Request to Appear as Delegation You must have JavaScript enabled to use this form. Meeting Date Meeting Requested - Select -BoardCommittee of the WholeElectoral Area Services CommitteeOther Meeting - Please Specify Type of Meeting - None -Agricultural Advisory CommitteeCommunity Grants CommitteeElectoral Area A Parks, Recreation and Culture CommitteeElectoral Area B Parks and Open Space Advisory CommitteeElectoral Area C Parks and Open Space Advisory CommitteeElectoral Area E Parks and Open Space Advisory CommitteeElectoral Area F Parks and Open Space Advisory CommitteeElectoral Area G Parks and Open Space Advisory CommitteeElectoral Area H Parks and Open Space Advisory CommitteeLiquid Waste Management Plan Monitoring CommitteeOceanside Services CommitteeSolid Waste Management Plan Monitoring Advisory CommitteeI acknowledge and understand that the meeting at which I wish to speak is a public meeting, and by requesting to speak and by disclosing personal information in my oral or any written presentation I consent to the disclosure of that information as reasonably necessary by the Regional District of Nanaimo for purposes of administration and operation of the service to which my presentation relates. I am also asserting that the presentation is in compliance with the Federal Copyright Act, and grant the RDN license to publish these materials. Name of Presenter Please note affiliated organization if applicable. Multiple presenters may be listed. Home / Business / Cell number Email Name of Applicant if other than above Subject of Presentation Will you be using a Power Point presentation? Yes NoIf yes, you are required to submit the presentation materials to delegations@rdn.bc.ca at least 24 hours prior to the start of the meeting. Action which is being requested of The Board or CommitteeDelegations must state the specific action which is being requested. Executive Summary of PresentationDelegations must provide an executive summary of up to two (2) pages for inclusion in the agenda package. How do you plan to attend the meeting? - Select -In personVirtually (connecting by Zoom)Phoning inVirtual attendance is an option for attendees who have symptoms of a communicable disease (e.g., fever or chills, coughing, diarrhea) so they can avoid being at the event when sick. Please contact delegations@rdn.bc.ca as soon as possible should your plans change.Name of presenter, subject of presentation, action being requested and executive summary of presentation will be made public and will be available for review by Directors in advance of the Meeting. Audio/visual presentations will become public when shown at the Meeting and will be reviewed in advance by authorized staff and Directors as necessary.Additional information collected on this form will only be used by authorized staff for contact purposes. Personal information collected by the RDN is protected in accordance with the Freedom of Information and Protection of Privacy Act.For additional information, please contact RDN Legislative Services at 250-390-4111/toll-free: 1-877-607-4111, 6300 Hammond Bay Road, Nanaimo, BC, V9T 6N2, Fax: 250-390-4163 Information collected on this form is done so under the general authority of the Freedom of Information and Protection of Privacy Act (FOIPPA), and is protected in accordance with FOIPPA. Questions about the collection of your personal information may be referred to the Legislative Services Department via email at foi@rdn.bc.ca. Signature Sign above CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank
