HomeMy WebLinkAboutMAY 17 2021 CRiA
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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.
1
Print Name: PA 0761L- -, TOWli‘71/1\
,
bibSI
1p {4Address: U 1Q,
City: ' rr\/1��1' ; 111,,Y3
Phone Number: --1 b - I J 7 B - a C,'Lt b
Date: 5) I i(241
I have read the requirements for speakers in the meeting of the Beaumont City Council
and will adhere to d ar by the ,quirements:
Signature: +I L �
PI ase 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.
I
. pc •
If you plan to speak to Council regarding an item on the Consent Agenda or Regular
Agenda, or duringthepublic commentperiod of the meeting, please fill out this form and
9
hand it to the CityClerk (who sits to the left of the podium) beforeyou approach the
PP
podium to speak. Thank you for helping us with the correct spelling of your name and
address for the official record.
Print Name: )�" Or 0 Pe)/—
Address:
3�7 _ Qr.//)� c
City: Dv] f *>C
Phone Number: Li 3 3 3 ci 3
Date: 51-7 `0-
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:
❑Pu is 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.
pe)
0 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. '
I
Print Name: I GNjec?ve,t) 4,
Address: (.0 :--55 I5A611` ri 1 ,l
City: geGdA t)
Phone Number: 6
-3
�yJ Date: 5 I
,,/ )
I have read the requirements for speakers in the meeting of the Beaumont City Council
and will adhere to and abide by th uire s:
Signature:
Please indicate your comme choice:
❑Consent Agenda
DPosted Item: please indica e item number
❑Work 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.