Delegation Request Form

A delegation is any person(s), group(s), corporation(s), or oganization(s), approved by the Clerk to make submissions at a council meeting.

Personal Information on this form is collected under the authority of the Municipal Act 2001 P.S.O. c45 and may be included in Agendas and Council Meeting minutes, both of which become part of the public record and posted on our municipal website.

First Name

Last Name

Email Address

Phone Number

How would you like to be contacted?

Email

Phone

Are you representing a group?

Yes

No

Please indicate the matter you wish to speak to (report name and item number on agenda, if available).

Minimum characters: 4

Provide a brief summary on submissions to be made at the Meeting. Please include what you are requesting from Council clearly in the notes.

Is this a matter listed on the current Council Agenda?

Yes

No

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

Yes

No

Will you have an oral or written presentation?

Oral

Written

How would like to attend the Council meeting? Please be advised that the method selected for attending the Council meeting may not be changed.

Electronically via Zoom (must have access to a computer or tablet with internet service or smart phone and will be required to join with both audio and video)

In-Person at the Leamington Municipal Building Council Chambers (111 Erie Street North, Leamington)

Please note: once we received your request to appear as a delegation you will be contacted by the Clerk's Department to confirm wheather your Delegation Request has been approved.

Delegation Request Form

Please note: once we received your request to appear as a delegation you will be contacted by the Clerk's Department to confirm wheather your Delegation Request has been approved.

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