Delegation Request Form

Members of the public may request to make a presentation to Port Coquitlam City Council at a Council Meeting about issues affecting the City.

Depending on the topic, some delegations will be scheduled for a Committee of Council meeting prior to/instead of going to Council.

Preferred Council Meeting Date

A Legislative Services staff member will contact you to confirm your attendance at the meeting. If you require any audio/visual equipment, please advise the staff member at that time.

Applicant's Name

Title and Organization

If applicable.

Phone

Mailing Address

Address 2

City

Province

Postal Code

Speaker's Name

If different from applicant.

Title and Organization

If applicable.

Please fully describe the topic you wish to address:

Will you be seeking a specific action or decision? If so, please explain:

Will you have PowerPoint slides to accompany your verbal presentation?

Yes

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 the collection of this information, please contact the City’s Records and FOIPPA Administrator at 604.927.5250 or [email protected].

CAPTCHA

Math question 2 + 8 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.