Form Builder

Alternative Document Request Form

Loyalist Township will provide documents upon request in the most appropriate accessible format. This may include electronic formats, large print formats, and/or audio formats, as examples.

Any document found on our website or that we provide can be available in a different format upon request.

Step One: Personal Information

Name (first and last)

Address and Contact Information

Street Name and Number

Unit or Apartment Number (if applicable)

City/Town

Postal Code

Phone Number

Email Address

What is the best way to reach you?

by mail, in writing

phone

Details of Request

Name of the document you would like in an alternate format

Which format type would you prefer?

Large Print

Audio

Electronic (Microsoft Word, PDF or HTML text)

Other

Desired completion date of your request

Collection of Information

Personal information on this form is being collected under the authority of section 12 of the Integrated Accessibility Standards, Ontario Regulation 191/11 under the Accessibility for Ontarians with Disabilities Act, 2005, and will be used to provide accessible formats and communication supports upon request. Questions can be addressed to the Clerks Division at 613-386-7351 and press 7 or by email.