City of Burnaby Proclamation Request Form

Please submit your request at least four weeks prior to the date the Proclamation is issued.

Requestor information

Organization name

Organization website

First name

Last name

Address

City

Postal code

A pdf of the proclamation will be emailed to the address below.

Phone

Proclamation information

New or repeat request

New

Repeat

Unsure

Occasion or campaign title

Start date

End date

Please provide website(s) where we can research the occasion or campaign, or where we can see how the other governments have recognized the occasion or issue.

Describe the significance and connection your Proclamation request has to the citizens of Burnaby. (200 words or less)

Provide suggested wording for the Proclamation to a maximum of five “whereas” statements and a maximum of 200 words in total (the City of Burnaby reserves the right to edit for length, grammar and appropriateness, in consultation with the requesting organization.)

Your privacy

Your personal information is being collected and used for the purpose of administering the proclamations program and will be managed in accordance with s. 26 (c) of the Freedom of Information and Protection of Privacy Act. All personal information collected through this form will remain confidential and will be de-identified when shared. For questions regarding the collection of Personal Information and receipt of electronic messages please contact Marketing and Corporate Communications at [email protected].