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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 /> • <br /> • DATE: . /l- lq- l11' . <br /> . NAME: •�i 2 cZ.11)�S-�Ptct--bC.1n. . <br /> ADDRESS: Z?>\2, iGPr%\u-1of- VI <br /> CITY/STATE: l�v-e-c.tz- 03 a_ (NZO <br /> I wish to speak to the Everett City Council under "Citizens. Comments" or <br /> - •1.,,.-,. " regarding a topic that is not on the agenda. Briefly describe <br /> • your topic below:� (�feC� • Igo t�VQ <br /> rased j marlvim ct 5 °rt. <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 tprnactice s to allow all <br /> contact the <br /> citizens a fair opportunity•to speak. If you wish to give a longer presenta , please <br /> Council Office at (425) 257.78703, before you speak, eitlier•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: <br /> ' Date: - <br /> Meeting/Activity Location: • • <br /> • <br /> Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington,98201 • <br /> Name(Please Print): Gender:°Male °Female <br /> General Ethnic Identification Category (please check one) <br /> ❑Caucasian °Hispanic American ❑American Indian/Alaskan Native _ <br /> °African American ❑Asian/Pacific Island <br /> °Other • <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 lights Restoration Act of 1987, and red �57 <br /> tes <br /> and regulations in all its programs and activities. Persons wishing information regarding the City's Title VI compliance.may call 42 <br /> 8703,Title VI Specialist for the City Council." <br /> J <br /> 1 <br />