Required fields are marked with asterisks (*)

Community Flagpole Request

Community groups will be required to submit a request for a flag raising at least four weeks prior to the date, along with a brief description of the nature of the flag raising. Requests will be confirmed on a first come, first served basis.

Organization Name

Contact First Name

Contact Last Name

Phone Number

Street Address

Address Line 2

City

Postal Code

Organization Website

Start Date of Flag Raising

End Date of Flag Raising

Provide a brief description of the nature of your flag raising.

Notice of Collection

Personal information contained on this form is collected in accordance with the Municipal Act and will be used for the purpose of responding to your request. Questions about this collection may be directed to the Municipal Clerk at 905-318-5932 or clerk@haldimandcounty.on.ca.