Lodge a Petition

Your Details
First name*
Last name*
Address 1*
Address 2 (optional)
Town/Suburb*
State*
Postcode*
Phone*
Email*
Preferred means of contact*
- Phone
- Email
Petition Details
Petition title*
Open date*
This is the date that you would like the petition to appear on Council's website
DD slash MM slash YYYY
Close date*
This is the date that the petition closes (generally a maximum of 6 weeks but can be less)
DD slash MM slash YYYY
Requested Action*
Briefly outline what action you wish Council to take
Petitioner's Statement*
Provide a clear and concise statement identifying the subject matter
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Your Details