Responsible Retailer Award Scheme

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					                                   Responsible Retailer Award Scheme
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                                             Application Form
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                                    Please complete in full

  Name of Applicant :

  Name of Business :

  Address with Post Code:


  Telephone:
  Fax:
  Email:
  Number of employees:

            Please tick relevant boxes                                                                     Yes   N/A

  My premises is licensed with the licensing authority……………………………………………………………

  My premises Licence summary is display on the premises…………………………………………………….
                                             Yes N/A             Yes N/A               Yes N/A
  We display the statutory notices Tobacco             Alcohol             Fireworks

  My staff and I ask the persons their age and for ID, we take all reasonable steps that we are required
  to ask for evidence of the person's age i.e. an appropriate and valid proof of age document, such as:
  Passport, Photo Driving Licence, Citizen-Card ,Validate Card If in any doubt We refuse sale……………..


  My staff and I will encourage our customers to nominate us as a Responsible Retailer……………………

  We encourage Challenge 21or 25 Policy…………………………………………………………………………


  ===========================================================

  I do fulfil the above criteria

  I would like to be considered for the Responsible Retailer Award

   Signature of applicant:                                                       Date:

				
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Description: Responsible Retailer Award Scheme