Petition format


To the Legislative Assembly of Victoria

The Petition of

(insert here the names or descriptions of the petitioner or petitioners, such as residents of Victoria or residents of [name of town, region or electorate in Victoria])

draws to the attention of the House


points out to the House

(insert here the circumstances of the issue)

The petitioners therefore request that the Legislative Assembly of Victoria

(insert here the request of the petitioners, showing clearly the nature of the remedy or action requested) 

NAME                                                 ADDRESS                                           SIGNATURE





PLEASE NOTE: The names and addresses of people who sign this petition will be made available to the public if the petition is presented in the Legislative Assembly.


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