Request to Add Agenda Item

2. First Name

3. Last Name

4. Date
   Date

5. Meeting Date
   Meeting Date

7. Organization

8. Objective

10. Proposed Agenda Wording

12. Background Information

14. Phone Number

    Home

15. Phone Number

    Work

16. Phone Number

    Cell

18. Determination

    1. Approved
    2. Denied

    By: Mayor

19. Determination

    1. Approved
    2. Denied

    City Manager

21. Proposed Meeting Date
    Proposed Meeting Date

Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field