Form Center

2. 
4. Requested by:*
   Enter name, organization, etc.
5. Email address*
   Please provide the best email to contact you if we have followup questions.
6. Date of Request
   Date of Request

   Date of Request
8. Discussion Item Name*
9. Discussion item type (what sort of item are you proposing discussion?)*
   -- Select One --Project requestFunding requestOrdinance changeEventInitiative supportOther

   NOTE: If you select "Funding request" you must also complete a Financial Request Form that is available at cityofelgin.org/scfundingrequest.
10. Which meeting are you requesting this item be added to the agenda?
    -- Select One --July 2019August 2019September 2019October 2019November 2019December 2019
12. Description of the discussion item*
13. What sort of outcomes would you like to see from this discussion? (New ordinance suggestion, support for an event, etc.)*
15. What would define success for this item?
16. What is the timeframe for implementation of this item?*

    1. Immediate (can be decided and enacted immediately)
    2. Will require further discussion (1-3 months)
    3. Long range project (3-12 months)
    4. Other
18. Upload any supporting documents
19. Upload any supporting documents
20. Upload any supporting documents
22. Include links to supporting websites, materials, etc. for review.
23. By signing my name below, I agree to submitting a proposed itemization of fund usage and a post-event survey/cost form should my event be approved.*
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field