Where the applicant for the licence or the licensee to whom that notice is given wishes to appeal from the decision to which the notice relates, he shall, within the time prescribed by subsection (1) of section 23 of the Act, give to the Minister notice of appeal in the form in the Schedule hereto, and shall specify therein the name of the person whom he has appointed to act as assessor on his behalf on the Board of Appeal, and that assessor shall give in writing his consent to act.