Public Speaker Form

Members of the public who attend the meeting in-person may make comments by signing up to speak by completing an appearance request form and submitting it by no later than one hour before the commencement of the meeting.

Discussion	Time to speak
Agenda Item	Three (3) minutes
Non-agenda Item	One (1) minute

First Name
Last Name
Business or Organization
Date of Appearance
Subject Matter
Home Phone
Area CodePhone Number
Business Phone
Area CodePhone Number

Address

Street Address
Street Address 2
City	State
Zip	Country

Email Address
Language Needed
Interperter Needed

Yes No
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