Application to Appear on City Council Agenda

Application to Appear on City Council Agenda
The deadline to appear on the City Council Agenda is the first of the month, prior to the scheduled Council Meeting that month. If you have additional information you would like for the Council to view, please attach it to this form. Do not submit this form until all items have been attached and the application is complete.
Date

MonthDayYear
Date
Meeting Date Requested
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Please enter a valid phone number.
Brief summary of Agenda item to be considered:*
What action is requested from the Council
Has additional information been submitted for this item?*

YesNo
Upload addtional Items

Cancelof
Before signing please ensure that all sections of this application have been filled out
Signature

Powered by Jotform SignClear
Should be Empty: