Required fields are marked with asterisks (*)

Delegation Request Form

Delegation Rules and Guidelines

Delegations are only permitted before Committee of the Whole provided that the Delegate has submitted the pre-requisite full copy of presentation material and has received approval of their submission.
In order to be included as a delegation on the public agenda, Delegates must submit to the Municipal Clerk, a written request to appear no later than 4:30 p.m. on the Wednesday before the scheduled day of the meeting, including a written full copy of their presentation and comments to be made at the meeting. Delegation requests received after this time will not be listed on the public agenda.
Delegation presentation material and comments are subject to approval before any delegation is confirmed. Delegations will receive confirmation of their delegation status upon approval by email address you have provided on the delegation request form.
Delegation are permitted 10 minutes for their presentation, not inclusive of questions from the Committee.
PowerPoint presentations are permitted provided that an electronic copy of the presentation is submitted to the Municipal Clerk as part of their delegation submission no later than 4:30 p.m. on the Wednesday before the meeting. A copy will be distributed to Members of Council sitting as Committee of the Whole as part of the delegation submission.
I understand and confirm that the photographs and/or video and/or audio recordings included in this delegation package are my property OR I have been granted explicit permission to use the photographs and/or video and/or audio recordings as part of my delegation presentation. I grant permission to the Municipality to publish these images on the Municipality of Port Hope and other websites and acknowledge that in doing so, they will be available to the public. I further understand that the Municipality of Port Hope has no control over, and is not responsible for, the use or misuse of materials on its website, including photograph and/or video and/or audio recordings submitted in this package.

Name of Delegate(s):

Group/Organization/Business Delegation Represents (If applicable):

I wish to appear before:

Regular Council

Committee of the Whole

Meeting Date Requested:

Purpose of the Delegation/General Nature:

Recommendation to Council/Committee/Board:

Have you appeared before the Municipality of Port Hope's Council or Boards in the past to discuss this issue?

Yes

Will you have an oral or written presentation?

Written

Oral

Do you have any equipment needs?

Yes

If selecting YES, please indicate the type of equipment needed for your presentation:

Please upload other documentation if needed.

Browse…

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

Will a PowerPoint presentation be made?

Yes

Accessibility Accommodation

Yes

If yes, what accommodation(s) do you require?

CONTACT DETAILS

First and Last Name

Phone Number:

Address:

Email Address:

By clicking "yes" I acknowledge that the information contained in this Form, including any attachments, will become public documents and listed on the Municipality of Port Hope Agenda.

Yes

By clicking "yes" I have read and understood the Delegation Rules and Guidelines.

Yes

Applicant Signature

Clear

Date

OFFICE USE ONLY

Delegation request:

Denied

Approved

Delegation Rescheduled to:

Mayor to Approve if:

To a Council Meeting

If presentation to exceed the alloted 10 minutes

Authorized alloted time will be:

If request exceeds the 5 permitted delegations

I Want To...

Get in touch

Apply and Register

Pay

Get Involved

Form Builder

Delegation Request Form

Delegation Rules and Guidelines

OFFICE USE ONLY