Authorization to Speak on Someone's Behalf Form

If you would like to speak at a Council meeting on someone’s behalf, the person will need to complete and submit an Authorization to Speak on Someone’s Behalf Form.

The personal information on this form is collected by the Town of High River pursuant to legislation governing personal information handling practices, specifically Sections 4(a) and (c) of the Protection of Privacy Act, Section 197(2) of the Municipal Government Act (Alberta) (MGA), and other legislation or bylaws governing the municipality, as may be applicable. By submitting this form, you acknowledge that in accordance with Section 20(2)(a) of the Access to Information Act, your name, address and other details related to your request will be used to process your request. Should you have any questions related to the collection or disclosure of your personal information, please contact the Town’s Privacy Officer at ATIPP@highriver.ca or 403-652-2110.

Authorizer Information

Authorizer's Full Name:
Authorizer's Mailing Address
Do you consent to being contacted to confirm this request?  
Type of Item 
If someone is speaking on your behalf at a public hearing, are you in support or in opposition? 

Authorized Person Information

Authorized Person's Name:
Authorized Person's Mailing Address:

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309B Macleod Trail S.W., High River, Alberta

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legislativeservices@highriver.ca

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403-652-2110

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