Application to address a Council meeting
(Clause 5.7 - Council's Code of meeting Practice)

Details of applicant
* denotes required field
Name:*
Address:*
Phone:*
Mobile:
Email:
Are you a resident/ratepayer of Kempsey Shire? Yes No
Details of application
Date of Council meeting:*
An item on Council's meeting agenda
Item No:
Subject matter:
Please indicate whether you are For or Against
or
I apply to address Council in respect of the following:
An issue that is not on Council's meeting agenda
Brief summary of your presentation:
Acknowledgement by applicant
I declare that the above information is true and correct in every detail and I have read and understood all the Guidelines for addressing Council.

I agree to comply with the Council’s Code of Meeting Practice in relation to order at meetings and to comply with the directions of the Mayor/Chairperson in this regard and will refrain from making any insult, allegation or personal reflection against any person, present or not at the meeting, during the course of my address to Council and any answers that I may give in response to questions from Councillors.

Confirmation of agreement and submission of request
(Click on "I Agree" button to confirm your agreement to the above and submit your application)