Patronage application

Please download a copy of the Patronage Application Form or complete the form below.

Organisation details:

Organisation contact:

Organisation information:

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.

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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