Delegation Request Form

Please ensure this form is completed, with an attachment, outlining your request to speak with Council regarding an item on the published Council agenda. The information is to be received by the Clerks Department electronically or at the Township of Perth East Administration Office, 25 Mill Street East, Milverton, no later than 11:00 a.m. the day of the Council Meeting.

Name(s) of Speaker(s)

Email Address

Phone

Your Address

City

Province

Postal Code

Date of the Meeting

I will be participating

In-Person

Electronically

Are you speaking on behalf of a group or organization?

Yes

Name of Group or Organization (if yes to previous question)

Agenda item you wish to speak to

Please indicate the action being requested by Council

Please include a written submission (you can either provide it in the space below or upload a document)

You must enter something in this field. If you are uploading a file, type in “file uploaded”.

Written submission document

Maximum file size: 104.86MB

Responsibilities of the Speaker(s):

Public Presentations and Delegations are limited to ten (10) minutes to address Council. Groups are encouraged to appoint one or two spokespersons to address Council on behalf of the group.
Please arrive 10 minutes before the start of the Council Meeting.
If joining the Council Meeting electronically, please join 15 minutes prior to the start of the meeting. Turn off your camera and mute your microphone until advised by the Chair that it is your turn to address Council.
Our Council Meetings are recorded and live-streamed on YouTube. By participating in the Council Meeting, you are agreeing to being recorded. The Township uses Zoom as its electronic meeting platform. If you are attending the meeting electronically, a unique link with access to the electronic meeting will be sent to you the day of the scheduled Council Meeting. The link is not to be shared with other individuals unless directed to do so.
All information submitted will be considered public information and therefore is subject to full disclosure under the Municipal Freedom of Information and Protection of Privacy Act.

I/We agree to the responsibilities of the speaker(s) listed above

Yes, I/We Agree

No, I/We Do not Agree

You must agree to the responsibilities of the speakers in order to submit the form.

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