Petition & Delegation Request Form - Nancy Walshe

TOWN OF VIEW ROYAL PETITION & DELEGATION REQUEST FORM

*Before completing this form, please refer to the Petition & Delegation Information Package

Request to appear on: 2015 - JUNE - 23

[x] Council [ ] Committee of the Whole

Anyone wishing to be placed on an agenda to address Council or Committee of the Whole may apply by delivering a request in writing to the Corporate Officer by 12:00 noon on the Thursday preceding the meeting date by completing this application form. Council meetings are held on the 1st and 3rd Tuesdays of the month with the exception of August; and only the 1st Tuesday of the month in December.

Each delegation is limited to fifteen (15) minutes unless extended or reduced by unanimous resolution of Council members present.

Date: JUN 17, 2015 Email: Name of Applicant: NANCY WALSHE On Behalf of: SELF (Organization, Business, Self, etc.) Mailing Address: #23, 118 ALDERSMITH PL, VICTORIA, V9A 7M Local Street Address: same Tel #: Fax:

Details of Presentation: IMPACT OF CHANGES TO HALLOWELL ROAD

(provide additional information as an attachment if required)

List any requested audio visual needs: NONE

NOTE: Council and Committee of the Whole meetings are public meetings. The information on this form will become part of the public record and will be distributed to Council, staff, media and the public. The information on this form is collected in order to respond to your request to appear before Council. If you have any questions about the collection and use of this information, please contact the Corporate Officer. The agenda is posted on the public notice board at the Town Hall and on the Town's website www.viewroyal.ca. Complete agenda packages are available for viewing at Town Hall.

Please return completed form to the attention of the Deputy Municipal Clerk by fax to 250-727-9551, by email to info@viewroyal.ca or in person to View Royal Town Hall, 45 View Royal Avenue, Victoria, BC V9B 1A2