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Example Pro forma for a petition

Checklist

Example Proforma - Petition to Preston City Council

You can download a PDF version of the Example Proforma - Petition to Preston City Council (PDF, 145 KB) here.

Statement of Petition: - (Please insert details here)

Contact details of Petition Organiser:

Name: 

Address:

Telephone number:

Email:

Signatories

By signing this form you are confirming that you are consenting to Preston City Council holding and processing your personal data.  

All personal information will be kept safe and secure and will only be kept for as long as is it necessary to deal with the Petition.  

If you do grant consent, please note that you can withdraw your consent by contacting ju.thorpe@preston.gov.uk.

Please include the following information

  • Name
  • Address
  • Signature
  • Identify if living, working or studying in Preston
  • Consent to hold and process your personal data - Please tick the box below to give your consent

Revised for GDPR - 17.5.18  - Cabinet Revised Scheme - 16.08.17  

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