Delegate Request - Township of Puslinch

Type of Meeting *

Council
Heritage Advisory Committee
Recreation Advisory Committee
Planning and Development Advisory Committee
Youth Advisory Committee

Meeting Date *

How many delegates are requesting to make this presentation? *

One (1)
Two (2)

A maximum of two delegates can present a single delegation item.

Type of Delegation *

This is a request to delegate on a topic on the upcoming agenda
This is a request to delegate on a general topic

Note delegation requests regarding a general topic will not be accepted after the agenda publication deadline (being 7 (seven) days in advance of the scheduled meeting).

Delegation requests regarding a topic on the upcoming agenda must be submitted prior to noon (12:00 p.m.) the day prior to the Council/Committee meeting. Any delegation requests received after 12:00 p.m. will not be accepted in accordance with the Procedural By-law.

Identify which agenda item you are requesting to delegate on? *

Type of Presentation *

This request is to present a verbal delegation
This request is to present a written delegation

Type of Attendance

In person
Via Zoom

If you intend to delegate via Zoom when staff contact regarding confirmation of your delegation request a zoom registration link will be provided.

Applicant Information

Name of Delegate *

First

Last

Mailing Address of Delegate *

Address Line 1

Address Line 2

City

Province

Postal Code

Phone Number of Delegate *

Email Address of Delegate *

Name of Second Delegate *

First

Last

Mailing Address of Second Delegate *

Address Line 1

Address Line 2

City

Province

Postal Code

Phone Number of Second Delegate *

Email Address of Second Delegate *

Purpose of delegation (state position taken on issue, if applicable) *

A formal presentation is being submitted to accompany the delegation *

Yes
No

File Upload

Click or drag a file to this area to upload.

The delegation will require the use of audio-visual equipment (power point presentation) *

Yes
No

Rules and Procedures Relating to Delegations

In accordance with the Procedural By-law 2022-046, I (we) understand that:

1) any presenter(s) under the age of 18 must provide the Clerk with written permission from the individual’s parent or guardian.

2) a copy of the completed Delegation Request Form and any supporting material will be made available to the public and included in the meeting agenda package. I understand that the Township will redact my address, phone number and email address when making the completed form public.

3) delegations are limited to 10 minutes.

4) no delegation shall be made to Council or Committee on matters relating to litigation or potential litigation, including those matters which are before and under the jurisdiction of any court or administrative tribunals unless such matter is referred to Council by the said administrative tribunal or court.

5) delegations shall refrain from repeating information on the same matter presented by other delegates.

6) no delegation shall speak on a matter that is not within the jurisdiction of the Council or Committee.

7) no delegation shall be made to a Notice of Motion on a Council or Committee Agenda. Delegations will have an opportunity to speak at a subsequent meeting when the item will be discussed.

8) no delegation shall be permitted to speak on a Notice of Motion to reconsider.

9) delegations shall not be permitted to appear before Council or Committee for the sole purpose of generating publicity for an event.

10) a delegate shall only be permitted to speak on behalf of another person, agency, group or corporation where written authorization from the person, agency, group or corporation has been submitted to the Clerk in advance of the Council or Committee meeting.

11) if the delegation is unable to attend the meeting for which the delegation has been requested that a written submission may be provided to the Clerk.

12) if a delegation has been made on a matter and a decision has been made by Council, the delegation cannot be heard again unless there is new information being presented.

13) Specific Interest Delegation Requests must be received by 12:00 noon on the business day prior to the Council/Committee meeting.

Acknowledgement *

I (we) have read, understand and acknowledge the Rules and Procedures relating to Delegations as prescribed by the Procedural By-law 2022-046.

Freedom of Information Disclaimer

Personal information collected on this form is collected under the authority of the Municipal Act and will be used only for the purpose of sending correspondence relating to matters before Council or the Committee and for creating a record that is available to the general public in a hard copy format and on the internet in an electronic format in accordance with the Municipal Freedom of Information and Protection of Privacy Act. Questions regarding the collection of this information may be directed to the Township Clerk’s office.

The Township of Puslinch is committed to providing accessible formats and communication supports for people with a disability. If another format would work better for you, please contact the Township Clerk’s office for assistance.

Applicant Information

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