Meeting Room Hire Application Form

DETAILS OF HIRER

Organisation*

Address*

Street Address Address Line 2 City State Post Code

Contact person*

Phone*

Email*

Preferred method of contact*

Phone
Email

DETAILS OF EVENT

Name of event/meeting*

Brief description of event/meeting*

Number of attendees*

Risk level associated with your room hire*

Low
Medium
High

Please upload public liability insurance certificate

Event date*

Please note: Room hire is only available Tuesdays to Fridays; we are unable to accommodate bookings on weekends or Mondays.

Event end date

(if mutliple days)

Access time*

What time do you need to access the room to set-up? Please note: access is from 9am only.

HH :

MM

Event start time*

HH :

MM

Event finish time*

What time does it finish?

HH :

MM

Booking finish time*

What time will you be finished in the room, after packing up? Please note: bookings must be completed by 4pm.

HH :

MM

AV equipment required*

Yes
No

AV equipment assistance required*

Yes
No

AGREEMENT

I understand and agree to the conditions of use*

Agree

Name of authorised person*

Date*

Email

This field is for validation purposes and should be left unchanged.

Just checking –do you, or someone you care about, need help with your mental health?

DETAILS OF HIRER

DETAILS OF EVENT

AGREEMENT