Deputation request form

Required fields are marked with an asterisk (*).

Contact Details

Contact Name * Please enter your name

Organisation Name (if relevant)

Phone Number * Please enter you preferred contact number

Email Address *

Deputation Request Details

Meeting Date * Please advise the date of the meeting (note at least 5 business days’ notice prior to the date of the meeting is required).

Day Month Year

Number of speakers * How many people will present the deputation

Name(s) of speaker(s) * Please advise who will be speaking

Subject * Please give details about the subject matter

Deputation Details * Please provide an explanation of the topic and content of the deputation request

To which matter, program, policy, strategy or other item currently before Council does the deputation relate? *

Have you spoken to an Elected Member or staff member about the matter or presented previously?

What outcome are you expecting as a result of the deputation? *

If relevant how might the community benefit from the outcome of this deputation? *

Are you presenting on behalf of a group, organisation, or association, and if so what is the name of the group, organisation or association? *