Application to Lease or Licence a Council Facility

 

Complete this online form to apply to lease or licence a Council facility.

To enable Baw Baw Shire Council to process the application, all required information must be attached to this application and all fields marked as 'required' must be completed.

Note: This form is fully compatible for use with Chrome, Firefox and Safari web browsers. Some components are not compatible for use with Internet Explorer.

Application to Lease or Licence a Council Facility
Section A - Application
Please note: Only authorised signatories (persons authorised to sign on the applicants behalf) are permitted to sign this application, by signing this application you are committing your group as the applicant.
You will need to download and execute the signatory page to make your application. The page can be downloaded from the section titled 'Related Information' at the foot of this page.
Section B - Applicant Details
14. Entity Type * (required)
Contact Person 1 (Licence)
Contact Person 2 (Accounts)
Membership Numbers (If applicable)
35. Are members charged a fee?
52. Is the applicant a not-for-profit organisation under Australian Tax Office definitions? * (required)
53. Is the applicant a legal entity registered under appropriate legislation (such as the Associations Incorporation Act 1981)? * (required)
54. Does the applicant have an Australian Business Number? * (required)
55. Does the applicant comply with all relevant legislation governing its activities and hold all licences and registration certificates required for it to operate? * (required)
56. Does the applicant have a committee or appropriate governance arrangements with established accountability and reporting methods to members of the group and/or to the community? * (required)
57. Has the applicant complied with all terms and conditions of any previous lease/licence agreement, service level agreement or any other agreement with Baw Baw Shire Council? * (required)
58. Is the applicant is currently receiving funding (Grant, subsidy, donation) from Baw Baw Shire Council for this or any other purpose? If yes, provide details: * (required)
60. Is there a Service Level Agreement (SLA) or Memorandum of Understanding (MOU) in place regarding the provision of funding or services? If Yes, provide a copy: * (required)
64. Is the use of this facility consistent with Council's vision and the goals outlined in the current Council Plan? If yes provide details * (required)
Type the characters you see in the image below * (Required)

Privacy Statement 

The personal information on this form is being collected by Council to enable the distribution of rates and charge details to Ratepayers and the preparation of the Municipal Voters Roll. The information will be used by Council for these primary purposes or directly related to municipal purposes only. Council may disclose this information to other authorities including Gippsland Water, South East Water, TXU, Origin Energy and Telstra to enable the provision of services to the property. If these contact details are not kept up to date, rate notices or other municipal information may not reach you and in the case of Rate Notices, interest and legal charges may be incurred if rates are not paid by the due dates. You may apply to Council to gain access to, or for the amendment of personal information held by Council. Information on Council's Privacy Policies can be obtained from Council's Privacy Officer during business hours on 03 5624 2411.