Deputation Request Form

The Shire of Boddington collects personal information to process requests, applications and related enquiries. Information may be shared with relevant parties where required or as authorised by law. If the information is not provided, the request or application may not be processed. Further information is available in the Shire's Privacy Statement.

Full Name*

Address*

Organisation Name (if applicable)

Number of People in deputation*

What role will you play during the deputation*

One of the two nominated speakers
Attendee

Reason for Deputation*

Attachments (if required)

Max File Size: 30.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx