Municipality of North Cowichan

Complete this application form if you or your group would like to appear before Council or the Committee of the Whole to make a presentation regarding a topic or concern that is important to you or your community, and if you would like to share your point of view with Council before a decision is made.

Note - it is important to read the Appear as a delegation webpage prior to completing this application.

A copy of your submission will be emailed to the email address provided in your application.

Name of Applicant:

On behalf of:

Address

Address 2

City/Town

Province

Postal Code

Email:

Phone:

I/We request to appear as a delegation before:

Council

Committee of the Whole

Other

Requested meeting date

Review the 2026 Council and Committee of Whole (COW) meeting calendar and provide two (2) requested dates to appear before Council. We will do our best to accommodate your date preference, but due to volume of requests, there may be a need to find alternate options.

Choose Two Dates

Re-order	Select first date	Select second date	Weight	Operations
	Select first date	Select second date	Item weight

Please provide some information about the purpose of your presentation, including an executive summary (if you need more space, you can upload a file below)

Attach a one-page (maximum) outline of your presentation (if more room is needed). Please be specific.

One file only.
32 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

What is the specific action (Resolution) being requested of Council or the Committee:

Will you be requesting a grant or financial assistance?

Yes

Will you be providing supporting documents to include in the agenda package?

Yes

How will you be presenting?

PowerPoint/PDF

Video

Verbal

I affirm that I/we own the rights to the media I/we are providing and hereby grant the Corporation of the District of North Cowichan (Municipality) the irrevocable right and license to use, edit, alter, copy and distribute all materials provided as the Municipality sees fit in its absolute discretion, and that I have obtained appropriate personal information releases from all identifiable individuals appearing in these materials for such use.

Yes

I confirm that I want to participate:

In-Person

Virtually

Unsure

You can work with staff after submitting this form to determine how you would like to participate. Your participation needs to be confirmed at least 24 hours in advance of the meeting.

If participating virtually, I confirm that I have tested my ability to participate in a Webex meeting:

Yes

I would like a member of the North Cowichan IT team to connect with me to confirm my configuration:

Yes

To test your ability to participate in a Webex meeting, start a meeting at this site: https://www.webex.com/test-meeting.html

Once you join the test meeting, use these instructions to test your webcam, speakers, and microphone: https://help.webex.com/en-us/bzg2s7/Test-Your-Speaker-and-Microphone-in-Webex-Meetings

Personal information is collected by the Municipality of North Cowichan under the authority of s.26(c) of the Freedom of Information and Protection of Privacy Act for the purposes of processing delegation requests. Should you have any questions about the collection of this personal information, please contact Information Management Officer, (250 746-3116; 7030 Trans-Canada Highway, Duncan, BC V9L 6A1.

Delegation to Council Application