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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.
    
    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
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34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field