SAMPLE A -
First page of petition
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PETITION TO THE
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Here identify
either
(House of Commons, House of Commons in
Parliament assembled, Government of Canada,
Minister of the Crown, Member of Parliament)
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We, the undersigned,
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Here identify, in general terms, who the
petitioners are, for example
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citizens (or residents) of Canada
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electors of (name
of electoral district)
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residents of the Province of (name)
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residents of the City (or Village or
Township, etc.) of (name)
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draw the attention of the
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Here identify
either
(House of Commons, House of Commons in
Parliament assembled, Government of Canada,
Minister of the Crown, Member of Parliament)
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to the following:
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THAT
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Here briefly state the reasons underlying the
request for the intervention of the addressee
by outlining the grievance or problem or by
summarizing the facts which the petitioners
wish the addressee to consider.
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THEREFORE, your petitioners request
(or call upon) the
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Here identify
either
(House of Commons, House of Commons in
Parliament assembled, Government of Canada,
Minister of the Crown, Member of Parliament)
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To
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Here set out the request by stating succinctly
what action the petitioners wish the addressee
to take or what action it should refrain from
taking.
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Signatures
(Sign your own
name.
Do not print.)
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Addresses
(Give your full home
address, or your city and province, or province
and postal code.)
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