BOOK A ROOM

Applicant Name *

Organisation Name *

ABN/ Incorporation Number (if applicable) *

Postal Address *

Telephone/Mobile Number *

Your Email (required)

Hire category (community/commercial) *

To *

From *

Date of Booking *

Start Time of Booking

Finish Time of Booking

Duration of Booking (total number of hours):

Purpose of Hire/ Nature of Activity:

Estimated Number of Attendees

Please specify if WIFI is required or not:

Required Area / Sections of the Centre

Certificate of Currency for Public Liability must be attached to Application Form

Bond Refund: The bond will be refunded by cheque. The cheque will be issued in the name of applicant

Acknowledgement : I acknowledge that
I have read and understood the Conditions of HireWhere the hirer is a company or incorporation association, I am authorised by the hirer to complete the application form on the hirer's behalfI am personally responsible for ensuring that the hirer complies with the Conditions of Hire and will be held accountable if any breach of these conditions occurBond will be forfeited after 6 months if not claimed

Name

Signature

Date of Application