City of Port Phillip

The Online Wish to Speak Form enables you to ask a question and/or make a comment at a meeting of Council/Committee.

To ensure that your question is received, please submit it prior to 4:00 pm on the day of the meeting.

If you have difficulties completing it, please Email our Governance unit via helpstat@portphillip.vic.gov.au or contact ASSIST on (03) 9209 6777

Required fields are marked with a *.

Meeting Date*

This field is mandatory

Your Details

The information you enter is held in the strictest confidence - see privacy statement below.

Name*

This field is mandatory

Address*

100 character(s) remaining.

Please enter full address, including street number, street name, suburb and postcode.

This field is mandatory

Telephone*

This field is mandatory

This field should be a valid email address

Interest in the item

Objector Applicant Supporter Not Applicable

This field is mandatory

Do you wish to *

ask a general question at Public Question Time ask a question and/or make a comment on an Agenda Item

This field is mandatory

Question to Council*

Please enter a question you have for Council.

5000 character(s) remaining.

This field is mandatory

Agenda Item Number and Name*

i.e 4.1 Petitions & Joint Letters, 8.3 Council Report Name.

5000 character(s) remaining.

This field is mandatory

Enter the text below*

This field is mandatory

The keywords are not match. Please try again

Get new keyword

Click the Submit button below and click 'OK' in the pop up configuration window for your question/s to be forwarded to the Council Meetings office for processing.

Thank you for taking the time to contact the City of Port Phillip.

Privacy Statement: The personal information requested on this form is being collected by the council for the purposes of enabling you to speak at a council/committee meeting. The personal information will be used solely by the council for this primary purpose or directly related purposes. The applicant understands that the personal information provided is for these purposes and that they may apply to the council for access and/or amendment of the information.