Change of Address

^(*) Mandatory Field

Change of Address

Name*

Please provide your full name and surname

Property Address*

(within the Corporation of the Town of Walkerville)

Residential Address

Mailing Address

Telephone Number Home*

Telephone Number Work

Mobile Number

Are you the (please select relevant box)*

Owner

Owner Occupier

Occupier

Do you have dog/s registered with Corporation of the Town of Walkerville?*

Yes No

Do you require the dog/s registration details to be transferred to new property address?*

Yes No

Email Submitted Data

Send a copy of the submitted form to this email address.