Public Question Time Request Form

Prefer to complete a paper form?

You can complete and submit this form online below. Alternatively, you can download the PDF version, complete it electronically or by hand, and return it using the submission details provided on the form.

Download the PDF form

Contact Information

First Name*

Last Name*

Organisation represented (if applicable)

Residential Address*

Email Address*

Phone Number*

Request Type

Complete the relevant section for Public Question Time and/or Deputation Request. Shire officers may contact you if further information is required.

Meeting Type*

Meeting Date*

Agenda Item Number or Subject

If Special Meeting, Purpose of Meeting / Relevance

Public Question Time

Complete this section if you wish to ask a question during Public Question Time. Questions should relate to a matter affecting the Shire and must be asked as questions rather than statements.

Question 1*

Question 2

Declaration & Acknowledgement

Acknowledgement for Public Question Time

I acknowledge that questions must be asked in accordance with the Shire of Carnarvon Meeting Procedures Local
Law 2021, including question limits, time limits and the requirement for questions to be clear, concise and framed
as questions.

Declaration*

I confirm that the information provided in this form is true and correct. I acknowledge that I have read the public time information contained in this form and understand that my participation is subject to the Shire of Carnarvon Meeting Procedures Local Law 2021.