Required fields are marked with asterisks (*)

Delegation Registration

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 here.

If you have any questions regarding this form, call our council coordinator at 519-747-8549.

Write your name as you would like it listed on the agenda for the council meeting

Do you have an email address?

Yes

Please provide a telephone number where we can contact you if needed

What municipality do you live in?

Waterloo

Kitchener

Woolwich

Wilmot

Wellesley

Cambridge

North Dumfries

Other (please specify)

Are you addressing Council as:

an individual

an organization such as business, neighbourhood association, interest group etc.

legal representative or consultant for a third party

Is there more than one person speaking to this topic in your delegation?

Yes

Is the topic you're speaking to on an upcoming Council agenda?

Yes

Unsure

Please provide a brief summary on the topic of what you would like to discuss with Council

Will you be making a request or recommendation to Council?

Yes

Will you have an electronic presentation to go with your appearance at Council?

Yes

Unsure

Please provide any additional details regarding your appearance before Council

To the extent that the foregoing information constitutes personal information as defined in the Municipal Freedom of Information and Protection of PrivacyAct, R.S.O. 1990, chapter M.56 as amended, the information is subject to provisions of that Act and will be used for the purposes of scheduling you as a delegation for Council. Questions about the collection of personal information should be directed to the City Clerk, Waterloo City Centre,100 Regina Street South, Waterloo, Ontario, N2J 4A8, telephone (519) 886-1550.

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Delegation Registration