HomeMy WebLinkAboutSPEAKER FORMS 05-02-05
CITY OF TUSTIN
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REQUEST TO ~PEAK
Providing the following information is strictly volu~tary. 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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PUBLIC INPUT l;JI
AGENDA ITEM NO. 0-
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TODAY'S DATE iQ - L - I) .5-
NAME /) N T H ~ N Y T f< V:1 ILL f) O~GANIZATION -
¡(if applicable)
HOMEIWðftKADDRESS'DD' CODE q 2. 7'S Ô
HOME/WQRK PHONE NO. § ' /-) E-MAIL ADDRESS
(please indicate one)