HomeMy WebLinkAboutSPEAKER FORMS 12-04-12CITY OF TUSTIN
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?
NAME
TODAY'S DATE ( ?,�
ORGANIZATION
{if applicable} ro O
HOMEWORK ADDRESS
, ,E-MAIL ADDRESS '
(please indicate one) �-�
CITY OF TUSTIN
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?
NAME
TODAY'S DATE q- f 2—
ORGANIZATION C�
(if applicable)
HOMEWORK ADDRESS CITY/ZIP CODE �nft
HOME/WIRK PHONE NO. E-MAIL ADDRES
(please indicate one)
CITY OF 7'USTIN
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 ClerklRecording Secretary.
^ AGENDA.ITEM NO. 0 PUBLIC INPUT I,d,
IN FAVOR ❑ OR OPPOSITION ❑ TO MATTER? TODAY'S DATE 1 z -
IMAM ��
E ORGAN iZATION
(if applicable)
HOMEIWORK ADDRESS CITYIZIP CODE
HOMEJWORK PHONE NO. E-MAIL ADDRESS
(please indicate one)