?hUUjhUUj hUUjKhUUj׆hUUjhUU h6/!5\h6/!5>*\h6/!jh6/!UmHnHujhUU6444455`ZZZZ$Ifkd$$Ifs4    T\S $` `&    0    44 saf455585`5b5`ZZZZ$Ifkd$$Ifs4    T\S $  &    0    44 saf4b5d5f5555`ZZZZ$Ifkd$$Ifs4    T\S $`  &    0    44 saf455555555555666666d77777777777777777 88888*8,8@8B8D8N8P8R8T8h8j8l8v8x8888jђhUUj]hUUjhUUjhUUj[hUUh6/!5>*hUUjh6/!UmHnHujshUUh6/!jhUU75555677`ZZZZZ$Ifkd'$$Ifs4    T\S $  &    0    44 saf477778 8`ZZZZ$Ifkdώ$$Ifs4    T\S $` `&    0    44 saf4 8"8*8R8z8|8`ZZZZ$Ifkd$$Ifs4    T\S $  &   0    44 saf4|8~88888`ZZZZ$IfkdE$$Ifs4    T\S $`  &   0    44 saf4888888888888888889999999(9*92949H9J9L9V9X9Z9\9p9r9t9~999999999999999999ڹڮڣژڍjٛhUUjehUUjhUUj#hUUjUhUUjhUUjhUUh6/!jh6/!UmHnHujhUUjhUU78889,9.9`ZZZZ$Ifkd$$Ifs4    T\S $  &   0    44 saf4.90929Z999`ZZZZ$Ifkdɗ$$Ifs4    T\S $` &   0    44 saf4999999`ZZZZ$Ifkd $$Ifs4    T\S $  &   0    44 saf4999 :4:6:`ZZZZ$IfkdM$$Ifs4    T\S $`  &   0    44 saf49999: : ::":$:&:0:2:8:<:@:B:::; <<*<,<.<H<J<f<h<j<<<<<<<<<<<<<<<= = ==ɷxj hUUjhUUjwhUUjhUUjhUUh6/!5>*\h6/!5\^Jh6/!5CJ\ h6/!5\jhUUjh6/!UmHnHujhUUjhUUh6/!/6:8:::@:B:::;; <`^^^XRRRR$If$Ifkd$$Ifs4    T\S $    &   0    44 saf4 <0<2<4<6<H<l<Zkd]$$Ifs4    Z\ 6"$`b   `!  "  0    44 saf4$Ifl<n<v<<<<<<`ZZZZZZ$Ifkd+$$Ifs4     \ 6"$ b   ! " 0    44 saf4<<<<==:4444$Ifkd$$Ifs4    TֈU 6"$       !   "  0    44 saf4===Z=\=================>>>>> >">6>8>:>D>F>H>J>^>`>b>l>n>v>x>>>>>>>>>>>>>>j,hUUjhUUjhUUjvhUUjhUUj4hUUjh6/!UmHnHujthUU h6/!5\h6/!5>*\h6/!jhUU6=====>>Zkd$$Ifs4    T\U $`    `&   0    44 saf4$If>> >H>p>r>`ZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4r>t>v>>>>`ZZZZ$Ifkd^$$Ifs4    T\U $` &  0    44 saf4>>>>"??@`ZZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4>>>>>>>>>???? ?"??????@ @ @@@(@*@,@6@8@:@<@P@R@T@^@`@p@r@@@@@@@@@@@@@@@@jXhUUjhUUjhUUjhUUjhUUh6/!5>*nhUUjh6/!UmHnHujhUUh6/!jhUU5@@@:@b@d@`ZZZZ$IfkdV$$Ifs4    T\U $` `&   0    44 saf4d@f@p@@@@`ZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4@@@@AA`ZZZZ$Ifkd̴$$Ifs4    T\U $` &  0    44 saf4@@@@@@@AAAAA"A$A8A:A*ܸhUUjhhUUjhUUh6/!jh6/!UmHnHujhUUj&hUU4AA"AJArACFC`ZZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4FCHCJCrCCC`ZZZZ$IfkdĹ$$Ifs4    T\U $` `&  0    44 saf4CCCCCC`ZZZZ$Ifkd$$Ifs4    T\U $  & 0    44 saf4CCCCCCCCCCCCCDDD D"D$D&D:DDHDJDXDZDnDpDrD|D~DDDDDDDDDDDDDDDDDDDDDDEE h6/!5\jThUUjhUUj hUUjhUUjhUUjxhUUjhUUh6/!jh6/!UmHnHujhUU6CCC$DLDND`ZZZZ$Ifkd,$$Ifs4    T\U $` & 0    44 saf4NDPDXDDDD`ZZZZ$Ifkd`$$Ifs4    T\U $  & 0    44 saf4DDDDDE`ZZZZ$Ifkd$$Ifs4    T\U $`  & 0    44 saf4EEE E E$EEFFF`^^^XRRRR$If$Ifkd$$Ifs4    T\U $    & 0    44 saf4 E E E$EEBFFFFFFFFFFF&G(GDGFGHGTGVGjGlGnGxGzG|G~GGGGGGGGG"H$H8H:H*\h6/!h6/!5\^J h6/!5\h6/!5CJ\/FFFFFFFZkd$$Ifs4    Z\ 6"$`b   `!  "  0    44 saf4$IfFFG GGG&GJG`ZZZZZZ$IfkdV$$Ifs4     \ 6"$ b   ! " 0    44 saf4JGLGTG|GG"H:4444$Ifkd$$Ifs4    TֈU 6"$       !   "  0    44 saf4"HJHLHNHvHHHZkd$$Ifs4    T\U $`    `&   0    44 saf4$IfdHfHhHrHtHvHxHHHHHHHHHHHHHHHHHHHHIIIII$I&I(I*I>I@IBILINI\I^IrItIvIIIIIIIIIIIڹڮڣژڍjhUUj%hUUjWhUUjhUUjhUUjhUUjhUUh6/!jh6/!UmHnHujhUUj_hUU6HHHHHH`ZZZZ$IfkdG$$Ifs4    T\U $  &  0    44 saf4HHI(IPIRI`ZZZZ$Ifkd$$Ifs4    T\U $` &  0    44 saf4RITI\IIIhJJ`ZZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4I*JhJjJ~JJJJJJJJJJJJJJJJJJJJJK K KKKKK0K2K4K>K@KHKJK^K`KbKlKnKpKrKKKKKKKKKjhUUjQhUUjhUUjhUUjAhUUjhUUjh6/!UmHnHuj hUUjhUUh6/!h6/!5>*\5JJJJJJ`ZZZZ$Ifkd$$Ifs4    T\U $` `&   0    44 saf4JJJKBKDK`ZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4DKFKHKpKKK`ZZZZ$Ifkd$$Ifs4    T\U $` &  0    44 saf4KKKKKMM`ZZZZZ$Ifkd9$$Ifs4    T\U $  &  0    44 saf4KKKKKKKKKKKKKRMMMMMMMMMMMMMMMMMMMMN NNN.N0N2NN@NBNVNXNZNdNfNnNpNNNڼڱڦڛڐڅjhUUjhUUjohUUjhUUj;hUUj{hUUh6/!5>*hUUh6/!jh6/!UmHnHujhUUjhUU4MMMM NN`ZZZZ$Ifkd$$Ifs4    T\U $` `&  0    44 saf4NNN@NhNjN`ZZZZ$Ifkd#$$Ifs4    T\U $  & 0    44 saf4jNlNnNNNN`ZZZZ$IfkdW$$Ifs4    T\U $` & 0    44 saf4NNNNNNNNNNNNNNNNNNNNO O OOO O"O6O8O:ODOFOHOJO^O`ObOlOnOtOxO|O~OOPPQQ.Q0Q2QLQ姞j?hUUh6/!5>*\h6/!5\^Jh6/!5CJ\ h6/!5\jhUUj hUUjKhUUjhUUjhUUh6/!jh6/!UmHnHujhUU3NNNNOO`ZZZZ$Ifkd$$Ifs4    T\U $  & 0    44 saf4OO OHOpOrO`ZZZZ$Ifkd$$Ifs4    T\U $`  & 0    44 saf4rOtOvO|O~OOPPQQ`^^^XRRRR$If$Ifkd$$Ifs4    T\U $    & 0    44 saf4 Q4Q6Q8Q:QLQpQZkd$$Ifs4    Z\ 6"$`b   `!  "  0    44 saf4$IfLQNQjQlQnQQQQQQQQQQQQQQQ RRRRRR^R`RRRRRRRRRRRRRRRRRSS SSS$S&S:SjhUUjhUUjhUU h6/!5\h6/!5>*`hUUjh6/!UmHnHujhUUjhUUj hUUh6/!jhUU2pQrQzQQQQQQ`ZZZZZZ$Ifkd$$Ifs4     \ 6"$ b   ! " 0    44 saf4QQQQRR:4444$IfkdA$$Ifs4    TֈU 6"$       !   "  0    44 saf4RRRRRSSZkd>$$Ifs4    T\U $`    `&   0    44 saf4$IfSS$SLStSvS`ZZZZ$Ifkdr$$Ifs4    T\U $  &  0    44 saf4:SSHSJSLSNSbSdSfSpSrSzS|SSSSSSSSSSSSSSSSSSSSSTTTT"T$T&TTTTTTTTUUUU$Uڹڮڣڛډj8hUU h6/!5\h6/!5>*hUUjPhUUjhUUjhUUj@hUUh6/!jh6/!UmHnHujhUUjhUU4vSxSzSSSS`ZZZZ$Ifkd$$Ifs4    T\U $` &  0    44 saf4SSSS&TT U`ZZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4 U UU6U^U`U`ZZZZ$Ifkd$$Ifs4    T\U $` `&   0    44 saf4$U&U(U2U4U6U8ULUNUPUZU\UlUnUUUUUUUUUUUUUUUUUUUUUUVVVVVV V4V6V8VBVDVFVHV\V^V`VjVlVnVڹڮڣژڍj2hUUjhUUjhUUj|hUUjhUUj:hUUjlhUUh6/!jh6/!UmHnHujhUUjhUU6`UbUlUUUU`ZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4UUUUVV`ZZZZ$Ifkd"$$Ifs4    T\U $` &  0    44 saf4VVVFVnV X2X`ZZZZZ$Ifkdd$$Ifs4    T\U $  &  0    44 saf4nVW X X X"X$X.X0X6X8XLXNXPXZX\X^X`XtXvXxXXXXXXXXXXXXXXXXXXXXYY YYYY&Y(Y*Y4Y6YDYFYZYjB hUUj hUUj hUUj hUUjhUUjfhUUjh6/!UmHnHujhUUjhUUh6/!h6/!5>*\52X4X6X^XXX`ZZZZ$Ifkd$$Ifs4    T\U $` `&  0    44 saf4XXXXXX`ZZZZ$IfkdN$$Ifs4    T\U $  & 0    44 saf4XXXY8Y:Y`ZZZZ$Ifkd $$Ifs4    T\U $` & 0    44 saf4:Y*\h6/!5\^Jh6/!5CJ\ h6/!5\jhUUj6hUUjvhUUh6/!jh6/!UmHnHujhUUjhUU.YYYYYY`ZZZZ$Ifkd$$Ifs4    T\U $`  & 0    44 saf4YYYYYZJZZZZ`^^^XRRRR$If$Ifkd$$Ifs4    T\U $    & 0    44 saf4 ZZZZZZZZkd$$Ifs4    Z\ 6"$`b   `!  "  0    44 saf4$IfZZZ[[ [[ [`ZZZZZZ$Ifkd$$Ifs4     \ 6"$ b   ! " 0    44 saf4[[%[&[0[1[\ \ \\\$\&\(\2\4\6\v\x\\\\\\\\\\\\\]]] ]] ]"],].]<]>]R]T]V]`]b]d]f]z]|]~]]]]jkhUUjhUUj)hUUjhUUjhUU h6/!5\h6/!5>*hUUjh6/!UmHnHujhUUh6/!jhUU6 [![%[\6\\:4444$Ifkdl$$Ifs4    TֈU 6"$       !   "  0    44 saf4\\\\]0]2]Zkdi$$Ifs4    T\U $`    `&   0    44 saf4$If2]4]<]d]]]`ZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4]]]]]]`ZZZZ$Ifkd$$Ifs4    T\U $` &  0    44 saf4]]]]]]]]]]]]]]]]^^^^^^^,^.^0^:^<^>^^^^__ _____2_4_6_@_B_D_F_Z_\_^_h_j_z_|__j$hUUj#$hUUjc"hUUh6/!5>*!hUUj{!hUUjhUUjh6/!UmHnHuj9hUUh6/!jhUU5]]]^>^^_`ZZZZZ$Ifkd! $$Ifs4    T\U $  &  0    44 saf4___D_l_n_`ZZZZ$Ifkd"$$Ifs4    T\U $` `&   0    44 saf4n_p_z____`ZZZZ$Ifkd %$$Ifs4    T\U $  &  0    44 saf4_____________________`````,`.`B`D`F`P`R`T`V`j`l`n`x`z`|`abb$b&b(b2b4b:b*]+hUUj*hUUj)hUUj(hUUj&hUUh6/!jh6/!UmHnHujhUUje&hUU4____ `"``ZZZZ$IfkdM'$$Ifs4    T\U $` &  0    44 saf4"`$`,`T`|`b6b`ZZZZZ$Ifkd)$$Ifs4    T\U $  &  0    44 saf46b8b:bbbbb`ZZZZ$IfkdE,$$Ifs4    T\U $` `&  0    44 saf4RbTb^b`bbbdbxbzb|bbbbbbbbbbbbbbbbbbbccccccc*c,c.c8c:cHcJc^c`cbclcncpcrcccccccccj4hUUj-4hUUjm2hUUj1hUUj90hUUj/hUUj.hUUh6/!jh6/!UmHnHujhUU7bbbbbb`ZZZZ$Ifkdy.$$Ifs4    T\U $  & 0    44 saf4bbbcc`ZZZZ$Ifkd0$$Ifs4    T\U $` & 0    44 saf4>c@cHcpccc`ZZZZ$Ifkd2$$Ifs4    T\U $  & 0    44 saf4cccccc`ZZZZ$Ifkd5$$Ifs4    T\U $`  & 0    44 saf4ccccccccccccccccddeeeeeeeeeffffgggg$g&g(gȿȶڰ}uj_j<hUUj9hUUh6/!5>*\jh6/!UmHnHsH uj8hUUmH sH h6/!mH sH jhUUmH sH  h6/!