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EVERETT CITY COUNCIL • <br /> • SPEAKERS REQUEST SHEET <br /> - NOTE: PLEASE STATE YOUR NAME AND ADDRESS BEFORE YOU BEGIN <br /> PLEASE PRINT: <br /> DATE: (C) 1 .. C 1 <br /> • <br /> NAME: -0-ricAze1a. I�-�" ► I <br /> ADDRESS: P �, 53 PI <br /> 5 5 <br /> • <br /> CITY/STATE: ' I`1 - Cx2) <br /> • <br /> I wish to speak to the Everett City Council under "Citizens. Comments" or - <br /> "Audience Comments" regarding a topic that is not on the agenda. Briefly describe <br /> your topic below: <br /> Poç ;tc _ fain ctcr ( I ' QHS <br /> c-'Ct,e) <br /> • <br /> I would like to comment on Agenda item # on today's agenda. You will be <br /> given an opportunity to speak when that item is called. <br /> Each citizen is asked to limit comments to 3 minutes. The purpose of this practice is to allow all <br /> citizens a fair opportunity to speak. If you wish to give a longer presentation, please contact the <br /> Council Office at (425) 257-8703, before you speak, either in writing, or by phone, so that other <br /> arrangements may be made to allow you the time you may need. Please return this form once <br /> completed to the Council Administrator before the meeting begins. <br /> Project of Activity Title: Date: <br /> Meeting/Activity Location: • <br /> • <br /> Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington,98201 <br /> Name(Please Print): Gender: <br /> ❑Male ['Female <br /> General Ethnic Identification Category (please check one) <br /> ['Caucasian DHispanic American ['American Indian/Alaskan Native <br /> DAfrican American DAsian/Pacific Island DOther <br /> Color: ; National Origin: <br /> "CIVIL RIGHTS ACT OF 1964, TITLE VI STATEMENT TO THE PUBLIC: The City of Everett hereby gives public notice that it is policy of • <br /> the City to assure full compliance with Title VI of the Civil Rights Act of 1964,the Civil Rights Restoration Act of 1987, and related statutes <br /> and regulations in all its programs and activities. Persons wishing information regarding the City's Title VI compliance may call 425-257- <br /> 8703, Title VI Specialist for the City Council." <br /> • <br /> . j <br /> • <br />