Accessible Information Request Form

The Municipality of Hastings Highlands is committed to providing information in a format that meets your needs. If you need information in an accessible format or with the assistance of a communication support, please complete this form. Your request will be sent to the Office of the Clerk. Alternatively, your request can be made by calling 613-338-2811 ext. 277 or emailing [email protected]

First Name

Last Name

Address (City, Town, Province, Postal Code)

Telephone Number

Explain what information you need in an accessible format:

What type of alternative, accessible format would you like to receive the information in? Examples of alternative formats include: (a) Printed in a larger size or font (b) Colour Contrast (c) Alternative Language (Plain Language, Non-English)

Personal Information contained on this form is collected under the authority of the Municipal Act, R.S.O. 2001, c.25, and will be used to provide accessible support/services with the Municipality of Hastings Highlands. Personal information contained on this form is collected in accordance with the provisions of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and will be used to answer your request. Questions about the collection of personal information should be directed to the Municipal Clerk [email protected] or (613) 338-2811 ext. 2811.