Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1-25-16 Speaker Forms
WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. *************************************************************************************************************************** SPEAKER REQUEST FORM (Please complete) Date: f C Name: AL- ( ) } Address: l ` City: Phone No.: o9 -S 8 i E-mail: C! 0 (S & p. 0_01% Ch PLEASE COMPLETE AND CHECK ALL THAT APPLY: wish to address the Commission under Courtesy of the Floor on: Agenda Item No. C and/or Topic not on the agenda: ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. • ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME 2 To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM 2 �/ (Please complete) Date: Name: �/4 Address: / ') CL /43 �2- City: A ) Phone No.: *it- ?d 077P E-mail: c: LJL. 2 C �G ,! "11 PLEAS COMPLETE AND CHECK ALL THAT APPLY: I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. 2 3 ( 8C) and/or Topic not on the agenda: ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item: WELCOME 3 To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please cop► fete) Date: / ?o/J ame: o h i /Ii ' s Address: rte. ��_h / emu s �1 City: iii r 3 7--2 Phone No.: E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. ____e9_Z' and/or Topic not on the agenda: Q/.4 ish to address the Commission during the Public Hearing for Agenda Item No. 6 __, . ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: //02 -7/ ` Name: V\nQ V f Kkesf- Address: C 3 C 9-1 c4-- City: Phone No.: /G - o E-mail: v\ e ) divt PLEASE COMPLETE AND CHECK ALL THAT APPLY: ErI wish to address the Commission under Courtesy of the Floor on: Agenda Item No. and/or Topic not on the agenda: ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME ,S To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: _ :. i�� , ,! ., Name: 10 Address: ,'. .�_ , /_ /i _ .c�,►_/`__� t City: 07 Phone No.: 24%) /C ?— .75/ E-mail: J, /9/ a o O m PLEASE COMPLETE AND CHECK ALL THAT APPLY: S wish to address the Commission under Courtesy of the Floor on: Agenda Item No. C. and/or Topic not on the agenda: E I wish to address the Commission during the Public Hearing for Agenda Item No. (F6 ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item.❑ I do of wish to address the Commission, but I am opposed to the a enda item. 57. - WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. *************************************************************************************************************************** SPEAKER REQUEST FORM (Please complete) Date: l Z5 I ItO Name: OA Inrilr101 j P Address: 11 D 8jh Aye, . City: / 11 . 13e. Phone No.: "c)2.-5— 1 Ot 1 E-mail: Mald-ht e -.iir1Gt.r Z I• ex vY) PLEASE COMPLETE AND CHECK ALL THAT APPLY: -(LI wish to address the Commission under Courtesy of the Floor on:'il Agenda Item No. - (1_ and/or p . Topic not on the agenda: 01 0 19-70(& Gti 1.A-Ali. (3--st4e, ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. . ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. El I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME 7 To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: / <> / Name: , ,A+ Fl°" „e Address: City. Phone No E-mail: (' >,, `.. - PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. and/or 4 '',' Topic not on the agenda: , ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME O To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. *************************************************************************************************************************** SPEAKER REQUEST FORM (Please complete) Date: I 2& 1( Name: S f1StAD, TA Rclo Address: cb ete.�... B14 City: Phone No.: E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: *ylI wish to address the Commission under Courtesy of the Floor on: Agenda Item No. C 16E4Q-C-1 and/or Topic not on the agenda: ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. . ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. SPEAKER REQUEST FORM (Please complete) Date: /1.' Name: J U re' Il c _ e Address: /� / u City: Al2.;? _} fir: ; Phone No.: E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. 8 2 and/or Topic not on the agenda: ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME 10 To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date:a r ki, 2 .7 l? / /Name: K -C13),r I?F tV/,4kTiW Address: D /`T, . ,�.iw De • City: 1 `' G1'(' f(). 1..' .. G ' P < Phone No f 64- k( --cX,5 3( E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: El I wish to address the Commission under Courtesy of the Floor on: Agenda Item No.204 '�., ; `r and/or Topic not on the agenda: El I wish to address the Commission during the Public Hearing for Agenda Item No. 7 El I am in support of the above agenda item. El I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: � )51(4. Name: L-0(-(l� � t C kj `��Lt f Address: ISM kt 6 Or- City: bfcvJ-faiJi C /e FL 3 a?c 3 h Phone No.: 7`G`jo5 a E-mail: Lc (3 C.OMcct.3J rieJ PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. and/or Topic not on the agenda: C[c,$/ Jc9�c. ,�}<Sccts /01 ygie ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. �jm I do not wish to address the Commission, but I am in support t of the agenda ifem. ( '' t�506,4 �f cr fer ec� J` Rev K /9G'. O e e c d� o 14_c r°L-e4 6 Ot. ve "pry ❑ I do not` vish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please corn lete) 16ax Date: . 4 . 4/� Name: �6�L —,/ Addre s: /57 (71-6_,I r / City: aj..6.ul r, oae:Q' A /�2- c 5 Phone No. 43 7 - E-mail:S,.d ,/)-7-7f,6 a-✓ e , eerx-- PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. and/or Topic not on the agenda: ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. e . ❑ I am in support of the above agenda item. ❑ I am opp.:-. to the above agen a i - . 