Delegations to Council Application

Date:

Council meeting date requested:

Title:

First name:

Last name:

Organization name (if applicable):

Home address

City/Town:

Postal code:

Home phone:

Cell phone:

Email address:

Please note: all delegations or petitions are limited to ten (10) minutes.

Subject of delegation:

Purpose of delegation:

Information only

Requesting a letter of support

Other

Note: If requesting action of Council, you must detail all information necessary to inform members of Council of your request. If necessary, add a separate sheet and attach to thisform.

Name of individual(s) making presentation:

Will you be providing supporting documentation?

Yes

If yes please complete the following:

Handouts at meeting (bring a minimum of 10 copies)

Power-Point presentations must be provided to the Clerk no later than Tuesday (7 days prior of the meeting) at 3:00pm preceding final preparations of the Agenda to test for software compatibility and pre-load on the Township’s laptop.

Publication in the agenda (one original or electronic copy) also due by no later than Tuesday (7 days prior of the meeting) at 3:00pm preceding final preparations of the Agenda.

Technical requirements needed:

Flip chart

Projector

Other

I understand and agree to the procedures for Delegation and/or Petition as detailed within this Schedule and agree to abide by them at all time.

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Delegations to Council Application