= 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

BOOKING DETAILS

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

BOOKING DATES & TIMES

Start Time
Finish Time
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.