Casual Mall Leasing Executive
Telephone: 07 5440 7919

casualleasing@noosacivic.com.au

Application form

To apply for a Casual Mall leasing site please submit the online application form below. If you prefer you may wish to download a printable version of the form to complete by hand.

Click here to download the application form (PDF)

Company information
Company name*
Company ACN
Company ABN*
Trading name*
Contact name*
Postal address*
Telephone*
Mobile phone
Facsimile
Email*
Public liability insurance information (Policy must adhere to clause 4.1(c) of the Terms of Agreement)
Insurer*
Policy Number*
Sum insured*
Policy expiry date*
CML site information
Requested CML site*
Requested start date*
Requested end date*
Description of the product or service you wish to promote*
Equipment hire required (Please indicate number required)
Trestle tables
Table cloths
Acoustic stands
Chairs
Other
Other comments

Text fields marked with an asterisk (*) are mandatory.