HomeMy WebLinkAboutSPEAKER FORMS 02-15-11I"T,,' Y OF T STW,
REQUEST TO SPEAK
Providing the following information is strictly voluntary. Only your name will appear in the
official Minutes of this Meeting. The other information may be used by staff to contact you.
Please complete and submit this form to the City Clerk/Recording Secretary.
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AGENDA ITEM NO. ❑ PUBLIC INPUT I4
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IN FAVOR ❑ OR OPPOSITION ❑ TO MATTER? TODAY'S DATE 2--
NAMEi�
ORGANIZATIONuc� � bmym Tw
(if applicable)
CORK ADDRESS CITY/ZIP CODE r]
OME ORK PHONE NO. E-MAIL ADDRESS
ase indicate one)
CITY OF TuSTI
REQUEST TO SPEAK
Providing the following information is strictly voluntary. Only your name will appear in the
official Minutes of this Meeting. The other information may be used by staff to contact you.
Please complete and submit this form to the City Clerk/Recording Secretary.
...............................................................................................................11................................................................................................................................
AGENDA ITEM NO. IN 1 PUBLIC INPUT ❑
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IN FAVOR �K OR OPPOSITION ❑ TO MATTER? TODAY'S DATE F'C*). J`J, 201'
NAME 1)jh\n f�j ORGANIZATION Yd I "I V j i V-�
(if applicable)
HOME/WORK ADDRESS