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_ EVERETTCITY COUNCIL <br /> SPEATF+RS REQUEST SHEET <br /> • -. NOTE: PLEASE STATE YOUR NAME AND ADDRESS BEFORE YOU BEGIN <br /> PLEASE PRINT: <br /> DATE: `5'/(i>/ (5 . . <br /> 5 . . . <br /> NAIVIE: -0-ta-)-5[--4- ine-Elfd- a '''Pa) , • <br /> • <br /> ADDRESS: • <br /> • <br /> CI'�' / TAR L:. <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 /> • <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 /> Con cil. Office at (425) 2S7-8703,-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 Conned Administrator before the meeting begins. . <br /> Project of Activity Title: Date' <br /> Meeting[Activity Location: <br /> Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington,93201 <br /> Name(P lease Print): Gender: <br /> ❑Male [Female <br /> • <br /> General Ethnic Identification Categmy (please check one) <br /> 0 G'4noasian. OHispp nicAmerican DAmericaniudi alA askznNattive _ <br /> DAL-:aanAmericas uAsiarfPaeificIsland 00her . <br /> Color: ,Nasional Orin: <br /> "CIYE.RIGHTS'ACT OF 1964,TITLE VI8T 1 N Aim TO TEE PUBLIC: The Ciy of Everett hereby gives psebiic notIce that it it policy of <br /> the City to assure full compliance with Title VI of the CivilRughts Act of 1954,the Civil Rig estora`ion lief of 1987, and related staff lies <br /> and r eg'da`ions in all its programs and activities. Persons wishing rymonation reg1dizg the City's This VI compliance-may call 25-257- . <br /> 8703, Title Y1 Specialist for the City Council." <br />