We have received your submission. A representative from Niagara Region will contact you to confirm your order within five business days.
* = Required
No Smoking (for walls)
10 x 10 cm Quantity:
No Vaping (for walls)
No Cannabis (for walls)
No Smoking/Vaping within 9 metres (for walls)
20 x 15 cm Quantity:
No Smoking (for glass)
No Vaping (for glass)
No Cannabis (for glass)
No Smoking/Vaping within 9 metres (for glass)
No Smoking / No Vaping (for glass)
Tobacco Product Age Restriction
35 x 18 cm Quantity:
Tobacco Product Identification
18 x 9 cm Quantity:
Vapour Product Age Restriction
* Contact Name
* Phone xxx-xxx-xxxx
* Email
* Business / Workplace
* Address
Unit #
* City Select City...Fort ErieGrimsbyLincolnNiagara FallsNiagara-on-the-LakePelhamPort ColborneSt. CatharinesThoroldWainfleetWellandWest Lincoln
* Postal Code
Any personal information or personal health information submitted in writing will be collected, used and disclosed by members of Regional Council and Regional staff in accordance with the Municipal Freedom of Information and Protection of Privacy Act or the Personal Health Information Protection Act, where applicable.
Freedom of Information
Any information you share will be used only for the intended purpose for which it was provided. If you have any questions, email foi@niagararegion.ca or call 905-980-6000 ext. 3779.