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JEVERETT CITY COIJNCIL <br />SPFdVE�U'TSizEruESi Sf[HET <br />NOTE: PLEASE ST TE <br />PLEASE PRINT: <br />DATE: <br />NAME: <br />ADDRESS: 7±11 0 ottsirt misfr <br />CITY/STATE: <br />NAME AND <br />6169-9-- <br />at; e. Uscnoty\er <br />e , 2.13 <br />• <br />• <br />I' RE YIU OGIN <br />• <br />• <br />wish to, speak to the Everett City Council under "Citizens Citizens Comxnents" or <br />"Audience Comments" regarding a topic that is not on the agenda. rieay describe <br />your topic below: <br />I would life to comment o Agenda item # on today's agenda.. You will be <br />given an opportunity to speak when that item is galled. <br />• <br />• <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 in: ay be ade to allow you the thin you may need. Please return this form once <br />completed to the Council Administrator before the meeting be so <br />Project of Activity Title: M a ct stt , Ser, <br />9-32) \est Date: G? 1 0--. <br />Meeting / Activity (Location: <br />Everett City Council meeting 3002 Wetmore Avenue, Everett, Washington, 98201 <br />Name (Please Print): <br />4t.At <br />eV° <br />General Ethnic Identification Category <br />Gender: <br />Male <br />( please check one) <br />• <br />Caucasian . Hispanic American American Indian / Alaskan Native <br />A erican Asiaii/Pacifc Island Other <br />Color: - National Origin: <br />"CIVIL RIGHTS ACT OF 1964, TITLE VI STATEMENT TO THE PUBLIC_- The City of Everett hereby � ves 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 reb clations in all its programs and activities. Persons wishing information regarding the City's Title VI conzplianee <br />may call 425?5 7 8703, Title VISpecialist for the City Council." <br />