Local Authority Deputation Form

(Alternatively, if you wish, you can download a PDF of this form at LA Deputation Form and email it to governance@centraldesert.nt.gov.au , including any documentation that will be discussed in your presentation)

Please complete all fields with an asterix.

Dear CEO.

I am requesting your permission to make a deputation to the

Community*

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Local Authority at its next meeting on

Please pick the date of the LA meeting*

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I want to:

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I am seeking to discuss the following:

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The relevance to the Local Authority / Council in relation to the subject matter:

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I understand that I need to keep my deputation brief (5 minutes), use plain English language or an interpreter and use pictures wherever possible.

(Please include any document/s that will be discussed in your presentation at the Local Authority meeting.)

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Name*

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Organisation

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Email*

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Phone

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Please sign here*

Sign Above

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Today's Date*

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*It is Council policy that requests for deputations must be made in writing, two weeks before a Local Authority.

*Please include any document/s that will be discussed in your presentation at the Local Authority meeting.

CAPTCHA*

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