Facility Hire

Applicants Details
Person responsible for payment and liability
Facilities Being Hired*
- Multi Purpose Hall
- Library Theatre
- Primary Undercover area
- Staffroom
Company Name*
Applicants Name*
First Last
Applicants Home Address*
Street Address Address Line 2 City State Post Code Country
Applicants Mobile Number*
Applicants Email Address*
Type of Identification*
- Drivers Licence
- Passport
Please note a copy of identification must be included with this application.
Drivers Licence number*
Passport number*
Hirer Details
Person/s responsible for event
First Name*
First Last
Address*
Street Address Address Line 2 City State Post Code Country
Mobile Number*

Available at time of the event
Email*
Hire Details
Please note hall can only be hired on a term by term basis
The purpose of the hire*
Is this a*
- Community
- Commercial
- Private
- Sporting Event
Please select one
Estimated number of persons on site
Start Date*
DD slash MM slash YYYY
End Date*
DD slash MM slash YYYY
Start Time*

: Hours

Minutes
End Time*

: Hours

Minutes
Identification document*
Max. file size: 12 MB.
Please upload your Identification Document before submitting
Public liability paperwork*
Max. file size: 12 MB.
Please upload your public liability paperwork before submitting your form
Worker Compensation Certificate of Currency
Max. file size: 1 GB.
Please upload your Worker Compensation Certificate of currency if applicable
I have read, understood and agreed to abide by the attached Terms and Conditions of hire. I will ensure that any alterations or cancellations are received in writing no less than seven days before the date in question. Please note a cost may be incurred if seven days notice is not received. This application becomes a binding agreement upon acceptance*
- Yes
- No
Please click here to view the Terms and Conditions.

Term Dates

2023

Term 1: 01/02/2023 – 06/04/2023
Term 2: 26/04/2023 – 23/06/2023
Term 3: 18/07/2023 – 22/09/2023
Term 4: 09/10/2023 – 12/12/2023

2024

Term 1: 01/02/2024 – 28/03/2024
Term 2: 16/04/2024 – 21/06/2024
Term 3: 16/07/2024 – 20/09/2024
Term 4: 07/10/2024 – 06/12/2024

Contact Information

Location:
19 Furley Road, Southern River, WA 6110
Phone Number:
+61 8 9455 1607
E-mail:
admin@providence.wa.edu.au
ABN:
42983626009

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