Delegation Request Form

In order to facilitate constructive and effective public engagement, delegations have a ten minute time limit. Please try to leave time for questions. Note that the name of person &/or group along with the topic will be published and made public in the agenda package.

* Full Name

Group Name

* Phone Number

- -

* Email

Address

Address

Country	Province/State

City	Postal/Zip Code

* Presentation Topic

* Purpose

Information only
Request for Letter of Support
Funding request
Other (provide details below)

Additional Detail

Meeting Date Requested

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* Supporting Documentation

Handouts will be provided at meeting (14 copies required)
Publication to be included in agenda (due 10 days in advance)
Verbal only

* Equipment Required

Laptop (Microsoft Windows 7, Office 2010/13, Adobe)
Multimedia Projector (standard VGA connection, 1/8
Flip Chart &/or Easel
Will provide own equipment
None

* Agreement

I understand & agree to these terms (as outlined on www.scrd.ca/Public-Input).

* Today's Date

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