Board Delegation Request

Board Delegation Request

For members of the public looking to provide a verbal delegation to the Board.

"*" indicates required fields

Name*

First Name Last Name

Title (if applicable)

Organization (if delegating on an organization's behalf)

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Primary Phone*

Ext

Alternate Phone*

Ext

Email Address*

Will there be any additional person(s) delegating with you?*

Yes

No

Title (if applicable)

Organization (if delegating on an organization's behalf)

Primary Phone*

Ext

Alternate Phone*

Ext

Is the topic of your delegation listed on a meeting agenda?*

Yes

No

Please describe in detail the topic you wish to speak on and a short description of the reason(s) you are appearing as a delegate*

Please include the Report No. or Agenda Item No. if applicable.

Meeting Date*

Please select the meeting date that you wish to delegate at.

Email

This field is for validation purposes and should be left unchanged.