Wairarapa College Hirer’s Application Form

Title of Hiring Group (the hirer):*

Event:*

Organiser / Contact:*

Address:

Street AddressCityRegionPostal CodeCountry

Phone (Work):*

Area Code

Phone Number

Phone (Mobile):*

Prefix

Mobile Number

Phone (Work):(1)*

Area Code

Phone Number

E-mail:*

Fax (Home):*

Area Code

Phone Number

Fax (Work):*

Area Code

Phone Number

Usage Days Dates and Times

Date:

Start Time:*

AM/PM

End Time:*

AM/PM

Comments / Special requirements:

Note occupation outside these times may incur penalty charges.

The hirer agrees to hire the facilities at Wairarapa College and the Board of Trustees of Wairarapa College agrees to hire the venue to the hirer for the hire period on the Wairarapa Collegs terms and conditions of hire:

Hirer Name:*

Hirer Position:*

Date (Applied):

The following fields are for internal use only.

Board Representative Name:

Board Representative Position:

Date (Approved):