HomeMy WebLinkAboutSPEAKER FORMS 11-07-05
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. 81 ~
............................
IN FAVOR 0 OR OPPOSITION 0 TO MATTER?
NAME
,/ /fVÞß
HOMEIWORK ADDRESS
ORK PHONE NO.
se indicate one)
e~1AI
?'-
PUBLIC INPUT 0
TODAY'S DAT:""~7~70t'-
ORGANIZATION
(if applicable)
CITY/ZIPCODE Ç21P1J
E-MAIL ADDRESS . ,
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.
P lea::_~'::~~~f~ï!:~t~~~ë:~:ì1~i~~~:::r:;~::~~ry .
,. "VCR L;:::;-;::=;-----=;~;=7-~¿;t?~ ~
NAME .. ORGANIZA nON 1-./111 £- ¡e! e::~
"
CITY/ZIP CODE It J:5 ,ì;{ij :;f-
HOMEIWORK PHONE NO. E-MAILADDRESS
(please indicate one) ,