HomeMy WebLinkAboutSPEAKER FORMS 01-17-05
CI¡TY' O¡F' T:US.TIN
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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.
ptease complete and submit this form to the City Clerk/Recording Secretary.
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AGENDA ITEM NO. 0
PUBLIC INPUT 0
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IN FAVOR D OR OPPOSITION D TO MATTER?
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TODAY'S DATE/--- /7-' ðb
NAME L (Lft' t\Y í3JøÐk 5 . ORGANIZATION A/,,~ e.
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ITY/ZIP CODE 7' À 7 g 0
HOMEIWORK PHONE NO. 7
(please indicate one)
E-MAIL ADDRESS þt) P. ~
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. 0 . PUBLIC INPUT ø
NAM E Y-:/ 'Jv1 Jv1L /¡ ()l-!a 0 R GAN IZA T 10;;;þ ! Ai.(..
(if applicable) a
HOMEIWORK ADDRESS CITY/ZIP CODE ~
HOME/WORK PHONE NO. . ' E-MAIL ADDRESS
(please indicate one)
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