Cygnet Town Hall - Expression of Interest Form

Front Rooms Usage & Furniture Requirements

When you submit this form, it will not automatically collect your details like address and email address unless you provide it yourself.

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Applicant details

Name *

Organisation/Group Name (if applicable)

Contact phone

Email Address

Postal address

Street addressStreet address line 2

City

StatePlease selectACTNSWNTQLDSATASVICWA

Postcode

CountryPlease selectAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe

Proposed use of space

Which rooms are you interested in using (Please tick all that apply) *

Police Room (front small room on left furnished as office hot desks)Magistrates Office (second small room on left furnished as a 6 person meeting room)Court House (large room on right available for events, exhibitions, workshops and larger meetings)

Police Room

(front small room on left furnished as office hot desks)

Do you require storage space for materials?

YesNo

If yes, what will be stored? *

Expected frequency of use *

DailyWeeklyFortnightlyMonthlyOther

Please specify

Please provide preferred day(s) *

Please provide preferred time(s) *

Duration of each session *

1-2 HoursHalf day (2.5 hrs)Full day (5+ hrs)Other

Please specify

Approximate number of people who will use the space *

List what furniture or features you would need to be able to use the space

Magistrates Office

(second small room on left furnished as a 6 person meeting room)

Do you require storage space for materials? *

YesNo

If yes, what will be stored

Expected frequency of use *

DailyWeeklyFortnightlyMonthlyOther

Please specify *

Please provide preferred days *

Please provide preferred time(s) *

Duration of each session *

1-2 hoursHalf day (2.5 hrs)Full day (5+ hrs)Other

Please specify *

Approximate number of people who will use the space *

List what furniture or features you would need to be able to use the space

Court House 

(large room on right available for events, exhibitions, workshops and larger meetings)

Do you require storage space for materials? *

YesNo

If yes, what will be stored *

Expected frequency of use

DailyWeeklyFortnightlyMonthlyOther

Please specify *

Please provide preferred days *

Please provide possible time(s) *

Duration of each session *

1-2 hoursHalf day (2.5 hrs)Full day (5+ hrs)Other

Please specify *

Approximate number of people who will use the space *

List what furniture or features you would need to be able to use the space

Any additional comments or requirements

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