HomeMy WebLinkAboutSPEAKER FORMS 03-20-06
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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 ~
R OPPOSITION 0 TO MATTER?
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HOMEIWORK ADDRESS
CODE tt5 /
E-MAIL ADDRESS
CITY OF TUSTIN
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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.
P..:_-:p~::~~~~~::~
___NNNNM__.._...._..___..___...._.._......__....
IN FAVOR D OR OPPOSITION D TO MATTER?
NAME ~...,/ (!d>c.O
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HOME/WORKADDRESS ) ~~;/(
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TODAY'S DATE
ORGANIZATION~!o -.. iU~yt'i\.
(if applicable) ~
CITYIZIP CODE ~/J(::-
E-MAIL
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CITY OF TUSTIN
SPEAKER'S FORM
PARKS AND RECRCA TION GOI'vIMISSION
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IF YOU WISH TO SPEAK TO THE PARKS AND RECREATION COMMISSION, PLEASE COMPLETE
THIS FORM AND SUBMIT TO THE SECRETARY PRIOR TO SPEAKING. COMPLETION OF THIS
FORM IS NOT MANDATORY, BUT IS REQUESTED SO THAT SPEAKERS' NAMES CAN BE
ACCURATELY SET FORTH IN THE MINUTES. THANK YOU FOR YOUR COOPERATION.
PLEASE PRINT:
Date: ~ ?/20 !n0
Name: (}f2.flYl__ ~
Address:
Telephone Number:
Regarding Subject or Agenda Item No. OOlA - tE:>0 J..:::t '5
/
Are you speaking in favor or in opposition / to this matter?
Name of company or group you are representing (if applicable):
CITY OF TUSTIN
REQUEST TO SPEAK
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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
.......................... ...............M................................................................................... .....................................................................................................
PUBLIC INPUT 0
IN FAVOR 0 OR OPPOSITION JirO MATTER?
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TODAY'S DATE
NAME
ORGANIZATION
(if applicable)
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E-MAILADDRESS !.-
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CITY OF TUSTIN
v
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 0
.................................................... .................-...........................
IN FAVOR 0 OR OPPOSITION 0 TO MATTER?
NAMEfiNTH/)MY TRU.11L/.-O
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HOMEIWORK ADDRESS ~
CODE.::r U ~ -r I AJ
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E-MAIL ADDRESS
CITY OF TUSTIN
v
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 ~ .-m II /l A . / ue m
...........................................-................_............_........._..c.........l!..~{
TODAY'S DATE 4:J I 0010 (p
IN FAVOR 0 OR OPPOSITION 1% TO MATTER?
NAME ./d Q.if ILl1 C, 13 V 0 LA..) A
HOMElWORKADDRESS~~
HOME/WORK PHONE NO.
(please indicate one)
ORGANIZATION
(if applicable)
CITYIZIP CODE
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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.
Please complete and submit this form to the City Clerk/Recording Secretary.
...........................................................................................--...............................................................................................................................................
HOMEIWORK PHONE
(please indicate one)
- M- AGENDA ITEM NO. 0 PUBLIC INPU~
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IN FAVOR 0 OR OPPOSITION 0 TO MATTER? TODAY'S DATE 5 /2-0 / () ~
NAME In ~ 4 ORGANIZATION ~.~
(if applicable)
E-MAIL ADDRESS
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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 0
IN FAVOR BOR OPPOSITION 0 TO MATTER?
TODAY'S DATE
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NAME a r~ '5 E t!3'f'J1/'t_, P CORGANIZATION
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CITYIZIPCODE J'b7D?
HOMEIWORKPHONENO. E-MAILADDRESSC
(please indicate one)
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.
...................................................................n.._................................................................................_..........................._..............................................,......
AGENDA ITEM NO. 0 PUBLIC INPUT 0 77/! _ ~ .. \/1 A
...................................................................-.............._..........._...._............................_.........~....._...._..~............_......._..............:.....~..~ / J/'l-->
IN FAVOR 0 OR OPPOSITION 0 TO MATTER? TODAY'S DATE .3 /(10 / () c-
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N . tf.___ . /~ ORGANIZATION7<<~. P~A-IU~)
U - (if applicable) {!~--(/tU<~
HOMEIWORKADDRESs3S0 ~ ~ CITYIZIPCODE - /~~
HOMEIWORK PHONE NO. )
(please indicate one)
E-MAIL ADDRESS