FORM FOR
AGENDA ITEM SUBMISSION
Date Item Submitted: _____________ Date of Scheduled Meeting: _____________
Name of Person Submitting Item: ____________________________________________
Address: ________________________________________ Phone: _________________
Names of person(s) to Address Council at Meeting: ______________________________
Address: _______________________________
Phone: _______________________________
Name: ______________________________
Address: ______________________________
Phone: ______________________________
ITEM AS IT WILL APPEAR ON AGENDA: __________________________________
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Intent and Objective of Item to be Discussed: ___________________________________
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