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2. Today's Date
   Today's Date
3. Work Session Date*
   -- Select One --January 6, 2022January 20, 2022February 10, 2022February 24, 2022March 10, 2022March 24, 2022April 7, 2022April 21, 2022May 5, 2022May 19, 2022June 9, 2022July 21, 2022August 4, 2022August 18, 2022September 8, 2022September 22, 2022October 6, 2022October 20, 2022November 10, 2022November 22, 2022December 8, 2022December 20, 2022
4. First Name*
6. Last Name*
7. Address
9. City
10. State
11. Zip Code
13. Email
14. Phone Number
15. Fax Number
17. Organization Represented
19. Topic: Statement of action you wish the council to take.*
21. Presentation: Will you be sharing a PowerPoint presentation, picture(s), or a video? If yes, please click "Choose File" below to upload.

    1. Yes

    1. No
22. Communication: Have you communicated with the Department(s) associated with this matter?

    1. Yes

    1. No
24. Please click "Choose File" to upload your presentation or video. Save the file as your name so it’s easily identifiable.
    • File Upload size is limited to 20MB
    • City policy prohibits unauthorized hardware and drives (e.g., flash drive) from being used or connected to City-owned equipment.
26. Please Note: You are permitted up to 3 minutes to speak and make your presentation.
    
    This form must be submitted by Monday at 5 p.m. 10 calendar days prior to the City Council Work Session at which you wish to speak. Once this form is submitted, no further reminder will be given. Citizens may call the Agenda Coordinator at 919-560-4222 to confirm receipt of this form.
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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