Community Booking Form
Please complete all fields in the following form
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Date of activity
Type of activity
Guest Speaker at your venue ($5 per head)
Talk and tour at the Perkins ($5 per head)
'Live in the Lab' experience at the Perkins ($35 per head)
Number of participants
NB: Any change in participant number must be advised 48 hours before visit.
For Guest Speaker
Nearest parking spaces
Audio visual equipment available
Yes - projector, computer and sound system
Yes - projector only (Perkins staff can bring a computer)
Event start time
Event finish time
Speaker start time
Speaker finish time
For visits to the Perkins
Bus parking required
Special requirements, e.g. disability, mobility, access issues
If you answered 'yes' to the above, please specify below
Cafe reservation for morning tea required
Please provide details of appropriate department for processing of invoice.
Cash on day
Invoice (please see below)
Direct debit (*please see below)
Same as above
Reference/purchase order number (optional)
Invoices will be mailed directly to billing email address.
*Direct debit details are:
- BSB: 306-089
- Account: 0260466
- Harry Perkins Institute
- Reference “LW com” – date of visit
Please send a copy of the transaction receipt as proof of payment to firstname.lastname@example.org.
Terms and Conditions
Visits to the Perkins
All participants MUST comply with the following PC2 Laboratory
Appropriate fully enclosed footwear to be worn. No thongs, ballet flats, high heels or
sandals. Tops of feet must be covered.
- Long hair to be tied up and away from the face (fringes should be pinned back).
No food or drink to be taken into the PC2 laboratory. This includes water and chewing
No mobile phones to be taken into the lab.
The Perkins requests one week’s notice for the cancellation of a booking.
If prior notice is not given, the organising body will be charged at 50% of the original cost of the booking.
It is the responsibility of the organiser to confirm final numbers one week prior to the booked date.
A decrease in the number of participants will not be accepted after this point and organisations will be invoiced accordingly.
We request your acknowledgement of our Terms and Conditions
I acknowledge that I have read and agree to the Terms and Conditions as stated above.