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Commission Agenda Item Application

2. Individual's Name*

3. Phone Number

5. Business Name

   If applicable

7. Street Address

9. Mailing Address

11. City

12. State

13. Zip

15. Subject matter to be discussed with the commission*

    This is the wording you would like on the agenda.

17. Background information regarding the subject

19. Requested Action sought from the commission

21. Attachments

29. Please note the City Commission's rules of procedures require all supporting documents to be provided at the time the agenda application is submitted. Please refrain from handing out material at the commission meetings. <br><br> The maximum time allowed for each request is 10 minutes.

    Please note the City Commission's rules of procedures require all supporting documents to be provided at the time the agenda application is submitted. Please refrain from handing out material at the commission meetings.
    
    The maximum time allowed for each request is 10 minutes.

31. Signature of Applicant*

    By typing your name in this box you are acknowledging the form and signing your name to the request.

32. Date
    Date

Leave This Blank:


33. 1. Receive email copy
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field