Required fields are marked with asterisks (*)

Delegation Request

In accordance with the Town’s Procedure By-law, if you wish to appear before Council or a Standing Committee of Council you must complete this form. Additional information regarding appearing before Council can be found on whitby.ca/delegations.

Date of Meeting

Name of Delegate(s)

Address

Unit #

City / Town

Postal Code

Phone Number

Are you...

Attending as an Individual

Representing a Group/Organization

Preferred attendance

In person

Virtually

Item number and/or Staff Report you wish to speak to

Reason(s) for wishing to appear as a delegation

Are you in favour of the recommendation?

Will a PowerPoint presentation be made?

Yes

Personal information contained on this form is collected in accordance with the Procedure By-law for the purpose of contacting individuals and/or organizations requesting an opportunity to appear as a delegation before Town of Whitby Council or a Standing Committee of Council. Personal information supplied with this form may be published with the public record of the meeting.

Questions regarding collection of the information on this form may be directed to the Office of the Town Clerk, 575 Rossland Road East, Whitby, ON L1N 2M8, 905.430.4315.

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Delegation Request