SAMPLE A — First page of petition
| 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) |
| We, the undersigned, |
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Here identify, in general terms, who the petitioners are, for example
- citizens (or residents) of Canada
- electors of (name of electoral district)
- residents of the Province of (name)
- 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) |
| 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. |
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) |
| 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. |
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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