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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.
AGENDA ITEM NO. ❑ PUBLIC INPUT
IN FAVOR ❑ OR OPPOSITION ❑ TO MATTER? TODAY'S DATE
NAME `r' ORGANIZATION
(if applicable)
HOMEWORK ADDRESS CITY/ZIP CODE
HOMEWORK PHONE NO.
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