Delegation Request Form

To register as a delegation to speak to an item at an upcoming Council meeting, please complete the form below and submit it before noon on the day of the Council meeting.

First name

Last name

Personal pronoun

He/Him

She/Her

They/Them

Phone number

Email address

Who are you representing?

Myself

An organization

Please list the name(s) of who will be presenting.

Please select the meeting you wish to attend.

Council

ad hoc Budget Committee

Unknown

How will you be attending?

In-person

Virtually

Date of the meeting you plan to attend.

Have you contacted Township staff?

Yes

No

Is the item your delegation pertains to on the agenda?

Yes

No

Are you available for a phone call the day of the meeting to discuss procedure and answer any questions you may have?

Yes

No

Presentation Information

Please summarize the information you wish to present as a delegation.

Include such information as to whether you are in support or opposition as well as identifying any questions you wish to have addressed, if applicable. Please note, if you have already been a delegate on this matter, you need to specify the new information you intend to present.

Please summarize the information below.

Guideliness for being a delegation

I (we) have read, understand and acknowledge the Rules and Procedures relating to Delegations as prescribed by the Procedure By-Law.

I (we) have read, understand, and agree to follow the guidelines as set out on the Township’s Appear as a Delegation at Council webpage.

I (we) understand and acknowledge that Council and Committee meetings at the Township of Wilmot are audio and video recorded and live streamed online.

I (we) acknowledge and agree to the guidelines for being a delegation.

Yes

No

Any personal information that is collected is done in accordance with Sections 27, 28, 29 and 30 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and will be used to contact you concerning the information you provided regarding your delegation request. Questions about this collection should be directed to:

Municipal Clerk
Township of Wilmot, Administrative Complex
60 Snyder's Road West
Baden, Ontario N3A 1A1
519-634-8444
clerks@wilmot.ca

Form Builder

Delegation Request Form

Presentation Information

Guideliness for being a delegation