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EVERETT CITY COUNCIL <br /> • SPEAKERS REQUEST SHEET <br /> • -• NOTE: PLEASE STATE YOUR NAME AND ADDRESS BEFORE Y e i I 7 t" <br /> PLEASE PRINT: / <br /> _3-----' <br /> / <br /> DACE: )--? <br /> -'72 . <br /> ,,://4- ---Th//71 <br /> . NAME: 1--- . <br /> / <br /> DRESS: ) 77 . <br /> 6 / <br /> CITY/STATE • •i/ 04I X- • <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 /> .. e°1/9–:) . <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 /> 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 /> Project of Activity Title: Date: -. <br /> Meeting/Activity Location: <br /> • <br /> Everett City Council meeting 3002 Wetmore Avenue, Everett,Washington,98201 <br /> Name(PIease Print): Gender: <br /> ❑Male hlFemale <br /> General Ethnic Identification Category (please check one) <br /> ❑Caucasian DHispanic American ❑American Indian/Alaskan Native <br /> ❑African American ❑Asian/Pacific Island ❑Other <br /> • <br /> Color: ,National Origin: • <br /> "CIVIL RIGHTS ACT OF 1964,TELE 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 />