Required fields are marked with asterisks (*)

Delegation Request - Committees

If you intend to make a presentation to one of the committees named in this form, you must complete a delegation request in advance. Requests must be submitted no later than 4:30 p.m. two days prior to the meeting date. Once we receive your delegation request, we will confirm your attendance and provide you with the instructions for participating in the public meeting.

If you are unsure of the committee date, please consult the meeting calendar.

You can also view our Virtual Meeting Participation Guide for more information.

Requested committee meeting date:

Please select a committee:

Committee of Adjustment

Planning Committee

Speaker name (and title if applicable):

Organization (if applicable):

Address:

Telephone:

Email:

File number:

Provide a brief summary of the information you wish to share as a delegation (If you have already been a delegate on this matter, specify the new information you intend to share)

Will you be providing supporting documentation?

Yes, but I will provide at a later date.

Yes

If your supporting documents are not ready at the time of the request, please submit them no later than 4:30 p.m. two days prior to the meeting to zoning_zonage@clarence-rockland.com. Documents not received prior to the deadline may be refused.

If yes (please complete):

PowerPoint presentations (electronic copy must be submitted with this request)

Word or PDF document (electronic copy must be submitted with this request)

Please upload supporting documentation

Browse…

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

I understand and agree to these procedures for delegations and agree to abide by them.

I agree

Form Builder

Delegation Request - Committees

I'd Like To...