Application to book community facility
Please read this first
This form will be scanned by electronic equipment. It is important that you:
• use a blue or black pen to complete this form; and
• print clearly.
Office use only
Cleaner advised? NAR
• Receipt
Booking entered?
Date entered
/ /
2 0 Amount paid
$
tararua district council
•
26 gordon street
•
po box 115
•
dannevirke 4942
•
06 374 4080
•
info@tararuadc.govt.nz
Applicant details (Please print in CAPITALS)
Name of organisation or individual
Contact person
0
-
0
-
0
-
Daytime phone number Afterhours phone number Mobile number
Email
Facility details (Please print in CAPITALS)
Purpose the facilities are being used for
Which facilities do you want to book?
Dannevirke Sports Centre
Stadium Boxing room Supper room Kitchen
Eketahuna Community Centre Eketahuna War Memorial Hall
Pahiatua Town Hall
Main hall Supper room Kitchen Heating
Woodville Stadium
Stadium Supper room Kitchen
What time and dates do you want to use the facilities? (If you are booking the facilities for a season, use A. If this is a one-off
booking, use B.)
A
Day of week (e.g. Monday)
:
M
:
M
Start time Finish time
/ /
2 0
Start date
/ /
2 0
Finish date
B
Day of week – in (e.g. Saturday)
:
M
/ /
2 0
In time In date
Day of week – out (e.g. Sunday)
:
M
/ /
2 0
Out time Out date
