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HomeMy WebLinkAboutAPR 06 20211 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: "" v Address: �l d City: Phone Number: Dater have read the requirements for speakers in the meeting of the Beaumont City Council and will adhere to and abide by the requirements: Signature: Ple a indicate your comment choice: onsent 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: �h �J� V1-S Address: City: 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 t require t Signature: Please indicate your comment choleee: ❑Consent Agenda ❑Posted Item: please indicate item number Mork Session: ❑P,�ublic 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: City: Phone Number: 17eO SSA r � S Date: 1112 /,'-) C I have read the requirements for speakers in the meeting of the Beaumont City Council and will adhere to and abide by then u Signature: Please indicate your comment choice ❑Consent Agenda ❑Posted Item: please indicate item number [Mork Session: ❑P earing 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. 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: L �C'- Address: CD C� r City: t-k r1\<0 Vim, 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 I]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. j Print Name: 6 Address: 3 xx City: f� ��� �,�er�� 7 A 7 7 7% 3 Phone Number: > 0/ 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 OWork Session: Public 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. 5 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: �� AILAW�_S: Address:�- City: Phone Number: Date:. `I / L / �-( I have read the requirements for speakers in the meeting of the Beaumont City Council and will adhere to and abide by the r quirements: Signature: (a — Please indicate your comment choice: ❑Consent 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. 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 re rd. Print Name: Address: City: v 1, vv / Phone Number: Date: I have read the requirements for speakers in the meeting of the Beaumont City Council and will adhere to and ab' a by the requirements: Signature: Please indicate your comment choice: ❑Consent Agenda ❑Posted Item: please indicate item number ❑Work Session: Olic 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.