Required fields are marked with asterisks (*)

Proclamation Request

Proclamations should be submitted at least 90 days in advance of the event/date of signifigance.
View the Proclamation, Flag-Raising and Lighting of Penman's Dam Policy for full details and eligibility requirements.
Please not that requests for a Flag-Raising or Lighting of Penman's Dam must be accompanied by a request for Proclamation.

Name of Individual, Organization or Community Group

Contact Name

Mailing address

City/Town

Postal Code

Email Address

Phone Number

Requested Date of Proclamation

Description of Organization

Purpose of Proclamation

Please provide the text you wish to see included for the Proclamation. Please note that the text is subject to approval by the County Clerk and may be edited or rewritten to ensure compliance with County policies and procedures.

Would you like to attach supporting information for this proclamation request?

Yes

Do you want to include a request for a flag-raising and/or lighting of Penman's Dam?

Flag-raising

Lighting of Penman's Dam

None

By signing below, I hereby certify that the information contained in this application form is accurate.

Date

Signature

Clear

Personal information on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c.25, as amended and will be used to administer your proclamation (flag raising, dam lighting, delegation) request the County of Brant. Questions about this collection should be directed to Council Services at clerks@brant.ca