City of Guelph

Personal information, as defined by the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) is collected under the authority of the Municipal Act, 2001, and in accordance with the provisions of MFIPPA.

Personal information on this form, such as name, address, telephone number and email address, will be used for the purpose of communicating with you about frozen pipe prevention activities and advisories.

If you have questions regarding this form please contact Water Services 519-837-5627 or waterservices@guelph.ca. If you have questions about this collection; use, and disclosure of this information, contact the City of Guelph’s Access, Privacy and Records Specialist at 519-822-1260 extension 2349 or privacy@guelph.ca.

For more information see the City of Guelph’s privacy policy.

* indicates required

First name (required) *

Required

Last name / business name (required) *

House number (required) *

Street name (required) *

Street suffix (required) *

Direction

Unit number

City (required) *

Province (required) *

Postal code (required) *

Primary contact number (required) *

Primary contact extension number

Email address (required) *

Are you a tenant? (required) *

Preferred format

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