PETITION & DELEGATION REQUEST FORM - David Brown

TOWN OF VIEW ROYAL PETITION & DELEGATION REQUEST FORM

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

Request to appear on:

• Year: 2017
• Month: May
• Day: 16th

[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: May 6, 2017 Email: Name of Applicant: David Brown, volunteer firefighter, View Royal Fire Rescue On Behalf of: David Brown Mailing Address: 309 Bessborough Avenue, Victoria, BC V9B 5M3 Local Street Address: 309 Bessborough Avenue, Victoria, BC V9B 5M3 Tel #: Fax: n/a

Details of Presentation: Donation in support of View Royal firefighter participating in 2017 Tour de Rock

The Canadian Cancer Society’s Tour de Rock (the Tour) is a 1,000 km ride that raises funds for children and their families who are dealing with paediatric cancer. Since its inception, the Tour has raised more than $20 million to support families on Vancouver Island, including families in our community.

Donations raised during the Tour fund life-saving research and support programs like Camp Goodtimes which provides recreational activities for children with cancer and their families.

The View Royal Firefighters’ Association has generously agreed to donate to the Tour. I am requesting a $2,500 donation from the Town of View Royal to help me meet my fundraising goal of at least $10,000.

List any requested audio visual needs: yes – I have a digital photograph that I would like to display during my presentation. I will need to have the photo loaded onto the Town computer and then displayed during my presentation. The digital photo has been included with my petition and delegation submission,

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 made available 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 complete agenda packages are available on the Town’s website (www.viewroyal.ca) and are available for viewing at Town Hall.

Please return completed form to the attention of the Deputy Corporate Officer 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