Customer Request Management Entry


Please complete the following form with as much details as you can to help us process your request in a timely manner. This form is only to be used for non-urgent requests. For any urgent or dangerous issues, please call the City of Rockingham on (08) 9528 0333.

Please note that we take your privacy seriously and will not disclose your details to any third party without prior permission.

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Select the Rated Property this request applies too (If the property does not display please use "Advanced Search") *

Search for the property the call is in relation to.

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    Customer details *


    Contact Details

    Residential address

    Residential address

    Postal address if different from residential

    Postal address if different from residential

    What is the preferred method of receiving correspondence?

    Upload attachments

    Browse for an attachment to link to this call.