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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: <br />� T <br />NAME: J� ►1z ►% <br />ADDRESS: <br />CITY/STATE: <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 />Fes-s)l �S <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: <br />Bate: <br />Meeting / Activity Location: <br />Everett City Council meeting 3002 Wetmore Avenue, Everett, Washington, 98201 <br />Name (Please Print): <br />Gender: <br />Male Female <br />General Ethnic Identification Category ( please check one) <br />Caucasian Hispanic American American Indian / Alaskan Native <br />African American Asian/Pacific Island Other <br />Color: National Origin: <br />"CIVIL RIGHTS,4CT 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 ivith 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 conspliance <br />may call 425-257-8703, Title VI Specialist for the City Council. " <br />