Fill and Sign the Edesign Curriculum Answer Key Form

L.C.V.S Enterprises Ltd Application for Workshop/Unit at Aire Street or Dock Street Workshops Date of application___________________ FULL NAME OF PERSON WHO WILL BE RESPONSIBLE FOR THE TENANCY: _____________________________________________________________________ HOME ADRESS: _______________________________________________________________________________ _______________________________________________________________________________________________ POST CODE_________________________ HOME (Landline) TELEPHONE NO. _______________________________ MOBILE TELEPHONE NO: __________________________________ WHEN WOULD YOU LIKE TO TAKE UP OCCUPANCY?_______________________ OCCUPANCY COMMENCEMENT DATE: _____________________________(LCVS USE ONLY) PREFERRED SIZE OF UNIT/WORKSHOP REQUIRED (SQUARE FEET): _____________________________________ TYPE OF BUSINESS: _____________________________________________S.I.C.______________________________ TRADING NAME OF YOUR BUISINESS: ______________________________________________________________________________ IS YOUR BUSINESS “NEW” OR “ESTABLISHED”? _________________________ IF “ESTABLISHED”- FOR HOW LONG? _________________________________________________________ NUMBER OF OCCUPANTS/EMPLOYEES who will be working in the unit: __________________ DETAILS and NUMBER OF ANY MACHINES/EQUIPMENT YOU WILL USE: _____________________________________________________________________________________________ ALL PORTABLE ELECTRICAL ITEMS BROUGHT ONTO LCVS PREMISES MUST BE P.A.T. TESTED HAVE YOUR ITEMS BEEN TESTED? YES/NO (PLEASE INDICATE) IF YES - PLEASE PROVIDE A COPY OF THE PAT REPORT IF NO – LCVS WILL ARRANGE FOR ITEMS TO BE TESTED AT YOUR EXPENSES ANY MACHINES WHICH CREATE? :NOISE: SMELL: SMOKE: FUMES: VIBRATION. Details of machinery_________________________________________________________________________________ ANY USE OF MATERIALS, MACHINES AND/OR SUBSTANCES WHICH CREATE? : SMELLS SMOKE FUMES HAZARDS INSURERS NAME & ADDRESS : _________________________________________________________________ _______________________________________________________________________________________________ A. LOSS OF PROPERTY/EQUIPMENT: _______________ B. PUBLIC LIABILITY:_____________________________ C. EMPLOYERS LIABILITY (IF YOU HAVE EMPLOYEES) YOU WILL BE RESPONSIBLE FOR FIRE SAFETY WITHIN YOUR WORKSHOP UNIT, YOU WILL NEED TO ENSURE YOU HAVE THE CORRCT FIRE EXTINGUISHERS IN PLACE IN THE UNIT ONCE YOU TAKE UP OCCUPANCY BANK DETAILS: BANK NAME & ADDRESS____________________________________________________________________ ________________________________________________________________________________________ PLEASE GIVE THE NAME AND ADDRESS OF ONE REFEREE. _______________________________________________________________________________________________ _______________________________________________________________________________________________ Please tell us why the Board of Trustees should consider your application for a workshop/unit at Aire Street or Dock Street premises. When considering applications for tenancies, LCVS Enterprises Ltd do not discriminate against any applicant for any reason that is not directly relevant to the normal commercial considerations of a workshop tenancy. Please return completed form to: LCVS Board of Directors, C/o Dock Street Workshops, 30-38 Dock Street, Leeds LS10 1JF If you have any questions or would like to look at any vacant units contact the LCVS Manager Tel: 0113 2465021 or Email: lcvsenterprises@btconnect.com