Form Builder - City of Burlington

Required fields are marked with asterisks (*)

Read-o-graph Application

Purpose

Use this form to submit a request to advertise with the City of Burlington. Your request will be assessed and City staff will contact you to discuss the availability of advertising space.

Questions about advertising inquiries

City of Burlington
Recreation, Community and Culture
426 Burlington, ON, L7R 3Z6
Phone: 905-335-7777
Email: advertise@burlington.ca

Personal information contained on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c. 25 and will be used for the purposes of administering your request for advertising. Questions about this collection should be directed to the Supervisor of Business Services, Recreation, Community and Culture, 426 Brant Street, P.O. Box 5013, Burlington, Ontario, L7R 3Z6 T: 905-335-7738 E: liveandplay@burlington.ca.

Personal Information (Representative)

First Name

Last Name

Email Address

Telephone No.

Organization Information

Name of Organization

Organization Type

Non-Profit

Commercial

Address

City

Postal Code