Request for Routine Access - Parks & Recreation

Required fields are marked with an asterisk (*)

Request for Routine Access

As noted in the Routine Disclosure Plan, please describe the records you are requesting:

Requested Information:

How would you like the information returned to you? *

Mail

Requestor's Information

Title

First name

Last name

Phone number *

Alternative number *

Email address *

Confirm email *

Address

Street number, name and type *

Unit / Apartment *

City / Community *

Province / Territory *

Postal code *

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 902.943.2148, email privacy@halifax.ca.