Constituency Assistance You may call my office at (416) 392-1374 or fill out the form below. If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required First Name * Last Name * Email * Home / Mobile Phone * Mobile Phone Street Number * Street * Unit City * Postal Code * Contact Method Preference * Home Phone Mobile Phone Email Nature of Request * Join Mailing List Yes No AUTHORIZATION I hereby give consent to the office of the Hon. Jim Karygiannis, Toronto City Councillor, Ward 22, Scarborough-Agincourt, to discuss/share* (see note below) details of my case with the appropriate municipal department and/or appropriate agency that is dealing with these matters. Furthermore, I authorize Mr. Karygiannis’ office to receive information related to these matters. This authorization shall exist until such time as it is rescinded in writing. *Information provided on this form may be shared with Departments and Agencies affiliated with the City of Toronto. if you agree with the above terms and conditions please check the box below I authorize sharing this information with necessary departments *