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EVEREI".1.' CIT-COUNCIL • <br /> • SPEAKERS REQUEST SHEET <br /> • <br /> • NOTE: PLEASE STATE YOUR NAME AND ADDRESS BEFORE YOU BEGIN <br /> PLEASE PRINT: <br /> • <br /> DA'.1E: plipi 7 <br /> . <br /> NAME: � i'e /"I • <br /> ADDRESS: 510 D 7 S aid <br /> CITY/STATE: Y 14* y 8'2-03 <br /> I wish to speak to the Everett City Council under "Citizens. Comments" or <br /> "Audience Comments7z regarding a topic that is not on the agenda. Briefly describe <br /> your topic-below: <br /> /;m a id>4ei 1`/tet d- Ga -mac <br /> • <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 /> • <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 /> • <br /> • <br /> Project of Activity Title: Date: <br /> Meeting/Activity Location: • <br /> Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington,98201 <br /> • <br /> Name(Please Print): Gender: <br /> ❑Male OFemale <br /> General Ethnic Identification Category (please check one) <br /> 0 Caucasian OHispanic American ❑American Indian/Alaskan Native <br /> DAfrican American DAsian/Paeific Island ❑Other • <br /> Color: :National Origin: • <br /> "CIVIL RIGHTS ACT OF 1964,THEE 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 Rights Restoration Act of 1987, and related statutes <br /> and regulations in all its programs and activities. Persons wishing nfor-mation regarding the City's Title VI compliance-may call 425-257- <br /> 870, Title VI Specialist for the City Council." <br />