^Jh6/!5\^Jh6/!5CJ\ h6/!5\j6hUUh6/!jh6/!UmHnHujhUUja6hUU%cccccddee`^^^XRLR$If$If$IfkdI7$$Ifs4    T\U $    & 0    44 saf4eeeeeffg$Ifxkd 9$$Ifs4    ^0 $b   &    0    44 saf4ggg6g^g`g:4444$IfkdW:$$Ifs4    TֈU 6"$       `!  " 0    44 saf4(g2g4g6g8gLgNgPgZg\grgtgggggggggggggggggggghhh$h&h:hhHhJhLhNhbhdhfhphrhthhhhhi摊 h6/!5\h6/!5>*BU2UU?U?U<hUUj<hUUh6/!jhUUjh6/!UmHnHu5`grggggg4kdh=$$Ifs4    TֈU 6"$`     !   "0    44 saf4$Ifgggghh4kdt@$$Ifs4    TֈU 6"$  !    " 0    44 saf4$Ifh$hLhthhiiiFinipiZkdC$$Ifs4    T\U $` `& 0    44 saf4$If i i iiii i4i6i8iBiDiFiHi\i^i`ijilizi|iiiiiiiiiiiiiiiiiiiiiijjjjj.j0jDjFjHjRjTjVjXjڹڮڣژڍjvKhUUjIhUUjBIhUUjGhUUjGhUUjNEhUUjDhUUh6/!jh6/!UmHnHujhUUjChUU7piriziiii`ZZZZ$IfkdE$$Ifs4    T\U $  & 0    44 saf4iiii j"j`ZZZZ$IfkdG$$Ifs4    T\U $`  & 0    44 saf4"j$j.jVj~j$kLk`ZZZZZ$Ifkd*J$$Ifs4    T\U $  &  0    44 saf4Xjljnjpjzj|j~jjj$k&k:kkHkJkPkRkfkhkjktkvkxkzkkkkkkkkkkkkkkkkkkkkl&(*jRhUUUjPhUUj`PhUUjNhUUjNhUUj^LhUU h6/!5\h6/!5>*\jh6/!UmHnHujhUUjKhUUh6/!5LkNkPkxkkk`ZZZZ$IfkdL$$Ifs4    \U $` `&   0    44 saf4kkkkkk`ZZZZ$IfkdO$$Ifs4    \U $  &  0    44 saf4kl*RT`ZZZZ$IfkdHQ$$Ifs4    \U $`  &  0    44 saf4 FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for this entertainment at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       I Provision of facilities for making music Standard days and timings (please read guidance note 6)Please give a description of the type of facilities for making music that the club will be providing  FORMTEXT      Will the facilities for making music be indoors or outdoors or both  please tick (please read guidance note 2) Indoors FORMCHECKBOX Outdoors FORMCHECKBOX DayStartFinishBoth FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT      State any seasonal variations for the provision of facilities for making music (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for the provision of facilities for making music at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       J Provision of facilities for dancing Standard days and timings (please read guidance note 6)Please give a description of the type of facilities for dancing that the club will be providing  FORMTEXT      DayStartFinishWill the facilities for dancing be indoors or outdoors or both  please tick (please read guidance note 2) Indoors FORMCHECKBOX Outdoors FORMCHECKBOX Both FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT      State any seasonal variations for the provision of dancing facilities (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for the provision of dancing facilities at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       K Provision of facilities for entertainment of a similar description to that falling within i or j Standard days and timings (please read guidance note 6)Please give a description of the type of entertainment facility the club will be providing  FORMTEXT      DayStartFinishWill the entertainment facility be indoors or outdoors or both  please tick (please read guidance note 2)Indoors FORMCHECKBOX Mon FORMTEXT       FORMTEXT      Outdoors FORMCHECKBOX  FORMTEXT       FORMTEXT      Both FORMCHECKBOX Tue FORMTEXT       FORMTEXT      Please give further details here (please read guidance note 3)  FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT      State any seasonal variations for the provision of this entertainment facility (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for the provision of facilities for this entertainment at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       L Supply of alcohol Standard days and timings (please read guidance note 6)Will the supply of alcohol be for consumption (Please tick box) (please read guidance note 7) On the premises FORMCHECKBOX Off the premises FORMCHECKBOX DayStartFinishBoth FORMCHECKBOX Mon FORMTEXT       FORMTEXT      State any seasonal variations (please read guidance note 4)  FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Thur FORMTEXT       FORMTEXT      Non-standard timings. Where the club intends to use the premises for the supply of alcohol at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       M Hours club premises are open to the members and guests Standard days and timings (please read guidance note 6)State any seasonal variations (please read guidance note 4)  FORMTEXT      DayStartFinishMon FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Tue FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Wed FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Non standard timings. Where you intend the premises to be open to the members and guests at different times from those listed in the column on the left, please list (please read guidance note 5)  FORMTEXT      Thur FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Fri FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sat FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Sun FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       N Please highlight any adult entertainment or services, activities, or other entertainment or matters ancillary to the use of the club premises that may give rise to concern in respect of children (please read guidance note 8)  FORMTEXT       O Describe the steps you intend to take to promote the four licensing objectives: a) General  all four licensing objectives (b,c,d,e) (please read guidance note 9)  FORMTEXT       b) The prevention of crime and disorder  FORMTEXT       c) Public safety  FORMTEXT       d) The prevention of public nuisance  FORMTEXT       e) The protection of children from harm  FORMTEXT       Please tick yesI have made or enclosed payment of the fee FORMCHECKBOX I have enclosed the plan of the premises FORMCHECKBOX I have sent copies of this application and plan to the responsible authorities FORMCHECKBOX I have completed and enclosed the club declaration and enclose a copy of the club rules FORMCHECKBOX I understand that I must now advertise my application FORMCHECKBOX I understand that if I do not comply with the above requirements my application will be rejected FORMCHECKBOX  IT IS AN OFFENCE, LIABLE ON CONVICTION TO A FINE UP TO LEVEL 5 ON THE STANDARD SCALE, UNDER SECTION 158 OF THE LICENSING ACT 2003 TO MAKE A FALSE STATEMENT IN OR IN CONNECTION WITH THIS APPLICATION Part 3  Signatures (please read guidance note 10) I FORMTEXT       (Insert full name) make this application on behalf of the club and have authority to bind the club SignatureDate FORMTEXT      Capacity FORMTEXT       Address for correspondence associated with this application (please read guidance note 11)  FORMTEXT      Post town FORMTEXT      Post code FORMTEXT      Telephone number (if any) FORMTEXT      If you would prefer us to correspond with you by e-mail your e-mail address (optional)  FORMTEXT       Notes for Guidance Describe the premises. For example the type of premises, its general