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2. Today’s Date
   Today’s Date
4. Date of Meeting to Attend
   Date of Meeting to Attend
6. Which board will you be addressing?*

   Please select which board meeting you are requesting to attend.

   1. Commissioners
   2. County Council
8. Name*
10. Name of Organization
12. Address*
14. City*
15. State*
16. Zip Code*
18. Phone*
19. Email Address
21. Brief description of topic to be discussed*
23. Documents
    Please attach any documents that you wish to be considered. Providing factual and background information will be helpful in reviewing your agenda request and will better prepare the Commissioners or Council members at the meeting.
25. Please note: Please limit your time to 10 minutes when presenting to the Board. Submission of this form does not insure that you will be added to the meeting agenda. Someone will contact you to confirm your request.
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field