Public Commission Hearing Participation Request Form

Help

If you need help completing this form or face any technical difficulties submitting this form, please contact the Canadian Nuclear Safety Commission Secretariat or send your submission by email to interventions@cnsc-ccsn.gc.ca. Find out more about how to participate in a public Commission hearing.

(*) indicates a mandatory field. Complete these fields before submitting the form.

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Public Hearing Details

Please enter the following information about the public hearing in which you would like to participate. This information can be found in the Notice of Public Hearing. Please note that submitting the request to intervene does not automatically provide intervenor status. Pursuant to rule 19 of the CNSC Rules of Procedure, the request needs to be accepted by the Commission. Acceptance will be confirmed by the Secretariat.

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*Date of Hearing (YYYY-MM-DD)
Licensee / Applicant
*Subject (as listed in the Notice of Public Hearing)

Contact Information

Name of Intervenor
*Title	Mr. Mrs. Ms.
* First Name
* Last Name
Organization (optional)
Email (optional)
*Mailing Address
*City
*Province/State
*Postal/Zip Code
*Telephone	( )
Fax (optional)	( )
How would you prefer to be contacted?	By email (Please enter your email address above) By mail By phone

Participation Details

*Will you be participating	Only in writing, by providing a written submission Both in writing and by making an oral presentation during the hearing
*Language of choice	English French

Intervenors are generally given 10 minutes to speak before the Commission. Oral presentations should summarize key points made in your written submission.

Optional - Representative information

Please complete the following section only if you choose to be represented by legal counsel, an agent, or a representative from your organization at the hearing:

First Name
Last Name
Organization
Mailing Address
City
Province/State
Postal/Zip Code
Telephone	( )
Fax	( )
Email

Written Submission

*Submit your written submission in one of the following ways: Attach your written submission(s) - Maximum combined file size 10MB - Accepted formats: DOC, PDF, XLS, TXT, RTF, PPT, WPD, ZIP, GIF, JPG, TIFF 1. 2. 3. 4. 5. and/or Paste or type your written submission in the box below

Additional Comments

Do you have any other comments, questions or suggestions?

 

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Privacy notice

The information on this form is required for the purpose of the public hearing of the Commisssion. It is collected under the authority of subsection 40(3) and section 44 of the Nuclear Safety and Control Act as well as subsection 18(1) and 19(4) of the Canadian Nuclear Safety Commission Rules of Procedure. The collection of the information is mandatory and is protected by the provisions of the Privacy Act.  If the noted information is not provided, the request to actively participate at a public hearing may not be accepted. The information collected will only be used and disclosed in the context of the public hearing process.