situation and layout and any other information which could be relevant to the licensing objectives. Where your application includes off-supplies of alcohol and you intend to provide a place for consumption of these off- supplies you must include a description of where the place will be and its proximity to the premises. Where taking place in a building or other structure please tick as appropriate. Indoors may include a tent. Please state type of activity to be authorised, if not already stated, and give relevant further details, for example (but not exclusively) whether or not music will be amplified or unamplified. For example (but not exclusively) where the activity will occur on additional days during the summer months. For example (but not exclusively), where you wish the activity to go on longer on a particular day e.g. Christmas Eve. Please give timings in 24 hour clock. (e.g. 16:00) and only give details for the days of the week when you intend the premises to be used for the activity. If the club wishes members and their guests to be able to consume alcohol on the premises please tick on, if the club wishes people to be able to purchase alcohol to consume away from the premises please tick off. If the club wishes people to be able to do both please tick both. Please give information about anything intended to occur at the premises or ancillary to the use of the premises which may give rise to concern in respect of children, regardless of whether you intend children to have access to the premises, for example (but not exclusively) nudity or semi-nudity, films for restricted age groups etc gambling machines etc Please list here steps you will take to promote all four licensing objectives together. The application form must be signed. This is the address which we will use to correspond with the club about this application.     PAGE  PAGE 1 *,@BDNP^`tvx46JLNXZ`bvxzjYhUUjXhUUjWhUUjUhUUh6/!5>*XUhUUjThUUjh6/!UmHnHujShUUh6/!jhUU5TV^4\`ZZZZZ$IfkdS$$Ifs4    \U $  &  0    44 saf4\^``ZZZZ$Ifkd@V$$Ifs4    I\U $` `&  0    44 saf4 `ZZZZ$IfkdtX$$Ifs4    I\U $  & 0    44 saf4 (*,68:<PRT^`fjnp2 "$&( ڽڥrګjڥh6/!5>*\jh6/!UmHnHsH uj(^hUUmH sH h6/!mH sH jhUUmH sH  h6/!^Jh6/!5\^Jh6/!5CJ\ h6/!5\jh\hUUj[hUUh6/!jh6/!UmHnHujhUUj4ZhUU&:bd`ZZZZ$IfkdZ$$Ifs4    I\U $`  & 0    44 saf4dfhnp2$`^^^XRLR$If$If$Ifkd\$$Ifs4    I\U $    & 0    44 saf4$&( >zzt$If$If$Ifxkd^$$Ifs4    p0 $`b  &    0    44 saf48:<>@BDTVXtvxz$&(hjľ;ͦ͛ͦ͐ͦwohͦ h6/!5\h6/!5>*ehUUjh6/!UmHnHuj ehUUjbhUUjhUUj-ahU5>*U\ h6/!^Jh6/!5\^Jh6/!h6/!5>*\^Jjm_hU5>*U\h6/!5>*\jhU5>*U\(>@BDVz`ZTTN$If$If$Ifkd_$$Ifs4    \ 6"$ b `!   "  0    44 saf4z|`ZZZZZZ$Ifkda$$Ifs4    j\ 6"$ b   ! " 0    44 saf4(:4444$Ifkdac$$Ifs4    TֈU 6"$        !   "  0    44 saf4 .0DFHRTVXlnpz| ڹڮڣژڍjnhUUjlhUUjBlhUUjtjhUUjjhUUj2hhUUjghUUh6/!jh6/!UmHnHujhUUjehUU7"$Zkdrf$$Ifs4    T\U $`    `&   0    44 saf4$If$&.V~`ZZZZ$Ifkdh$$Ifs4    T\U $  &  0    44 saf4`ZZZZ$Ifkdj$$Ifs4    T\U $`  &  0    44 saf40 2`ZZZZZ$Ifkd*m$$Ifs4    T\U $  &  0    44 saf4  ",.0   "$.068LNPZ\^`tvx(juhUUjshUUj`shUUjqhUUj,qhUUjlohUU h6/!5\h6/!5>*\jh6/!UmHnHujhUUjnhUUh6/!5246^`ZZZZ$Ifkdo$$Ifs4    T\U $` `&  0    44 saf4`ZZZZ$Ifkdr$$Ifs4    T\U $  & 0    44 saf4:<`ZZZZ$IfkdHt$$Ifs4    T\U $`  & 0    44 saf4(*,68FH\^`jlnpPRfhjtv|~ڼڱڦڛڐڅj&}hUUj|hUUjzhUUj~zhUUjxhUUh6/!5>*FnPx`ZZZZZ$Ifkd|v$$Ifs4    T\U $  &  0    44 saf4xz|`ZZZZ$Ifkd$y$$Ifs4    T\U $` `& 0    44 saf4(*`ZZZZ$Ifkdf{$$Ifs4    T\U $  & 0    44 saf4$&.0DFHRTVXlnpz|  ",.48<>圓h6/!5\^Jh6/!5CJ\ h6/!5\jƒhUUjNhUUjhUUjhUUjZhUUj~hUUh6/!jh6/!UmHnHujhUU3*,.V~`ZZZZ$Ifkd}$$Ifs4    T\U $`  & 0    44 saf4`ZZZZ$Ifkd$$Ifs4    T\U $  & 0    44 saf402`ZZZZ$Ifkd$$Ifs4    T\U $`  & 0    44 saf4246<>`^^^XRRR$If$Ifkd6$$Ifs4    T\U $    & 0    44 saf4     * , H J L V X b d                    !"