* Denotes that the field is mandatory.

DISCLAIMER - Personal Information collected by Council is used for municipal purposes as specified in the Local Government Act 1989. The Personal Information will be used solely by Council for these purposes and or directly related purposes. Council may disclose this information to other organisations if required by legislation. The applicant understands that the Personal Information provided is for the above purpose and that he or she may apply to Council for access to and/or amendment of the information. Requests for access and or correction should be made to Council’s Privacy Officer.

Applicant details
This page allows you to enter new information about a person's contact details. Once the information has been entered click the Next button to continue.
Licencee/Applicant Details 
Company Name *
Surname *
Given Names *
Address Line 1 *
Address Line 2
Suburb *
State Code *
Postcode *
E-Mail Address *
Phone (Mobile) *
Phone (Business Hours)