Request to Appear as Delegation

Requested Date to Appear	Alternate Date Preference
Requested Date to Appear	Alternate Date Preference

Organization	Designated Speaker(s)
Organization	Designated Speaker(s)

Topic You Wish to Discuss

Please provide a brief summary.

Will you be seeking a specific action/decision?

Please Explain the Action/Decision You Are Seeking

Do you have an audio/visual requirement(s)?

Please Explain Requirements

Please note: requests will be assessed in accordance with the criteria in the Council Procedure Bylaw.

This form and the details provided will become part of the public Council agenda package. The personal information provided in the “Requestor Information” section of this form is being collected pursuant to Section 26(c) of the Freedom of Information and Protection of Privacy Act as further defined at the end of this form for the purposes of communicating with the Requestor, and will be withheld from the public Council agenda.

Requester Name

Company

A confirmation email with a copy of the submitted values will be sent to the address provided above.

Phone

Address

Address 2

City/Town

Province/State

Postal Code/ZIP

Country

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Personal information entered on this form is collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act (FOIPPA) for the purposes of processing your input. If you have any questions or concerns about how your information will be used, contact the FOI Office by calling 604-466-4300 or by emailing FOI@MapleRidge.ca. For more information about FOIPPA at the city, please visit our Freedom of Information page.