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• <br /> _ E1ER1fICITY <br /> COVLC1( • <br /> • SPEAKERS REQUEST SHEET <br /> NOTE: PLEASE STAIE YOUR NAME ANDADDRESS BEFORE YOU BEGIN <br /> PLEASE PRINT: <br /> 7 - <br /> - ` ` b ( .1 . <br /> NAME: 1 . - . . _Dp_ _ _/ <br /> _ , <br /> ADDRESS: <br /> CITY/STA'T'E: - <br /> I wish to speak to the Everett City Council under "Citizens. Comments" or - <br /> "Audience Comments7s regarding a topic that is not on the agenda. Briefly describe <br /> your topic•below: - <br /> /LI-0( ((WI. ( A t 5 rct+7 o (0 • . <br /> • <br /> - 0 ' A Mil ' . 1 9 ��� • <br /> � h �r-- G (-- <br /> �v r PK'c)06561 <br /> I would like to comment on Agenda item # - on today's agenda. You will <br /> given an opportunity to speak when that item is called. -1L--I UC--0ONCIL • <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) 25778703, 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 /> • <br /> Project of Activity Title: Date: "• <br /> Meeting/Activity Location: • <br /> Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington,98201 - <br /> Name(Please Print): Gender: <br /> OMale !Nero ate <br /> General Ethnic Identification Category (please check one) . <br /> 0Caucasian DHispanic American ❑American Indian/Alaskan Native <br /> DAfrican American ❑AsianlPacific Island QOther • <br /> Color: :National Origin: . <br /> "CIVIL RIGHTS ACT OF 1964,TITLE Vi STATEMENT TO TEE 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 III compliance-may call 425-257- <br /> 8703, Title YI Specialist for the City Council." <br />