<p>Theo Notaras Multicultural Centre 2nd Floor, North Building, 180 London Circuit, Canberra City</p><p>July 2017 FUNCTION ROOM/GALLERY/KITCHEN BOOKING FORM CONTACT AND EVENT INFORMATION</p><p>Organisation Booking Date Name Session/Time</p><p>ABN/ACN Booking Reference Number- Office use only</p><p>Type of Community Government Business organisation</p><p>Hirer name Contact details Phone (business hours) Mobile</p><p>Email Postal Address</p><p>Suburb: State: Postcode:</p><p>Event Type e.g. Number of Exhibition, attendees function, meeting, conference, youth event Scheduled Times Access/ Set-up Start time Finish time</p><p>Room/s required Meeting Room Function Room Kitchen Gallery</p><p>Seating capacity 20 seated – Theatre 250 seated – N/A 70 standing style Theatre style 15 seated – Dining 150 seated – Style Dining Style 25 standing 300 standing</p><p>Page 1 of 3 Theo Notaras Multicultural Centre 2nd Floor, North Building, 180 London Circuit, Canberra City CHARGES (GST inclusive) </p><p>Session timings-Three sessions are available: 08:00-12:00 (Session 1); 13:00-17:00 (Session 2); 18:00-22:00 (Session 3). All confirmed bookings will incur a minimum fee of one session or one hour.</p><p>FUNCTION ROOM WEST WING MEETING GALLERY KITCHEN ROOM (kitchen closes at 10.00pm) Not-for-Profit $180.00 for session 1 $40.00 per hour No charge $50.00 per hour Community $270.00 for session 2 2xhrs standard, extra Organisation $405.00 for session 3 hours can be Rates negotiated Business $200.00 for session 1 $40.00 per hour $100.00 per hour Rates $360.00 for session 2 2xhrs standard, extra $540.00 for session 3 hours can be negotiated Additional Lectern Chairs______Sounds System equipment Overhead projector Microphone ___ Others: ______Government $250 for session 1 $40.00 per hour No charge $100.00 per hour Rates $360 for session 2 2xhrs standard, extra $540.00 session 3 hours can be negotiated Please note: Additional fees if you require room set up will be charged at $38 ph (minimum four hours) </p><p>For the kitchen Hire upfront $200.00 Refundable deposit prior to use </p><p>Additional cleaning charges will be applied if the venue (including chairs, tables and equipment) is not left in a suitably clean condition. Repair or replacement of damaged items will be charged to the hirer.</p><p>*An additional cost of $250 per booking may be applied for opening and closing the Theo Notaras Multicultural Centre during weekends and public holidays. This cost is applied to cover costs associated with ACT Government employees attending after hours.</p><p>Page 2 of 3 Theo Notaras Multicultural Centre 2nd Floor, North Building, 180 London Circuit, Canberra City</p><p>PAYMENT OPTIONS</p><p>Cheque or money Make bank cheques or money order or organisation/agency cheques payable to the order ACT CSD Operating Account. Electronic Funds Account name: ACT CSD Operating Account Transfer (EFT) BSB: 032 777 Account number: 000129 Bank: Westpac Bank Reference: Invoice Number </p><p>BUILDING ACCESS (to be arranged with the Centre Management)</p><p>IN CASE OF EMERGENCIES SUCH AS, FIRE OR MEDICAL ASSISTANCE, PLEASE CALL 000 SIGNATURE</p><p>I have read and agree to the terms of the Multicultural Centre Function/West Wing Meeting Room/Gallery/Kitchen Hire Conditions and Agreement (cross out venue not applicable).</p><p>I have provided a current copy of the organisation’s/agency’s $20 million public liability Insurance certificate. Printed Signed: Date: Name:______</p><p>PLEASE NOTE: THE BOOKING WILL NOT BE CONFIRMED UNTIL THE COMPLETED BOOKING FORM AND PROOF OF PAYMENT OF HIRE FEE/S ARE RECEIVED BY CENTRE MANAGEMENT The completed and signed booking form and proof of payment of hire fee/s can be provided to Centre Management by hand at: By hand: 2nd Floor North Building 180 London Circuit CANBERRA CITY or, Email: [email protected]</p><p>Page 3 of 3</p>