!^!`!t!v!x!!!!!jhUU h6/!5\jhUUj4hUUjhUUjhUUjކhUUjh6/!UmHnHujhUUh6/!jhUUh6/!5>*\6 $Ifxkd$$Ifs4    0 $b   &  0    44 saf4      :4444$IfkdR$$Ifs4    hֈU u"$` ` `  `L   G  0    44 saf4 * N P R T 4kdx$$Ifs4    hֈU u"$     L G 0    44 saf4$IfT V X b   4kd$$Ifs4    hֈU u"$        L   G  0    44 saf4$If    ^!!!!!!!Zkd$$Ifs4    T\U $`    `&   0    44 saf4$If !!!!!!!!!!!!!!!!!" " """$"&"("2"4"<">"R"T"V"`"b"d"f"z"|"~""""""""""""""""""j hUUjhUUjʔhUUjVhUUjhUUjhUUjFhUUjh6/!UmHnHujhUUjҏhUUh6/!7!!!"6"8"`ZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf48":"<"d"""`ZZZZ$Ifkd$$Ifs4    T\U $` &  0    44 saf4"""""##`ZZZZZ$Ifkd>$$Ifs4    T\U $  &  0    44 saf4"r#t#############$$$$$$$($*$:$<$P$R$T$^$`$b$d$x$z$|$$$$$$$$$$$$$$$$$$$%j8hUUjĝhUUjhUUjhUUjhUUj@hUUjh6/!UmHnHujhUUjhUUh6/! h6/!5\h6/!5>*\6###$,$.$`ZZZZ$Ifkd$$Ifs4    T\U $` `&   0    44 saf4.$0$:$b$$$`ZZZZ$Ifkd($$Ifs4    T\U $  &  0    44 saf4$$$$$$`ZZZZ$Ifkdj$$Ifs4    T\U $` &  0    44 saf4$$$%<%& '`ZZZZZ$Ifkd$$Ifs4    T\U $  &  0    44 saf4%%%%%%%*%,%.%8%:%<%&&&&&&' '''&'('*'4'6'8':'N'P'R'\'^'l'n'''''''''''''''''ڼڱڦڛڐڅjhUUjVhUUjhUUj"hUUjhUUjhUUh6/!5>*zhUUh6/!jh6/!UmHnHujhUUjhUU4 '''8'`'b'`ZZZZ$Ifkdb$$Ifs4    T\U $` `&  0    44 saf4b'd'l''''`ZZZZ$Ifkd$$Ifs4    T\U $  & 0    44 saf4''''((`ZZZZ$Ifkdʥ$$Ifs4    T\U $` & 0    44 saf4''''''(((((( (4(6(8(B(D(F(H(\(^(`(j(l(t(v((((((((((((((((()****姞參{h6/!mH sH jhUUmH sH  h6/!^Jh6/!5\^Jh6/!5CJ\ h6/!5\jhUUj~hUUjhUUjJhUUjhUUh6/!jh6/!UmHnHujhUU/(((F(n(p(`ZZZZ$Ifkd$$Ifs4    T\U $  & 0    44 saf4p(r(t((((`ZZZZ$Ifkd2$$Ifs4    T\U $`  & 0    44 saf4((((()***`^^^XRLR$If$If$Ifkdf$$Ifs4    T\U $    & 0    44 saf4******++++ , ,,,,0,2,4,>,@,B,D,X,Z,\,f,h,~,,,,,,,,,,,,,,,ȸȭȸȢȸȉȸ~ȸsȸj5hUUjhUUjhUUjh6/!UmHnHuj3hUUjhUUjhUUh6/!5>*\h6/!h6/!mH sH jh6/!UmHnHsH ujhUUmH sH jhUUmH sH )****+++,$Ifxkd($$Ifs4    ^0 $b   &    0    44 saf4,,,B,j,l,:4444$Ifkdt$$Ifs4    TֈU 6"$       `!  " 0    44 saf4l,~,,,,,4kd$$Ifs4    TֈU 6"$`     !   "0    44 saf4$If,,,,,-- -"-$-0-2-F-H-J-T-V-X-Z-n-p-r-|-~-----....".$.*.,.@.B.D.N.P.R.T.h.j.l.v.x....ڹڱڟڔډjkhUUjhUUj7hUU h6/!5\h6/!5>*÷hUUjOhUUjhUUh6/!jh6/!UmHnHujhUUjhUU2,,,-&-(-4kd$$Ifs4    TֈU 6"$  !    " 0    44 saf4$If(-0-X---&.(.*.R.z.|.Zkd$$Ifs4    T\U $` `& 0    44 saf4$If |.~.....`ZZZZ$Ifkdߺ$$Ifs4    T\U $  & 0    44 saf4.................///////(/*/:/*hUUjhUUjӾhUUj_hUUjhUUh6/!jh6/!UmHnHujhUUj+hUU4.../,/./`ZZZZ$Ifkd$$Ifs4    T\U $`  & 0    44 saf4./0/:/b//d00`ZZZZZ$IfkdG$$Ifs4    T\U $  &  0    44 saf4000000`ZZZZ$Ifkd$$Ifs4    \U $` `&   0    44 saf4000000000000001111111*1,1.181:1B1D1X1Z1\1f1h1j1l111111111111111111111ڹڮڣژڍjuhUUjhUUj3hUUjhUUjhUUj}hUUjhUUh6/!jh6/!UmHnHujhUUj;hUU60001<1>1`ZZZZ$Ifkd#$$Ifs4    \U $  &  0    44 saf4>1@1B1j111`ZZZZ$Ifkde$$Ifs4    \U $`  &  0    44 saf41111133`ZZZZZ$Ifkd$$Ifs4    \U $  &  0    44 saf41v3333333333333444 44 4"4,4.4<4>4R4T4V4`4b4d4f4z4|4~4444444444444444444 h6/!5\jhUUjhUUjQhUUjhUUjhUUjhUUjh6/!UmHnHujhUUjhUUh6/!h6/!5>*\433340424`ZZZZ$Ifkd]$$Ifs4    \U $` `&  0    44 saf42444<4d444`ZZZZ$Ifkd$$Ifs4    \U $  & 0    44 saf4444444`ZZZZ$Ifkd$$Ifs4    \U $`  & 0    44 saf44444455D6F6f6`^^^XRRRR$If$Ifkd$$Ifs4    \U $    & 0    44 saf4 444556f6h66666666677$7&7(74767J7L7N7X7Z7\7^7r7t7v7777777888 8"8(8*8>8@8әәәxjhUUjhUUjfhUUjh6/!UmHnHujhUUjhUUjhUUjEhUUjhUUh6/!5>*\h6/!h6/!5\^J h6/!5\h6/!5CJ\/f6666666Zkd$$Ifs4    Z\ 6"$`b   `!  "  0    44 saf4$If6666667*7`ZZZZZZ$Ifkd$$Ifs4     \ 6"$ b   ! " 0    44 saf4*7,747\777:4444$IfkdG$$Ifs4    TֈU 6"$       !   "  0    44 saf47$8&8(8P8x8z8ZkdD$$Ifs4    T\U $`    `&  0    44 saf4$If@8B8L8N8P8R8f8h8j8t8v888888888888888888888999999&9(96989L9N9P9Z9\9^9`9t9v9x999999jhUUj,hUUjlhUUjhUUj8hUUjhUUjhUUh6/!jh6/!UmHnHujhUU7z8|88888`ZZZZ$Ifkdx$$Ifs4    T\U $  & 0    44 saf48889*9,9`ZZZZ$Ifkd$$Ifs4    T\U $` & 0    44 saf4,9.969^999`ZZZZ$Ifkd$$Ifs4    T\U $  & 0    44 saf4999999`ZZZZ$Ifkd$$Ifs4    T\U $`  & 0    44 saf499999999999999:::::::(:*:,:6:8:::;;;;;;;;;;< < <<<<<0<2<4<><@<N<P<d<f<ڹڱڦڛڐڅj~hUUjhUUjJhUUj|hUUh6/!5>*hUUjhUUjhUUh6/!jh6/!UmHnHujhUUj`hUU4999:::;;`ZZZZZ$IfkdH$$Ifs4    T\U $  &  0    44 saf4;;;<B<D<`ZZZZ$Ifkd$$Ifs4    T\U $` `& 0    44 saf4D<F<N<v<<<`ZZZZ$Ifkd2$$Ifs4    T\U $  & 0    44 saf4f<h<r<t<v<x<<<<<<<<<<<<<<<<<<<<=====$=&=(=*=>======================UUUU&UUU6/!6/!ԱU7<<<<<<`ZZZZ$Ifkdf$$Ifs4    T\U $`  & 0    44 saf4<<=(=P=R=`ZZZZ$Ifkd$$Ifs4    T\U $  & 0    44 saf4R=T=V=~===`ZZZZ$Ifkd$$Ifs4    T\U $` & 0    44 saf4====>>`ZZZZ$Ifkd$$Ifs4    T\U $  & 0    44 saf4===========>> >> >">,>.>0>2>F>H>J>T>V>\>^>`>d>f>>D?~?????????@@0@2@4@>@@@B@D@X@ڹڰژڍڂj5hUUjhUUh6/!5>*\h6/!5CJ\ h6/!5\h6/!5\^JjhUUjhUUjhUUh6/!jh6/!UmHnHujhUUjNhUU3>>>0>X>Z>`ZZZZ$Ifkd6$$Ifs4    T\U $`  & 0    44 saf4Z>\>^>d>f>>D???`^^^XRRR$If$Ifkdj$$Ifs4    T\U $    & 0    44 saf4????$Ifxkd*$$Ifs4    Z0 $`b   `&    0    44 saf4???@@@$Ifxkd $$Ifs4     0 $ b   &   0    44 saf4@@@B@j@l@`ZZZZ$Ifkd$$Ifs4    T\S $       &   0    44 saf4X@Z@\@f@h@p@r@@@@@@@@@@@@@@@@@@@@@@ A AAAA"A$A8A:A*hUUjuhUUjh6/!UmHnHujhUUjhUUh6/!4AAAA$BCC`ZZZZZ$Ifkd$$Ifs4    T\S $`  &   0    44 saf4CCCD0D2D`ZZZZ$Ifkd$$Ifs4    T\S $  `&  0    44 saf42D4D6D^DDD`ZZZZ$Ifkd $$Ifs4    T\S $`  & 0    44 saf4tDvDxDDDDDDDDDDDDDDDDDDDDEE EEEE&E(E*E4E6EDEFEZE\E^EhEjElEnEEEEEEEEEEEEEEEڹڮڣژڍj!hUUjahUUjhUUj-hUUjhUUjhUUjhUUh6/!jh6/!UmHnHujhUUj hUU7DDDDDD`ZZZZ$Ifkd9 $$Ifs4    T\S $  & 0    44 saf4DDDE8E:E`ZZZZ$Ifkdm$$Ifs4    T\S $`  & 0    44 saf4:EI@IIIIIIIJ J JJbJdJxJzJ|JJJJJJJJJJJ&K(KK@KJKLKKKKKKKKKKKKKӺӺӺӺӺj hUUjhUUjhUUjhUUjh6/!UmHnHujhUUjhUU h6/!^Jh6/!5CJ\h6/! h6/!5\jhUU^J3HHHH>I@IIJ$If !bkd3$$Ifs0$    044 saJJJbJJJ1bkdC$$Ifs$    044 sa$Ifbkd;$$Ifs$    044 saJJJJJJ&KNK[$bkdK$$Ifs$    044 sa$IfNKPKRKKK$If[$bkdS $$Ifs$    044 saKKKKKK-ckd!$$Ifs4$    044 saf4 $$Ifa$bkd[!$$Ifs    $0    44 saKKLLNLjLlLnLrLtLLLLLLLLMMMMMMMjNlNNNNNNOOO O"O&O(OOO P PPPQQ RRRRRR*R阒鉘h6/!5\^J h6/!^J h6/!5\j{(hUUjE'hUUj&hUUj$hUUj#hUUjs"hUUjhUUh6/!$jhUhUCJUmHnHu3KKLLpLrLvLLLikd"$$IfsF"$    T    "    0    44 sa$If $$Ifa$LLLMMxoii$If $$Ifa$kd$$$IfsF"$    T    "    0    44 saMMMjNNxoii$If $$Ifa$kdO%$$IfsF"$    T    "    0    44 saNNNO$Oxoii$If $$Ifa$kd&$$IfsF"$    T    "    0    44 sa$O&O*OOPxoii$If $$Ifa$kd'$$IfsF"$    T    "    0    44 saPPPQQRRRRjR S S S"S$Ifmkd'*$$If0}$f"04a"S$S.SVSzz$If~kd*$$Ifs    0N$  0    22 V4+4 saVSXSjSSzz$If~kd:,$$Ifs    0N$0    22 V4+4 saSSSLTtT~xr$If $If~kd-$$Ifs    0N$ 0    22 V4+4 satTvTTTTT$Ifekd.$$Ifs4    p$0    44 saf4TTTTTTTTTTTTTT$U&U:UUHUJUNUUUVVV V"V,VTVleneretexeze~eeeeeeeμʴʩδʐʇ{{{{w{w{hUhdKjhdKUh6/!5\^Jj2hUUjh6/!UmHnHujx1hUUjhUUj/hU5U\h6/! h6/!5\ jh6/!5U\mHnHujhU5U\j/hU5U\+TT$ULUe_Y$If$Ifkdp0$$Ifs    \Z$) 0    44 saLUNUU$V$Ifskd1$$Ifs    0 $ 0    44 sa$V&V(V,VRVTVdY6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH H`H skNormal CJOJQJ_HaJmH sH tH <@< sk Heading 1$@&mH sH B@B sk Heading 2$@&5\mH sH F@F sk Heading 3 $@&a$5\mH sH >@> sk Heading 4$@& 5CJ\B@B sk Heading 5$@&5\mH sH F@F sk Heading 7$@&5>*\mH sH N @N sk Heading 9 $@&5CJOJQJ\mH sH DA`D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List :Q@: sk Body Text 3mH sH >O> skText d[$5\mH sH 2B@2 sk Body Textx4 @"4 skFooter !.)