Patronage Request

Vice Regal Patronage provides organisations with the name and prestige of the Vice Regal office.

Patronage Request

  • Organisation details

  • If yes, please provide details
  • Organisation contact

  • Organisation information

  • Statutory authority, incorporated association, informal entity, other
  • eg, medical, sports, art, military
  • Max. file size: 16 MB.
  • eg. national body, local branch, peak body
  • If yes, please provide broad details and number of employees
  • If yes, please list.
  • Max. file size: 16 MB.
    Please upload a formal cover letter including a current list of office bearers (indicating the principal point of contact) and a short background history of the organisation from its inception to present day.
  • Organisation declaration

    I confirm that the information provided is true and accurate. I understand that any incorrect or incomplete information may impact on the decision by Government House Western Australia to recommend Vice Regal support to my organisation.
  • MM slash DD slash YYYY
    Note: this information is sought for the sole use of Government House Western Australia and will not be disclosed to a third party without the consent of the originating body

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