Delegate Request

Download the printable PDF form.

Meeting Date *

Applicant Information

Name *

First

Last

Mailing Address *

Address Line 1

Address Line 2

City

Province

Postal Code

Phone Number *

Email Address *

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

I am submitting a formal presentation to accompany my delegation *

File Upload

Click or drag a file to this area to upload.

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

Note: delegations are permitted to speak for 10 minutes. Your form or letter must be received 24 hours before the preparation of the Council agenda. This usually means at least one week prior to the Council meeting.

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 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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