Required fields are marked with asterisks (*)

Name submission form for public places in Dieppe

(Parks, Streets, Trails, Municipal facilities, Rooms)

Pour le français, cliquez ici.

Your information

First name

Last name

Phone number

Your suggestion

Proposed name

Select the category best describing the significance of the proposed name.

Name related to New Brunswick or Acadian culture or arts

Name of a deceased person who has made history in the region or municipality

Name rooted in heritage or inspired by local folklore or history

Name reminiscent of a landmark event for the region

Name inspired by marine, railway or air traffic heritage

Name reminiscent of traditional trades

Name related to regional geography or geology

Name reminiscent of the region’s fauna, flora or natural characteristics

Other

Please provide details (references, historical facts, dates, stories, etc.) as to how the name is significant to our community.

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188PD10.23

Personal information on this form is collected under the authority of the Right to Information and Protection of Privacy Act and the Personal Health Information Privacy and Access Act for the purpose of processing your application. Questions about this collection of personal information can be directed to the Clerk, 333 Acadie Avenue, Dieppe, New Brunswick, E1A 1G9, 506.877.7900.