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Delegation Request Form

I wish to appear before

Council

Advisory Committee of Council

Date of Meeting

Name of Delegate(s)

Address

Phone

Capacity in which you will be attending

Attending as an Individual

Representing a Group / Organization

Have you contacted Administration regarding this matter?

Yes

Reason(s) for Delegation Request (subject matter to be discussed). If the request is in response to an item on the agenda, please specify the item's agenda #

If your request is in response to an agenda item, are you in favour of the recommendation? If not, please provide your reasoning below

Will a powerpoint presentation be made?

Yes

Note: An electronic copy of the PowerPoint presentation is required to be submitted to delegations@amherstburg.ca no later than 12:00 noon on the Friday before the meeting.

Please upload speaking notes and presentation materials - 4 Attachments Max (10MB Each) (pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif)

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Personal information contained on this form is authorized under Section 5 of the Town of Amherstburg’s Procedure By-law, for the purpose of contacting individuals and/or organizations requesting an opportunity to appear as a delegation before Council or an Advisory Committee of Council. The Delegation Request Form may be published in its entirety with the public agenda which is also posted on the Town’s website. The Procedure By-law is a requirement of Section 238(2) of the Municipal Act, 2001.

Please note that all meetings are open to the public except where permitted to be closed to the public under legislated authority. Questions regarding collection of the information on this form or additional accessibility requirements may be directed to the Municipal Clerk, 271 Sandwich Street South, Amherstburg, ON
N9V 2A5, 519.736.0012.