Required fields are marked with asterisks (*)

Petition Submission Form

When a completed Petition Submission Form and Petition is received, it will be reviewed to ensure it complies with the Town's Petition Policy and the person who submitted the form will be contacted by Council Services Department with the next steps. Please read the following prior to submitting a Petition:

The Petition must be appropriate and respectful in tone, and must not contain any improper or offensive language or information.
The Petition must be typed or legibly handwritten and printed on letter size paper. (No pencil)
Each Petitioner must print and sign their own name and must provide their full address or roll number.
The subject of the Petition must be at the top of each page of signatures.
The Petition must clearly disclose on each page that it will be considered a public document at the Town of LaSalle and that the information contained will be subject to public viewing.

All Petitions and any corresponding supporting material, presented to Council shall be retained by Council Services in accordance with the Records Retention By-law in effect at that time, and will be available for public viewing upon request.

The Petition Submission Form and Petition will be reviewed by the Clerk. Please ensure your submission meets the requirements of the Petition Policy in all areas.

Please Note: The request for action or opinions being conveyed must be within the authority of Council.

First Name

Last Name

Phone Number

Street Address

City/Town, Province

Postal Code

E-mail Address

Please describe in detail the issue that you seek to address in your Petition, including the desired action or outcome requested of Council

Minimum characters: 20

Please describe in detail what course of action you have taken to date in regard to your issue

Minimum characters: 20

Personal information is being collected and will be used to correspond with the Petitioner and for the purpose of informing Town of LaSalle Council as to your views on the matter specified in this petition. The Petition and corresponding Petition Submission Form are considered a public documents and the information contained therein may be made public through the public meeting process, including the distribution of the Petition as an item on an agenda. The personal information collected on this petition is collected under the authority of the Municipal Act, 2001, and will be maintained for the purpose of creating a record that is available to the general public in accordance with the provisions of the Municipal Freedom of Information and Protection of Privacy Act. Questions about the collection, use, and disclosure of personal information can be directed to the Clerk, at 519-969-7770.