@1. sk Page Number4@B4 U0Header B#JQJ U0 Header CharCJOJQJaJmH sH tH PK![Content_Types].xmlj0Eжr(΢Iw},-j4 wP-t#bΙ{UTU^hd}㨫)*1P' ^W0)T9<l#$yi};~@(Hu* Dנz/0ǰ $ X3aZ,D0j~3߶b~i>3\`?/[G\!-Rk.sԻ..a濭?PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!Ptheme/theme/theme1.xmlYOo6w toc'vuر-MniP@I}úama[إ4:lЯGRX^6؊>$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3ڗP 1Pm \\9Mؓ2aD];Yt\[x]}Wr|]g- eW )6-rCSj id DЇAΜIqbJ#x꺃 6k#ASh&ʌt(Q%p%m&]caSl=X\P1Mh9MVdDAaVB[݈fJíP|8 քAV^f Hn- "d>znNJ ة>b&2vKyϼD:,AGm\nziÙ.uχYC6OMf3or$5NHT[XF64T,ќM0E)`#5XY`פ;%1U٥m;R>QD DcpU'&LE/pm%]8firS4d 7y\`JnίI R3U~7+׸#m qBiDi*L69mY&iHE=(K&N!V.KeLDĕ{D vEꦚdeNƟe(MN9ߜR6&3(a/DUz<{ˊYȳV)9Z[4^n5!J?Q3eBoCM m<.vpIYfZY_p[=al-Y}Nc͙ŋ4vfavl'SA8|*u{-ߟ0%M07%<ҍPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 +_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!Ptheme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] b   (*,/ MY |"^%&)V+J-0\13589=>@CEdHIKNLQ:S$UnVZY[]_Rbc(giXj* (!"%'*,.014@89f<=X@AtDEHK*RTee6;AFGKQ\cgkpuz37;?DHLQW[`dhlptx}V Z xX4 lk=,jyB| b !8"""B#X%% &`&&'((D)***L+|,,0--//H000P1222*3345b557 8|88.9996: <l<<=>r>>@d@@AFCCCNDDEFFJG"HHHRIJJDKKMNjNNOrOQpQQRSvSS U`UUV2XXX:YYYZZ [\2]]]_n__"`6bbb>cceg辱i"kk$>$2<x*2  T  !8""#.$$$ 'b''(p((*,l,,(-|.../00>113244466*7788,999;<<<R==>>??@ٴAC2ͼD:EEFHJKKLMN$?45689:<=>@ABCEFGIJKMNOPRSTUVXYZ\]^_abcefgijkmnoqrsuvwyz{|~ )5;Xdj-9?LX^iu{"(o ".02>@BNPR^`bnpr~ "$024@BDPRT`bdpr@ L R   D T * : o  : J g w '-/;A+13?E(.6BHJV\(4:>JPR^dlx~ 07CIKW] !-3;GMO[a %*6<>JPXdjlx~GSY]ioq} !#/5"'39;GMUagiu{ $*,8>COUWcir~amsw $)5;=IOWcikw} \hnr~   !!!!!!-!3!5!A!G!"+"1"5"A"G"I"U"["c"o"u"w"""""""""""""""""""# #### $#$3$:$F$L$N$Z$`$$$$$$$$$$$$$$% %%%"%$%0%6%>%J%P%R%^%d%%%%%%%%%& &&&&)&/&4&@&F&H&T&Z&b&n&t&v&&&X'd'j'n'z''''''''''''''''''(( ((( (,(2(4(@(F()()6)F)`)p)w))))))))))*****"*.*4*6*B*H*M*Y*_*a*m*s*{******+ +++#+)+++7+=+F+R+X+Z+f+l+q+}+++++++++++,,,,,,,,,,,,,,,----$-*-2->-D-F-R-X-]-i-o-q-}--V.f.t........../(/./2/>/D/F/R/X/`/l/r/t///////////////:0F0L0P0\0b0d0p0v0000000000000000000111111112 222!2-23282D2J2L2X2^2f2r2x2z22222222233324B4I4U4[4]4i4o4{4444444444444444;5G5M5Q5]5c5e5q5w5555555555555555555T6`6f6j6v6|6~666666666666666667777777778888 8,82848@8F8K8W8]8_8k8q8@9L9R99999:':.:::@:B:N:T::::::::::::::::;;;;$;*;2;>;;;;;;;;;;;;;< <<< <,<2<7<C<I<K<W<]<e<q<w<y<<<j=v=|===================>>>>'>->2>>>D>F>R>X>?)?/??????@ @@@@*@0@q@}@@@@@@@@@@@@@@@@@@AAAA A"A.A4AAAAAAAAAAAAAAAB BBBB*B0B8BDBJBLBXB^B4C@CFCJCVC\C^CjCpCxCCCCCCCCCCCCCCCCCCCDDDD"DE+E1EEEEEEEEEFFF!F'F)F5F;FCFSFZFfFlFnFzFFFFFFFFFFFGGGG%G+G0G mq &&A+E+z0~055< <AADDZG^GLLQQTT]]xbzb{b}b~bbbbbbb:?6:TTXX^^xbzb{b}b~bbbbbbb33333wbxbbbbf HEx^w1-lKlGCcR j:F#3L$S H|,J>00r        w                                   2                                                                                r        RMU6/!I="XHRJUQ`B`D`F`H`J`L`P`R`T`V`X`@`\`^```b`d`f`h`j`UnknownG*Ax Times New Roman5Symbol3. *Cx ArialKBlissCourier New;Wingdings?= *Cx Courier NewA BCambria Math"qh",",S2S2!`20FbFb 2X  $P6/!.!xxH          Oh+'0 px  Normal1Microsoft Office Word@@l@lS՜.+,0 `hpx  2Fb  Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !#$%&'()2Root Entry Fp24Data 31Table*zWordDocument7SummaryInformation(DocumentSummaryInformation8"CompObjy  F'Microsoft Office Word 97-2003 Document MSWordDocWord.Document.89q