UNE Room Booking Form

							                               UNE Room Booking Form

                                         User Details
Organisation Name:

ABN ( If applicable ):

Contact Person Name:

Contact Person Phone
                                                       Email Address:
Number:

Organisation Address or
Billing details:

Organisation Email Address :

Organisation Phone Number:                             Fax Number:

                                 Booking Requirments
                               Venue 1          Venue 2            Venue 3           Venue 4

Preferred Location or Space
(Refer to Room Schedule):

Dates:

Times:

Alternative     Location or
Space (if      preferred not
available):

Dates:

Times:

Frequency of Use:

Type of Use:                   Teaching        Performance       Meeting          Other

Explain if other:




 Note: Please fax this form to Facilities Management Services on 6773 6403 for the scheduled charges
                            to be determined before proceeding any further.
                                     Scheduled Charges

This section is to be completed by Facilities Management Services to quote the scheduled charges based
on the above booking requirements.




                                           Agreement

I / We understand and agree to abide by the Terms and Conditions contained within the Conditions of
Hire and CB Newling Usage Policy and the Licence Agreement (if a Licensee) and acknowledge that I /
We have received this documentation.
I / We accept the scheduled fee for hire.

Name:                                 Signature:                              Date: _ _ / _ _ / _ _ _ _


                                          Official Use

Fee Structure                             Commercial       Community       Notes:

Service Levy Applicable                   Yes      No     Notes:

Conditions & Fee Structure Agreed        Conflicts Checked               Booking Entered

Is a Custodian Required for this booking: Yes      No     Notes:

Has the user completed the CB Newling Registration Form:      Yes     No