HomeMy WebLinkAboutSPEAKER FORMSCITY 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.
................................................................................................................................................................................................................................................
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AGENDA ITEM NO. ❑ PUBLIC INPUT ❑
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IN FAVOR OR OPPOSITION ❑ TO MATTER? TODAY'S DATE ) t='Z 7 Z;20%,S
NAME iQ.X\C_ 1/ 1&QCX!n, 1'C 1 ORGANIZATION
(if applicable)
HOMEWORK ADDRESS �. �: . - CITY/ZIP CODE __
HOMEWORK PHONE NO.?/ E-MAIL ADD �
(please indicate one)
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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.
...........................I.......( x.........................
AGENDA ITEM NO.PUBLIC INPUT ❑
..............................................................................................................................................................................................................................................
IN FAVOR ❑ OR OPPOSITION ❑ TO MATTER?
TODAY'S DATE
NAME 90
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ORGANIZATION
(if applicable)
HOMEWORK ADDRESS
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CITY/ZIP CODE `'�
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HOMEWORK PHONE NO. _
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. ❑ Q, PUBLIC INPUT ❑
................................................................................................................................................................................................................................................
IN FAVORk OR OPPOSITION ❑ TO MATTER? TODAY'S DATE
NAME I �Y �� h ORGANIZATION
(if applicable)
HOME/WORK ADDRESS �� ✓' CITY/ZIP CODE _
HOME: F®RPHONE NO. ADDRESS
o
(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 N0..O/...... ................................PUBLIC INPUT..❑........................... .... .......
................................................................................................................................................................................................................................................
IN FAVOR .VOR OPPOSITION ❑ TO MATTER? TODAY'S DATE 0 Z �J
NAME I�_ �/� �� ORGANIZATION
(if applicable)
HOMEWORK ADDRESS
CITY/ZIP CODE
HOMEWORK PHONE NO� MAIL ADDRESS
(please indicate one)
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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 ❑
................................................................................................................................................................................................................................................
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IN FAVOR OR OPPOSITION ❑ TO MATTER? TODAY'S DATE U /
NAME JWIVt V1 1, b
ORGANIZATION
T `' ' (if applicable)
HOMEWORK ADDRESS ) CITY/ZIP CODE
HOMEWORK PHONE NO. 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. A, "2— PUBLIC INPUT ❑
..........................................................................................................................................................................................................
IN FAVOR;jR OR OPPOSITION ❑ TO MATTER? TODAY'S DATE
NAME �� �') ORGANIZATION
l (if applicable)
HOMEWORK ADDRESS CITY/ZIP CODE _
O /WORK PHONE NO. MAIL ADDRESS
`–(ease indicate one)
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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. n '2,- PUBLIC INPUT ❑
.................................................................................................................................................................................................................................................
IN FAVOW�'OR OPPOSITION ❑ TO MATTER? TODAY'S DATE
NAME �G�j��G� f I'"l ORGANIZATION ��
(if applicable)
HOME/WORK ADDRESS �` ZIP CODE �
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HOMEWORK PHONE NO.
(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. ❑ 1 PUBLIC INPUT ❑
.....................................................................................................................................................................................................................
IN FAVOR OR OPPOSITION ❑ TO MATTER? TODAY'S DATE
NAME ij-111 0 A W () S) ORGANIZATION
IL (if applicable)
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HOMEWORK ADDRESS - > CITY/ZIP CODE
HOMEWORK PHONE NO. ` E-MAIL ADDRESS
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