Required fields are marked with asterisks (*)

Delegation Request Form

Thank you for your interest in appearing before the Municipality of South Huron Council.

The Delegation Request Form and any written submissions or background information for consideration by either South Huron Council or committees of Council must be received by the Clerk's Office by noon on the Tuesday prior to the requested meeting date. For meeting dates see the Agendas and Minutes page.

Please be aware that written submissions from approved delegates to the Municipality of South Huron's Council may be distributed publically.

First Name:

Last Name:

Email:

Phone:

Address:

Postal Code:

Are you representing a group?

Yes

What is your preferred meeting and date to appear as a delegation?

Please indicate how you intend to interact with the Council Meeting

In person

Audio

Video

Both audio and video

Provide written comments only

Please describe the issue you intend to present?

Please indicate specific actions you would like Council to take.

Staff Report Number (if known)

Please provide your comments in support or opposition to the staff recommendation:

Do you require any accessibility accommodation?

Yes

Optional: Upload the written submission that you wish to share with Council

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

Do you give your permission to be audio and video recorded on the Municipality of South Huron's council meeting stream?

Yes I give my permission

Should you require assistance completing this form, please contact the Clerk at 519-235-0310, ext. 227.

Personal information on this form is collected under the legal authority of the Municipal Act, as amended. This information is collected and maintained for the purposed of creating a record that is available to the general public, pursuant to Section 27 of the Municipal Freedom of Information and Protection of Privacy Act. Questions about this collection should be directed to the Clerk, at 322 Main Street S, Exeter ON N0M 1S6, 519-235-0310