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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. I $ PUBLIC INPUT tl/
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IN FAVOR NOR OPPOSITION ❑ TO MATTER? TODAY'S DATE
NAME �`��. /I/ORGANIZATION
(if applicable)
HOMEIWORK ADDRESS�-. ,_CITYIZIP CODE 2,Z% r'L_____
HOMEMORK PHONE NO. � �% E-MAIL ADDRESS
(please indicate one)