Application form

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Application form

'Name Your Seat' provides a unique opportunity where alumni, proud WAAPA supporters, staff, students and their families can make an invaluable contribution to the Academy and at the same time commemorate their association or the association of a loved one with WAAPA by having a 'naming plaque' placed on a seat in The Geoff Gibbs Theatre, Roundhouse Theatre or the Music Auditorium.

Registration form

* denotes required form responses

Your personal details

Title: *

First Name: *

Surname: *

Your contact details

Street Number:

Street Name:

Suburb:

State:

Country:

Post Code:

Telephone: *

Mobile:

Email: *

ECU Alumni?: *

ECU Staff Member?: *

Proposed 'Name Your Seat' inscription

Inscription: * (max 200 characters)

Theatre: *

Payment

The $300 cost of each 'Name Your Seat' sponsorship is fully tax deductible.

Payment Option: *

Salary instalments are effective from the next pay period and you'll need to supply your ECU Staff Number

Staff Number: *

The donor is encouraged to seek their own independent tax advice.

Edith Cowan University

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