Form Builder

Required fields are marked with asterisks (*)

Personal information contained on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c.25 and will be used for the purpose of delegate registration.

Please note that adresses, email addresses and phone numbers will be kept confidential in accordance with the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c.M.56, however other information contained in this form may be included in Council Meeting agendas and minutes, both of which become part of the public record and posted on the municipal website.

If you have any questions about the collection please contact the Division Leader - Legislative Services at 519-728-2700 or by email Clerk@lakeshore.ca.

Delegation Request Form

Date of Meeting

Delegation requests for Council Meetings (not planning related) must be submitted prior to 4:30 PM on the Monday before the meeting takes place for that week.

To find a list of upcoming Council Meetings, please visit events.lakeshore.ca/meetings

Subject to Discuss

Have you appeared before Council in the past to discuss this issue?

Yes

Do you have any accompanying documentation (eg. petition, presentation, document)?

Yes

How are you going to attend the meeting?

In-person

Using a computer or smart device (it should have a camera, microphone and speakers to interact with council)

Calling in via phone only (experience similar to a conference call)

Full Name:

Phone Number: (ex. 999-999-9999)

Email:

Form Builder

Delegation Request Form

I'd Like To

Apply or Register For

Pay For

Know More About

Read and Report