Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
  1. Only first name and last initial will be used.

  2. For follow up.

  3. Collection and Use of Personal Information

    By submitting this form you are consenting to the collection, use and disclosure of your personal information between the City of Coquitlam and our Service Providers (CivicPlus, Upaknee, Tri-City News etc.). Your information is collected for the purposes of Volunteer Week in accordance with the Freedom of Information and Protection of Privacy Act. Volunteers will have the information they provided posted on social media, the City website, on posters in City facilities and in the newspaper. For questions regarding the collection and use of your personal information, please email Community Services.

  4. Leave This Blank:

  5. This field is not part of the form submission.