14 I do not wish to address the Commission, but I am in support • t ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM ` r (Please complete) Date: l ��"�t[3 Name: ��..Ir�4r\l‘ts -! Q i S Address: %Ak ° e\xt City: `ècL Phone No.: E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. and/or Topic not on the agenda:QL1kS\ver 54t$S Geit.41, ILNMA‘..STOv• ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. I do not wish to address the Commission, but I am in, rt of the agenda i em. 1.S,43@`'l, ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Alj e Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. **********************************************x**************************************************************************** SPEAKER REQUEST FORM (Please complete) Date: 1- Name: VE c LL,c i% Address: 70( e-ttch if 1-e_ City: 44-/am.ife_ , z2-3 3 Phone No.: WIZ--a -2 87 E-mail: SJic/<SLo iscO Q07, c 4---- PLEASE COMPLETE AND CHECK ALL THAT APPLY: O 1 wish to address the Commission under Courtesy of the Floor on: Agenda Item No. e92.— and/or Topic not on the agenda: C.1_01. 4-4`s _leu+4 ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. Ai c6C I do not wish to address the Commission, but _ &D /te_. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. *************************************************************************************************************************** SPEAKER REQUEST FORM (Please complete) Date: 1^ ‘ ,5- -,2?/),/ ( Name: Zeb 0/1oZb "a.)7- I-1 ,I 1 N 1. Address: 11, &i9eJI 9V a City: X nm-N r►e_ 1R J4 . rL 1 Phone No.: E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. ge-- and/or Topic not on the agenda: _"r r " f, of _ ; Te_—,► s e:Glss!D/J ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. . ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. y6I do not wish to address the Commission, but I am inThima<of the agenda item. LDS 7-iE - p ❑ I do not wish to address the Commission, but I am opposed to the agenda item. ' WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: / (Q6-/- (3,?O/' Name: `/ /CJ/lrr�` )/ n Address: 7,? C 4 i)-1/6A/a City: /47-4/g-A/77ei 36519e-/-/ / Phone No.: E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ 1 wish to address the Commission under Courtesy of the Floor on: Agenda Item No. 8 a and/or Topic not on the agenda: C)Lots T (No t/� (?TC /�/s Liss/©A/ ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. I do not wish to address the Commission, but I am ins of the agenda item. Cr.D$ ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: j S cam.-✓A... ()I Name: 1 Address: rd J `�' (352t- City: Phone No.: y z/' O�,�/�'�, � � �1 E-mail: e X f_',00/V r_ 114 Tt* PLEASE COMPLETE AND CHECK ALL THAT APPLY: O I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. and/or Topic not on the agenda: ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. ❑ I do not wish to address the Commission, but I am in support of the agenda item. P2/I do not wish to address the Commission, but I am opposed to the agenda item. 6, C (.14 5 k >57 k/L 6- 4-7k D 6 Nom 1,09 A/7f U WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: ,? a i,:).,:.. Name: Address: 1 t --: �_ r City: -- Phone No.: , _ E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: • I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. and/or Topic not on agenda: ❑ I wish to ress the Commission during the Public Hearing for Agenda Item No. . ❑ I a n support of the above agenda item. ❑ I am opposed to the above agenda item. ‘ 6,.I o not wish to address the Commission, but I am-in support of the agenda item. ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: / Name: J /e///e l�jJ j A Address: Q2 ,A YTC/4-L. J City: A-`j -1-.14-,1 7�L Phone No.: E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. )g e— and/or Topic not on the agenda: y STi?'�S' T '�-- .SGG15.5Jvw ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. not wish to address the Commission, but I am in s prt of the agenda ite . 774- 6 ❑ I do not wish to address the Commission, but I am opposed to the agenda item. WELCOME To the Atlantic Beach City Commission Meeting We will conduct meetings of the City Commission with a level of civility and respect that the democratic process deserves. This allows for better public input and supports making the best decisions for the citizens who we are here to serve. We ask that everyone in the meeting practice the following principles of Respect for each other. RESPECT Refrain from putdowns, criticism and personal attacks. Encourage others to state their views. Support each other, even if you don't agree. Practice active listening. Express yourself assertively, not aggressively, not submissively. Collaborate, do not compete or collude. Trust each other, unless and until such trust is violated. SPEAKER REQUEST FORM (Please complete) Date: `�'��,s �... d�o Name: �C10. P.As Address: e/ City: 4- i1ii77cTIe1si4 Phone No.: E-mail: PLEASE COMPLETE AND CHECK ALL THAT APPLY: ❑ I wish to address the Commission under Courtesy of the Floor on: Agenda Item No. and/or Topic not on the agenda: (%/8/ aterit ❑ I wish to address the Commission during the Public Hearing for Agenda Item No. ❑ I am in support of the above agenda item. ❑ I am opposed to the above agenda item. 141 do not wish to address the Commission, but I am in ort of the agenda itern'CL0.5�� ❑ I do not wish to address the Commission, but I am opposed to the agenda item.