Hall Hire Permit

Issued for the Private Hire of a Council Hall

* Mandatory Field

Application Details
Applicant Details
Permit Number

To be completed by the Southern Mallee District Council

Organisation/Business Group Name*

hereinafter called the Permit Holder

Postal Address*
Email Address*

Please include your Home and Mobile Telephone Numbers

Application To*
Event Name and Dates
Event Name*
Date of Hire

Allow for preparation and cleanup days in the hire term

Date of the Event*
Event Hours*
Location of the Event*

Please select the Event Location from the drop down list

Rooms Required*
Event Description
Activity Description*

Please Describe the Activity

Details if Food and Drink are to be Sold

If Food or Drink is to be sold please provide details

Details if Alcohol is to be Sold

If Alcohol is to be provided or sold please provide details

Details if any Music will be Played

If any Music will be played please provide details

Agree with the Terms and Conditions
Hall Terms and Conditions*

By ticking this box you are deemed to have read and agree with the Hall Hire Terms and Conditions

Click Here to view the Hall Hire Terms and Conditions

Please attached current copy of your Insurance and any required Licences

Confirmation of Attached Required Documents*

Please check the box if you have included all the documents outlined in the Terms and Conditions

If you see this, leave this form field blank.

Send a copy of the submitted form to this email address.