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If you plan to speak to Council regarding an item on the Consent Agenda or Regular
Agenda, or during the public comment period of the meeting, please fill out this form and
hand it to the City Clerk (who sits to the left of the podium) before you approach the
podium to speak. Thank you for helping us with the correct spelling of your name and
address for the official record.
Print Name: VVY S
Address: I X-1.
City:
Phone Number:Sr-
Date: 9— / 0' � %
I have read the requirements for speakers in the meeting of the Beaumont City Council
and will adhere to and abideb-the reouireme-nts;
Signature:
Please indicate your
OConsent Agenda
❑Posted Item: please indicate item number
❑Work Session:
❑Public Hearing
Public Comments
Falsely identifying yourself on this enrollment form or orally at the podium may constitute a crime. A person
commits an offense if he knowingly makes a false entry in a governmental record. Penal Code Section
37.10(a), Tampering with a Governmental Record.
if you plan to speak to Council regarding an item on the Consent Agenda or Regular
Agenda, or during the public comment period of the meeting, please fill out this form and
hand it to the City Clerk (who sits to the left of the podium) before you approach the
podium to speak. Thank you for helping us with the correct spelling of your name and
address for the official record.
Print Name: 3 `Q C Ci GRcjvz
Address: 2 �J(1G.2_)t r'lCc
City: L P,
Phone Number:
Date: OR - C - l
I have read the requirements for speakers in the meeting of the Beaumont City Council
and will adhere to and abide by the requirements:
Signature:
Please indicate your comment choice:
❑Consent.Agenda
❑Posted Item: please indicate item number
Mork Session:
ublic Hearing
ublic Comments
Falsely Identifying yourself on this enrollment form or orally at the podium may constitute a crime. A person
commits an offense if he knowingly makes a false entry in a governmental record. Penal Code Section
37.10(a), Tampering with a Governmental Record.
ll j
n If you plan to speak to Council regarding an item on the Consent Agenda or Regular
�J Agenda, or during the public comment period of the meeting, please fill out this form and
hand it to the City Clerk (who sits to the left of the podium) before you approach the
podium to speak. Thank you for helping us with the correct spelling of your name and
address for the official record.
Print Name:
Address:
City:-�A�`MO�V
Phone Number:
Date:
I have read the requirements for speakers in the meeting of the Beaumont City Council
and will adhere to and abide by the requirements -
Signature:
Please indicate your comment choice:
Consent Agenda
❑Posted Item: please indicate item number
Mork Session:
❑Public Hearing
Public Comments
Falsely identifying yourself on this enrollment form or orally at the podium may constitute a crime. A person
commits an offense if he knowingly makes a false entry in a governmental record. Penal Code Section
37.10(a), Tampering with a Governmental Record.
If you plan to speak to Council regarding an item on the Consent Agenda or Regular
Agenda, or during the public comment period of the meeting, please fill out this form and
hand it to the City Clerk (who sits to the left of the podium) before you approach the
podium to speak. Thank you for helping us with the correct spelling of your name and
address for the official record.
Print Name: ` 51-C'
Address: WO
City: m"",y`
Phone Number: li� 41-
Date:
1
Date: C1 ,0 ,
I have read the requirements for speakers in the meeting of the Beaumont City Council
and will adhere to and abide by there� ents:
Signature:
Please indicate your comment choice:
❑Consent Agenda
❑Posted Item: please indicate item number
OWork Session:
❑Public Hearing
6Public Comments
Falsely identifying yourself on this enrollment form or orally at the podium may constitute a crime. A person
commits an offense if he knowingly makes a false entry in a governmental record. Penal Code Section
37.10(a), Tampering with a Governmental Record.
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If you plan to speak to Council regarding an item on the Consent Agenda or Regular
Agenda, or during the public comment period of the meeting, please fill out this form and
hand it to the City Clerk (who sits to the left of the podium) before you approach the
podium to speak. Thank you for helping us with the correct spelling of your name and
address,f1orrtt e official record. 5 It Q-
�J C- C
Print Name: M OOsc c 016ki bk'
Address: 02 q 3 5 IAW 5 Dear W �h A C'
City:�Ull a►t"VI--t, Tx
Phone Number: L401'112--blf(eS
Date: o 111 Df 101
I have read the requirements for speakers in the meeting of the Beaumont City Council
and will adhere to and abide by the requirements:
Signature:
Please indicate your comment choice:
❑Consent Agenda
❑Posted Item: please indicate item number
.OWork Session:
❑Public Hearing
�Oublic Comments
Falsely identifying yourself on this enrollment form or orally at the podium may constitute a crime. A person
commits an offense if he knowingly makes a false entry in a governmental record. Penal Code Section
37.10(a), Tampering with a Governmental Record.
Pc • •
If you plan to speak to Council regarding an item on the Consent Agenda or Regular
Agenda, or during the public comment period of the meeting, please fill out this form and
hand it to the City Clerk (who sits to the left of the podium) before you approach the
podium to speak. Thank you for helping us with the correct spelling of your name and
address for the official record.
Print Name: 6� 6 S0(V - l ' pe S P 8 0 e /I/
Address: 10 0 (1170fffaYARO ®R 1
City: CA, OM , -Itj f "7-7?o(
Phone Number:
Date: q - l D �-
I have read the requirements for sp(
and will adhere to and abide by the
Signature:
Please indicate your comment cWoice:
❑Consent Agenda
in the meeting of the Beaumont City Council
�ments:
❑Posted Item: please indicate item number
Mork Session:
❑Public Hearing
Public Comments
Falsely Identifying yourself on this enrollment form or orally at the podium may constitute a crime. A person
commits an offense if he knowingly makes a false entry in a governmental record. Penal Code Section
37.10(a), Tampering with a Governmental Record.
If you plan to speak to Council regarding an item on the Consent Agenda or Regular
Agenda, or during the public comment period of the meeting, please fill out this form and
hand it to the City Clerk (who sits to the left of the podium) before you approach the
podium to speak. Thank you for helping us with the correct spelling of your name and
address for the official record
Print Name:
Address: /,�",s', �' S,. , y1/1. -z' A
City:. % 7 774>7
Phone Number:�1�
Date:
I have read the requirements for speakers in the meeting of the Beaumont City Council
and will adhere to and abide by the requirements -
Signature:
Please indicate your comment choice:
❑Consent Agenda
❑Posted Item: please indicate item number
[Work Session:
❑Public Hearing
FdFublic Comments
Falsely identifying yourself on this enrollment form or orally at the podium may constitute a crime. A person
commits an offense if he knowingly makes a false entry in a governmental record. Penal Code Section
37.10(a), Tampering with a Governmental Record.