HomeMy WebLinkAboutSPEAKER FORMS 04-19-11~ITIf Q~ TI~STIN
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.
AGENDA ITEM NO. ^ PUBLIC INPUT'
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IN FAVOR ^ OR OPPOSITION [~'TO MATTER? TODAY'S DATE ` ~~ ~~~~
NAME ~ 1~ ~ ~/ ~ ~ ~~ ~ ~ ~ ' `~°' ORGANIZATION
(
ADDRESS ~" "~~~~~~~~~~ ~'~
(ple a i~ one
~~~~ QF ~~.~T~N
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.
AGENDA ITEM NO. ^ PUBLIC INPUT Q~
IN FAVOR ^ OR OPPOSITION ^ TO MATTER? TODAY'S DATE L-
NAME ~~~lJ ~~! ~ ~~ ~ ~~ ORGANIZATION~_ GVt/Jf/ ~`FrJ 1Y1 ~~ ~ ~ ~~~
E-MAIL ADDRESS ~ ~
MITI( QF TI~STIN
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.
.............Y...........................................................................................................................
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AGENDA ITEM NOr` ~ PUBLIC INPUT'+~
IN FAVOR OPPOSITION ^ TO MATTER? TODAY'S DATE `~`~ ~C
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NAME ~s~`'~~.,~ ` 1.1°~~~~`~ ~'~` ~~~-~ `~...~~'~~ ORGANIZATION ~~~ `~`t~'r~~~~ t~'; ~``C~y` ~ -.,z~= ~:. a^
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HOMEWORK PHONE NO. E-MAIL
~~~ QF ~~~~~~
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.
..................................................................................................................................... .
........................................................
AGENDA ITEM NO. ~_ PUBLIC INPUT
.....................................................................................................................................................................................................
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IN FAVOR OR OPPOSITION [] TO MATTER? TODAY'S DATE____~
`'f
NAME _ - ~fi . ~~ ~I(~1 ~ C.~ ~~v ~,
..~ ORGANIZATION ~ ~ ~ t ~t. ,~- f
(if applicable)
HOMEWORK ADDRESS ~~~~ ,~,~_ ~.~~(, ~- ~ ~
~ ~ E-MAIL ADDRESS ~~~ ~~~~~~
(please indicate one) -~-.
~~ ~~ ~~~~
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.
.. ...... ..... . ... . ..... . ... . ..... . ... .. ....... . ..... ... ...... ...... .... .. .... ... ... .......... .. . .. .. ... ... .... .. .. .. ... . . . . ... . . .. . ... . ... .... ... .... ... ... . .. ... . . . .. .... .. ..... . . . . .. . ..... . . .
AGENDA ITEM NO. ^ PUBLIC INPUT
IN FAVOR ^ OR OPPOSITION] TO MATTER? TODAY'S DATE. V I~~
NAME ORGANIZATION "-"""`
(if applicable)
HOMEWORK ADDRESS ~ ~ CITY/ZIP CODE ~ ~ ~ ti~ ~ ~i~~~
HOMEWORK PHONE NO. ~~~~~~ E-MAIL ADDRESS.. ~ ~ (~ ~ ,~~
(please indicate one)
~tTY ~F TI~StTtI~
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.
................................................................................................................................................................................................................
AGENDA ITEM NO. ^ PUBLIC INPUT
~ ~
IN FAVOR j] OR OPPOSITION ~ TO MATTER? TODAY'S DATE `~~ ~ ~ ~~~ ~ ~`'r
,~ r
NAME ~~, f..t; ~ ; `. ~_~ ~1 (~ ~ ; ORGANIZATION
r (if applicable)
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HOMEWORK ADDRESS ~ ~~ ~~ ..~ ~~` ~~ ~'~~ ~' ~~~`.CITY/ZIP CODE ~ ~ ~~~ ~`~ ~"~' ~ ~ ~~~ T" > ~~
HOMEWORK PHONE E-MAIL ADDRESS
(please indicate one)
CITY ~~ fius~rr~
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.
AGENDA ITEM NO. ^ PUBLIC INPUT
~~ ~-lJ
IN FAVOR ^ OR OPPOSITION ^ TO MATTER? TODAY'S DATE
NAME ~ D~~ ORGANIZA N
CITY/ZIP CODE ~~~ j
HOMENVORK PHONE ~ ~ + ~ E-MAIL ADDRESS ~~ ~ ~~ ~" '~' ~ `~-! .-
(please indicate one) . ~ ~~
~~T~ ~~ SST
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.
AGENDA ITEM NO. ^ PUBLIC INPUT,'
IN FAVOR ^ OR OPPOSITION ^ TO MATTER? TODAY'S DATE ~ ~ l~ ~/
NAME ~~~C/E /SI~,~ c5'~ t~ ORGANIZATION -S'GE~
(if applicable)
HOMEWORK ADDRESS /'~/'
' ~~~ E-MAIL ADDRESS
(please indicate one)
~ ~_q ~~~-~ 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.
...........................................................................................................................................................................................
AGENDA ITEM NO. ^ PUBLIC INPUT
IN FAVOR ^ OR PPOSITION ^ TO MATTER? TODAY'S DATE ~~/ ~~
NAME
ORGANIZATION_ ~VG...
~ ~ ~, ~~ // ~~~ plicable)
HOMEWORK ADDRESS _~=,~~.~~ ~~~
ADDRESS
~~~