PETITION TEMPLATE

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					                                               PETITION


Please feel free to print off this template to use as the format for your petition. When complete,
please either:


         a)     give to your local ward councillor(s) (you can find out who your ward councillor is
                on our website at www.basingstoke.gov.uk/go/mycouncillor or by calling 01256
                844844) for presentation at a Council meeting;

Or:

         b)     deliver it to Committee Services, Basingstoke and Deane Borough Council, Civic
                Offices, London Road, Basingstoke, Hampshire RG21 4AH.

Topic:



What do you want the council to do?: _______________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Lead petitioner:         Name: ----------------------------------------------------------------------

                         Email address: ----------------------------------------------------------

                         Telephone:              Home ----------------------------------------------

                                                 Work -----------------------------------------------

                                                 Mobile ----------------------------------------------

                         Address: -------------------------------------------------------------------

                         ---------------------------------------------------------------------------------

                         -------------------------------------------------------------------------------
                                                                      First sheet


We, the undersigned, want Basingstoke and Deane Borough Council to:

_____________________________________________________________

Lead petitioner



                               SIGNATURES



     NAME                          ADDRESS                     SIGNATURE
                                                         Continuation sheet number [ ]


Continuation Sheet – (Copy as many times as necessary)

We the undersigned want Basingstoke and Deane Borough Council to:

_____________________________________________________________

Lead petitioner



      NAME                          ADDRESS                         SIGNATURE