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Federal Lobbying Act Communications Disclosure Form

Lobbyist information
Name * Required
First Last
Faculty/Department * Required
Phone extension * Required
Email * Required
Lobbying details
Date(s) of lobbying with public official(s) * Required
Name(s)/title(s) of contacted public official(s) * Required
Subject of communication * Required
Project, funding or legislation topic * Required
Was the communication prearranged * Required
- Yes
- No
Was the communication spoken or written * Required
- Spoken
- Written
Will there be ongoing communication * Required
- Yes
- No
- Unsure
Name
This field is for validation purposes and should be left unchanged.

Collection notice

Brock University protects your privacy and your personal information. The personal information requested on this form is collected under the authority of The Brock University Act, 1964, and in accordance with the Freedom of Information and Protection of Privacy Act (FIPPA) for the administration of the University and its programs and services. Direct any questions about this collection to Government Relations at govtrelations@brocku.ca