Register yourself with Brakspear pubs

Registration form

For enquiries please contact Helen Mozley on
01491 570214 or helenmozley@brakspear.co.uk

	Applicant	Partner
Name
Address
Date of birth
National insurance number
Mobile phone number
Email address
Style of outlet interested in: Food led tavern Food led inn with rooms Drinks led local Community pub
Number of bedrooms required
Any particular area
Previous experience
Credit references: (Please note that we will run a credit check before any firm offer of a pub is made to you)
Agreed: Please tick if agreed
Available capital: Unborrowed Borrowed Total

Declaration: Please tick if agreed.

I hereby confirm that the details herein are correct and understand it will be used for credit vetting purposes and I therefore give my authority for personal and credit information to be released directly to the Company. I understand all personal information will be treated in strict confidence and be handled in accordance with the Data Protection Act 1984. By retaining this form via email I understand I am agreeing to the above declaration.

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Brakspear Pub Company, The Bull Courtyard, Bell Street, Henley on Thames, Oxon, RG9 2BA. Telephone 01491 570200 Fax 01491 570201 Email information@brakspearpubs.co.uk

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