TO THE COUNCIL OF THE CITY OF WHITTLESEA

We, the undersigned, residents and ratepayers of the City of Whittlesea, request the Council to:
<< Insert details here of what is being requesting of Council. This wording must appear at the top of every
page of the petition and is referred to as the “prayer”. >>
Lead petitioner details [please print]

Name:

Address:

Telephone / Mobile:

Email:

Signature:

I, as head petitioner, wish to address Council in Yes ☐ If you agree to speak at the Council Yes ☐
support of the submitted petition at a Council No ☐ Meeting, do you as head petitioner or No ☐
Meeting. representative of the head petitioner give
consent for your name to be published in
OR
a Council Meeting Agenda and Minute
I, as a representative of the head petitioner, wish to Yes ☐ document. Yes ☐
speak in support of the submitted petition at a Council No ☐
Do you give consent to your name, No ☐
Meeting.
address, contact phone number and
Name of representative: email address being provided to media
outlets if requested.
Address:
Telephone/Mobile:
Signature:

Full Name [please print full name] Full Address [must provide full address] Signature

1.

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 TO THE COUNCIL OF THE CITY OF WHITTLESEA
We, the undersigned, residents and ratepayers of the City of Whittlesea, request the Council to:
<< Insert details here of what is being requesting of Council. This wording must appear at the top of every
page of the petition and is referred to as the “prayer”. >>

Full Name [please print full name] Full Address [must provide full address] Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

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Please Note:

1. Petitions should be addressed "to the Council".

2. A petition must:
 include the full name and address and contact details of the head petitioner;
 include the full name and full address of each person who signs the petition to be
counted as a valid signature; (eg: John Smith 12 Citizen Drive South Morang) (please
see our website for rules about signatures which includes where a person is unable to
sign due to illness or disability);
 only include persons signing this petition who live, work, study or do business in the
City of Whittlesea and should include a valid address including a post code;
 only have each individual sign this Petition once (ie. one person can’t sign multiple
times); and
 refer to a matter which is within the power of Council to address.
3. A petition should preferably be in English or alternately be accompanied by a certified
translation.
4. Please do not:
 attach letters or other documents to the petition or joint letter;
 paste or attach signatures to the petition or joint letter, or incorporate photocopies of
names;
 sign, or allow anyone else to sign, on behalf of another person.
5. Where a petition consists of more than one sheet, each sheet must be headed with the
prayer and details of the petition.
6. Each sheet should be numbered Page 1 of [total number of pages].
7. Each petitioner signing the petition should be numbered in sequence commencing on each
page with the number 1(one) so as to identify the number of signatures on each page.
8. All correspondence in relation to the petition or joint letter will be addressed to the head
petitioner signatory to a joint letter, or all petitioners/signatories to a petition/joint letter where
there are 12 or less signatories. It is the head petitioner’s responsibility to update the rest of
the petitioners in relation to the matter.
9. Please note if you will be addressing Council at the Council meeting where the petition will be
tabled, the meeting will be livestreamed and it will be assumed that you have provided
consent to being featured in the broadcast and recording of the Council meeting.
10. Please note that the contents of this form will be maintained in accordance with the Public
Records Act 1973 and Privacy and Data Protection Act 2014.

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