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EVERETT CITY COUNCIL <br /> • SPEAKERS AKERS REQUEST SHEET <br /> -- NOTE: PLEASE STATE YOUR NAME AND ADDRESS BEFORE YOU BEGIN <br /> PLEASE PRINT: <br /> ' -- z_9 -- /--k) I 7 . <br /> • DATE: <br /> NAME: <br /> ,---r.. <br /> r ` u - <br /> • •I <br /> ADDRESS: L( 6 0�Z JA- >�-��-� <br /> • . <br /> ........_ <br /> CITY/STA'L'E: \, A <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 /> (-0vo vy.c).0 .A- . L-C. V - . • <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) 25778703, before you speak, either-in. writing, or by phone, so that other <br /> arrangements may be made to allow port 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: Date: ,-- <br /> Meeting/Activity Location: • <br /> 98201 <br /> Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington, <br /> Name(Please Print): Gender: <br /> DMale fFemale <br /> General Ethnic Identification Category (please check one) <br /> U Caucasian DHispanic American ❑American Indian/AlaskanNative _ <br /> (JAfricanAmerican [JAsianlPacificIsland El Other <br /> • <br /> Color: ,National Origin: - <br /> - "CMZ RIGHT. S 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 />