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Delegation Request Form

Municipality of Kincardine Procedure By-Law

By-Law No. 2023 - 138

Schedule 'A'

Your request must be received by noon on the Wednesday prior to the meeting, outlining the subject matter of the delegation and submitting an electronic version of any Microsoft PowerPoint presentation or other presentation material proposed to be used. Failure to provide the required information on time will result in loss of privilege to appear as a delegation.I have read and understand the delegation protocol attached to this form and acknowledge that the information contained on this form, including any attachments will become public documents and listed on the Municipality of Kincardine’s Council meeting agenda.

Date of Request

Council Meeting Date Requested

Delegation's Name

Phone Number

E-mail

Organization (if applicable)

Name(s) of Speaker(s)

Email address(es) of speaker(s)

Purpose of Presentation

Information Only

Request Support

Other

Key Points of Delegation (Please attach full presentation)

All presentation materials (ie. Powerpoint, handouts, etc.) must be attached to this Delegation Request Form. Do you have any accompanying presentation materials?

Yes

The desired action of Council that I am seeking on this issue is