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EVERETT CITY COUNCIL <br /> SPEAKERS REQUEST SHEET <br /> NOTE: PLEASE STATE YOUR NAME AND ADDRESS BEFORE YOU <br /> BEGIN <br /> PLEASE PRINT: <br /> DATE: //4-' O <br /> NAME: �-(/ A) 124 G �� <br /> r <br /> ADDRESS: /df) <br /> CITY/STATE: L'j, ,�. z 4 <br /> I would like to comment on Agenda item # on today's agenda. You <br /> will be given an opportunity to speak when that item is called. <br /> I wish to speak to the Everett City Council under "Citizens Comments" <br /> regarding a topic that is noton the agenda. Briefly describe your topic below: <br /> <r111 12 ter kid 12 ( 1 ? L f. — <br /> Each citizen is asked to limit comments to 3 minutes. The purpose of this <br /> practice is to allow all citizens a fair opportunity to speak. If you wish to give <br /> a longer presentation, please contact the Council Office at (425) 257-8703, <br /> before you speak, either in writing, or by phone, so that other arrangements <br /> may be made to allow you the time you may need. Please return this form <br /> once completed to the Council Administrator before the meeting begins. <br /> Project of Activity Title Date <br /> Meeting/Activity Location: <br /> Name(Please Print): Gender: <br /> CMale ❑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 />