Fillable FORM All bookings are required to be finalised (Services Australia)

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FORM All bookings are required to be finalised (Services Australia)

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The FORM All bookings are required to be finalised (Services Australia) form is 2 pages long and contains:

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  • 17 check-boxes
  • 32 other fields

Country of origin: AUSTRALIA
File type: PDF

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Services Australia, (previously DHS - Department of Human Services) is responsible for delivering services relating to health and welfare of Australian citizens. It processes payment of child support other services.

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BBQ BOOKING
FORM
www.derwentvalley
.tas.gov.au
(03) 6261 8500
P.O. Box 595
New Norfolk
TAS 7140
All bookings are required to be finalised and fees paid one (1) week prior to the event.
APPLICANT DETAILS
Date of application:
Name of Club/
Organisation/
Association
Address:
Postal Address:
As Above
Contact name:
Contact addr
ess:
Phone:
Home
Business
M
obile
Copy of driver’s licence attached
Yes No
Yes No
Yes No
Email:
Driver’s licence no.:
Do you require power?
Are you having a coffee van at your event?
DETAILS OF BOOKING
Location
Time
Hire fees
:
$
Will alcohol be consumed?
Yes No
Has a Liquor
Permit been provided?
Yes No
Number of attendees
BBQ Booking Form
Derwent Valley Council | This document becomes uncontrolled once printed 2
DECLARATION
I
of
(
Residential address only)
hereby make application for the premises set out in the Schedule to this application for the day and times
specified in the Schedule. I acknowledge having read a copy of the Conditions of Use (Recreational
Grounds & Facilities) and undertake to be bound by and comply with these Conditions in every respect. I
further undertake to be responsible for ensuring that all individuals or groups using the facility in association
with this application shall comply with the Conditions.
Signature
Date
RETURN COMPLETED FORM AND ABOVE REQUIREMENTS TO COUNCIL
IN PERSON
Council Chambers
Circle
Street
New Norfolk
MAIL
Customer Service
Derwent Valley Council
PO Box 595
New Norfolk TAS 7140
EMAIL
dvcouncil@dvc.tas.gov.au
OFFICE USE ONLY
Hire fees paid
?
Yes No N/A
(Cash/Inv) Amount
$
Inv date
Receipt No.:
Liquor
Permit
provided
?
Yes No N/A
Event approved
?
Yes No N/A
Notes
:
Name and Position
of Council Officer
Signature
of council
officer:
Date of approval:
Information included in
booking system
?
Yes No N/A
Reservation sign
completed
?
Yes No N/A
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FORM All bookings are required to be finalised (Services Australia)

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Completed 20 April 2022

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