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Public Comment and Request to Speak Form

2. Your Name

4. Prefix

   (Optional)

5. First Name*

6. Last Name*

8. Address

10. Address Line 1*

12. Address Line 2

14. City*

15. State*

16. Zip Code*

18. Additional Information

20. Email*

21. City Resident*

    1. Yes
    2. No

23. Phone Number

    (Optional)

24. City Property Owner*

    1. Yes
    2. No

26. Council/Workshop Meeting Date*
    Council/Workshop Meeting Date

27. City Business Owner*

    1. Yes
    2. No

29. Organization (If Any)

    (Optional)

31. Public Participation*

    1. General
    2. During Agenda Item

33. Agenda Item(s)*

    Please indicate which agenda item(s) you wish to speak on.

35. Public Comments*

    Please enter your public comments. If your request is to speak, please type "Request to Speak."

37. Comments at public hearings and during audience participation are limited to three minutes per speaker.

    Comments at public hearings and during audience participation are limited to three minutes per speaker.

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39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field