Test Form

IT Test Form Delegation Registration Form

Please fill out this form in full if you wish to speak to council during a council meeting. To find out when a council meeting is taking place, view our council calendar.
Name of Individual
First Last
Name of Organization
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Select what committee you would like to address (for committees not listed, please call 613-392-2841)(Required)
- Council
- Committee of Adjustment
- Planning & Development Services
Date of Meeting(Required)
MM slash DD slash YYYY
Subject(Required)
Reason for Delegation Request
Are you making a formal presentation with your request?
- Yes
- No
Any Additional Information
The personal information collected on this form is protected under the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and the Personal Information and Electronic Documents Act (PIPEDA). The information will only be used by Municipal Staff to prepare agendas and not be disclosed or used for any other purpose. Please direct inquiries to the Deputy Clerk, the City of Quinte West, at 613 392-2841 or deputyclerk@quintewest.ca. All requests for delegations are forwarded to the respective Committees. You will be notified of the time and date of your presentation by the responsible Department. For further information, call 613-392-2841.
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