Request to Present to Council Form

About Person/Group Presenting

First Name:

Last Name:

Name of Organization/Group (where applicable):

Address

City or Town:

Province:

Postal Code:

Country

Day Time Phone Number:

Valid format is (506) 555-1234

If you do NOT wish to have your personal information (address, phone number, email) become part of the public record, please check this box.

About your Request

Topic of Presentation:

Purpose for Presentation (what is the ask of Council):

Background Information:

Are you making a request for funding?

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