Request to Speak Form
AT MONTHLY BOARD OF DIRECTORS MEETING (1ST WEDNESDAY OF EACH MONTH - 6:30 AT SEVEN HILLS MEMBERS CLUB)
Name
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First Name
Last Name
Date
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/
Month
/
Day
Year
Date
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
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Area Code
Phone Number
Cell Phone Number
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Area Code
Phone Number
What would you like to discuss?
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SPEAKERS ARE LIMITED TO FIVE (5) MINUTES
Board members may choose to respond or ask questions of the speaker. Board members may not vote on this topic if not on the printed agenda, but may schedule your topic as a future agenda item.
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Form must be signed before submitting.
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