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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: //- 3 a 6 1 D <br /> NAME: ig/e,0 JL't (Es' <br /> ADDRESS: 6M — 6 G , pi, /03f <br /> CITY/STATE: /71J1 , Z <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 /> I would like to comment on Agenda item # j' 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: �/tL cl/4-(41-7-1 04-.1 Date: <br /> Meeting/Activity Location: <br /> Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington,98201 <br /> Nam lease Print): — Gender: <br /> ❑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 ACT 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 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 VI compliance may call 425-257- <br /> 8703, Title VI Specialist for the City Council." <br />