Belmont Hub Application to Lease Form

The second floor of the Belmont Hub at 213 Wright Street is home to several new office spaces, funded by Lotterywest.

If you are a community service provider looking for a new space to lease, you may apply provided your registered not-for-profit organisation meets the application criteria, including the ability to help create positive outcomes across the City of Belmont community.

To apply, fill in the below form and attach all relevant documentation.

Download the Belmont Hub Tennancy Selection Criteria document to complete and upload with your application.

Criteria
The City will, at its discretion, score each of the sub-criteria based on the level of evidenced experience and performance contained in the applicant’s response.

Belmont Hub Application to Lease Form

Contact Information

Name of organisation

ACN

ABN

Is the organisation incorporated

yes
no

Is the organisation registered as a Not-for-profit

yes
no

Organisation postal address

Primary Contact Information

Title

Primary contact full name

What is your position / role in the organisation?

Mobile number

Email address

Secondary Contact Information

Secondary contact title

Secondary contact full name

What is the secondary contact person's position / role in the organisation?

Secondary contact mobile

Secondary contact email address

Property Information

Are of space required (m2)

Annual rent consideration

Proposed number of years requested for the lease term (maximum 5 years)

Facilities required (e.g. kitchen, toilets, outdoor area)

Types of activities conducted from the facility

Proposed days and times your organisation would use the facility

Member information

Total number of members in your organisation

Children 0 to 4

Children 5 to 13

Youth 14 to 19

Adults 20 to 40

Adults 40 to 65

Seniors 65+

Supporting Documentation

Please upload your Belmont Hub Selection Criteria Document

Please upload your Certificate of Incorporation

Please upload your constitution or rules of association

Please upload a copy of your Public Liability Insurance

Please upload your profit / loss statement for the last financial year.

Please upload your indicative fit out plan (if office space is known)