Shenton Park Precinct LHS nomination form

Please complete this nomination form relating to the Shenton Park Local Heritage Survey. You can nominate more than one place, but please use a separate form per nomination.

The closing date for nominations is 5pm Monday 4 August 2025.

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About me

Your full name (first and last name)

* required

Maximum 100 characters

0/100

Your address

* required

Maximum 150 characters

0/150

Your suburb

* required

Select option

Your email address

Your contact phone number (optional)

Maximum 20 characters

0/20

Please enter number without spaces.

Your nomination

The place being nominated can be a building, group of buildings, an archaeological site, garden, man-made park, a tree or group of trees

Type of nomination:

* required

Building

Group of buildings

Archaeological site

Garden

Man-made park

Tree or group of trees

Name of place being nominated (if any)

Maximum 150 characters

0/150

Address of place being nominated

* required

Maximum 200 characters

0/200

For a heritage area nomination include the boundaries of the heritage area, for example: Nos 3 to 21 and Nos 4 to 28 Jones Street)

Current owner (if known)

Maximum 150 characters

0/150

It is not compulsory to inform the owner before submitting your nomination, this can be followed up by the City when reviewing the nominations.

10.

If you are not the owner, is the owner aware of this nomination?

Yes

It is not compulsory to inform the owner before submitting your nomination, this can be followed up by the City when reviewing the nominations.

11.

In your opinion, how does this place relate to the history of the City of Subiaco?

* required

(dot points encouraged)

12.

Please provide a physical description of the place you are nominating. If known, please include information on the construction date, original owner or other owners, and the original designer and builder.

(dot points encouraged)