= Required Fields

Online Form - Application to Consume on Alcohol on Shire of Coolgardie Premises.

Please click here to read the approval conditions for this form.

Postal Address


*If you are supplying, distributing, or selling alcohol, please provide an Alcohol Management Plan with your completed application.


Alcohol Consumption Policy 3.8 states

Monday – Thursday 11am-10pm

Friday and Saturday 11am – 2am

Sunday 11am – 9pm

Do you agree to adhere to the approval conditions (please see link above to download full approval conditions.) By ticking yes, you confirm agreement with the approval conditions.

APPROVED          NO

                             YES               __________________________________            __________________  

                                                                Signed: Chief Executive Officer                                            Date