Online Form - RE-BRANDING - please record your vote

First name *

Surname *

I live locally at ...

Street Address:

City:

State:

Post Code:

Country:

Phone Number

Email

My preferred option for the new brand for York is.... *

Option OneOption Two

Comments....

The Shire of York values the privacy of our residents, customers and stakeholders. In an effort to improve transparency in decision making, when submissions are provided as part of a report (or an attachment to a report) that is presented to Council, the name of the submitter will be published, unless otherwise requested by the submitter. *

I am happy for my name to be included in the report to Council
I do NOT want my name included in the report to Council