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Deputation Request Form

In the Township of Brock, you can request to speak at a Council or committee meeting on a specific issue or agenda topic.

You must submit your request, together with all background information for consideration, no later than Tuesday at 12:00 p.m. the week before the meeting. View our Council Calendar for upcoming meeting dates.

Name

Mailing Address

Email Address

Phone Number

Preferred Meeting Date

I am requesting a deputation to speak

on behalf of an organization, business, group or association

on my own behalf

I would like to use:

laptop

projector

Subject of Presentation

Please upload any documents you would like provided to Council.

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

Confirmation

I hereby confirm that the information provided in this form is true, complete, and accurate to the best of my knowledge.

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Deputation Request Form