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Cockburn Health and Community Facility Application for Hire Form

Print Form

Cockburn Health and Community Facility - Application for Hire form

All fields are required except where indicated

1. Details of Hirer

2. Details of Booking

Please add your booking days/dates to the fields below
If booking multiple dates press ‘Add new date’ for each booking.
NB: A maximum of ten bookings can be made at one time, for example once a week for ten weeks, once a month for ten months.

3. Rooms required

NB: Conference Room bookings can include Community Room use for no extra cost.  Please make sure to select both if this is a requirement.

Occupancy: Currently 50 people max
  • $50.00 Per hour
Occupancy: Currently 100 people max
  • $100.00 Per hour  (max 4 hours)
  • $700.00 Full Day (max 10 hours)
Will alcohol be consumed onsite?:

4. AV and Equipment

AV Equipment Hire:
AV Equipment hire is included in room hire fees and charges
EG: Meeting, Workshop, Conference

5. Invoicing requirements

For City of Cockburn Departments, please provide your Budget Number instead

6. Signature


View the Terms and Conditions

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Contact

Address

City of Cockburn
Whadjuk Boodja
9 Coleville Crescent,
Spearwood 6163

PO Box 1215, Bibra Lake DC,
Western Australia, 6965

Office opening hours:
8.30am to 4.30pm
Monday to Friday (excluding public holidays)

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Cockburn Nyungar moort Beeliar boodja-k kaadadjiny. Koora, yeyi, benang baalap nidja boodja-k kaaradjiny.
Ngalak kaditj boodjar kep wer kaadidjiny kalyakool yoodaniny, wer koora wer yeyi ngalak Birdiya koota-djinanginy.

City of Cockburn acknowledges the Nyungar people of Beeliar boodja. Long ago, now and in the future they care for Country.
We acknowledge a continuing connection to land, waters and culture and pay our respects to the Elders, past and present.