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• <br /> EVERETT CITY COUNCIL <br /> • SPEAKERS REQUEST S H FIT <br /> - NOTE: PLEASE STATE YOUR NAME AND ADDRESS BEFORE YOU BEGIN <br /> PLEASE PRINT: <br /> DATE: 'Jr t-1 (11 - <br /> NAME: <br /> ADDRESS: C, \111-1-0 rt dIc .4\ <br /> CITY/STATE: q7 747 <br /> • <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 /> 61-G6C-. (/,`C Vl. 109 6—f <br /> I <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 Ionger 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 /> 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 DFemale <br /> • <br /> General Ethnic Identification Category (please check one) <br /> OCaucasian ❑Hispanic American ['American Indian/Alaskan Native <br /> ❑African American ❑Asian/Pacific Island DOther <br /> Color: National Origin: <br /> • <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 Right. 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 />