Client Information Request Form

Please note: The fields marked * are mandatory.
Date
Select a date from the calendar.
Full Name*
Address
City
Province
Postal Code
Business Phone
Alternate Phone
Company Name
Type of Company
Business Start Date
Select a date from the calendar.
How did you hear about us
Would you like to be added to our mailing list for newsletters and event announcements?*

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Privacy Statement

The personal information on this form is collected under authority of the Municipal Act SO 2001, c. 25. Questions about the collection of personal information should be directed to our Call Centre by dialing 3-1-1 (within Brampton city limits) or 905.874.2000 (outside city limits). Please review the City’s Privacy Statement for more information.