Required fields are marked with an asterisk (*) Event details Name of event * Event website (if applicable): First name * Last name * Phone number * Email address * Date of event Location * Start time * End time (Approximate) * Invitation details Mayor's role * Remarks and greeting required? * Yes No Dress code? * Casual Formal Business Is the media invited? * Yes No Is a guest or spouse permitted? * Yes No How many people are expected at the event: * Please list other dignitaries or speakers invited: Alternate Council Designate, if Mayor unavailable? * Yes No If yes, which Councillor? Additional comments: Privacy statement: In accordance with Section 485 of the Municipal Government Act (MGA), the personal information collected on this form will only be used by municipal staff and, if necessary, individuals under service contract with the Halifax Regional Municipality, for purposes relating to the processing of your recognition request. If you have any questions about the collection and use of this information, please contact the Access and Privacy Office at 902.490.7490, email email@example.com. What code is in the image? * Enter the characters shown in the image.