The personal information submitted on this page is collected under the authority of the Municipal Act and will be used to help promote environmental stewardship and to contact you should we require additional information. Questions about this collection of personal information should be addressed to Jamie Skimming, Manager of Air Quality at 300 Dufferin Ave., London, ON N6A 4L9. Tel: 661-2500 ext. 5204, or by email to email@example.com
BY CLICKING ON THE SUBMIT BUTTON BELOW I HEREBY GIVE MY CONSENT TO THE CITY OF LONDON TO MAKE PUBLIC MY NAME, MY ADDRESS (FOR THE PURPOSES OF INDICATING MY LOCATION ON THE MAP), MY WEBSITE ADDRESS (IF PROVIDED), MY COMPANY NAME (IF PROVIDED), MY IMAGE FILE (IF PROVIDED), AND MY COMMENTS AND OPINIONS PROVIDED ON THIS PAGE.