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HomeMy WebLinkAbout_2021 01 11 City Commission Regular Meeting Public Input forms CITY OF WINTER SPRINGS, FLORIDA PUBLIC INPUT FORM - REQUEST TO SPEAK Please complete this form if you wish to address the Mayor and City Commission on any subject. ADDRESSING THE MAYOR AND CITY COMMISSION Please print clearly and neatly! Date: Name: Address: /„ � — -----_ — City: 1 5 -- - ---- - State/Zip Code: �-� �U --`l- ------ Email address: Phone number (optional): - GUIDELINES ON WHEN TO SPEAK: • Consent (300's) and Regular(500's) Agenda Items and miscellaneous matters not on the Age"da should be addressed during the ls'Round of Public Input • Public Hearings (400's) Agenda Items have separate and dedicated Public Input and any Public Input must be given during the applicable Public Hearing Agenda Item • Miscellaneous comments may be made during the 2"d optional Round of Public Input, if time p(--rmits. Would you like to address a topic that IS on this Agenda? 1. Which Agenda Item do you wish to comment on? 2. For the Record, regarding the Agenda Item above, are you IN FAVOR ❑ OR OPPOSED 3.a) Do you wish to verbally address the Mayor and City Commission on this Agenda Item? YES ❑ OR NO ❑ 3.b) If you said NO* to 3.a), but wish to submit a brief statement for the record of the meeting, please use the space below to note your comments (please print clearly): Would you like to address a_ topic that is NOT on this Agenda? Please use the space below for your comments (please print clearly): Revised 11/13/2017 For important information,please see other side -thank you for your input! CITY OF WINTER SPRINGS, FLORIDA PUBLIC INPUT FORM - REQUEST TO SPEAK Please complete this form if you wish to address the Mayor and City Commission on any subject. ADDRESSING THE MAYOR AND CITY COMMISSION Please print clearly and neatly! Date: Name: Address: C 41 / r City: i� �j State/Zip Co e: C Email address: L o� — �> Phone number (optional): GUIDELINES ON WHEN TO SPEAK: • Consent (300's) and Regular (500's) Agenda Items and miscellaneous matters not on the Agenda should be addressed during the 11'Round of Public Input • Public Hearings (400's) Agenda Items have separate and dedicated Public Input and any Public Input must be given during the applicable Public Hearing Agenda Item • Miscellaneous comments may be made during the 2 n optional Round of Public Input, if time permits. Would you like to address a topic that IS on this Agenda? 1. Which Agenda Item do you wish to comment on? A—, - 2. For the Record, regarding the Agenda Item above, are you IN FAVOR ❑ OR OPPOSED ❑ ? 3.a) Do you wish to verbally address the Mayor and City Commission on this Agenda Item? YES ❑ OR NO* ❑ 3.b) If you said NO* to 3.a), but wish to submit a brief statement for the record of the meeting, please use the space below to note your comments (please print clearly): Would you like to address a topic that is NOT on this Agenda? Please use the space below for your comments (please print clearly): ye--s A- Revised 11/13/2017 For important information,please see other side-thank you for your input! CITY OF WINTER SPRINGS, FLORIDA PUBLIC INPUT FORM - REQUEST TO SPEAK Please complete this form if you wish to address the Mayor and City Commission on any subject. ADDRESSING THE MAYOR AND CITY COMMISSION Please print clearly and neatly! Date: 11 I( , Z 02-V Name: jSS, Z�>� l�� — — -- - Address: Cit : r ' r�� 5 I State/Zip Code: S� > City �ti A�� \ - -�� - - - - Email address: duPe Phone number (optional): t10 9 -2 1 GUIDELINES ON WHEN TO SPEAK: • Consent (300's) and Regular(500's) Agenda Items and miscellaneous matters not on the Agenda should be addressed during the 1St Round of Public Input • Public Hearings (400's) Agenda Items have separate and dedicated Public Input and any Public Input must be given during the applicable Public Hearing Agenda Item • Miscellaneous comments may be made during the 2nd optional Round of Public Input, if time permits. Would you like to address a topic that IS on this Agenda? 1. Which Agenda Item do you wish to comment on? 2. For the Record, regarding the Agenda Item above, are you IN FAVOR ❑ OR OPPOSED ❑ ? 3.a) Do you wish to verbally address the Mayor and City Commission on this Agenda Item? YES ❑ OR NO* ❑ 3.b) If you said NO*to 3.a), but wish to submit a brief statement for the record of the meeting, please use the space below to note your comments (please print clearly): Would you like to address a topic that is NOT on this Agenda? _ Please use the space below for your comments (please print clearly): Revised 11/13/2017 For important information,please see other side-thank you for your input! CITY OF WINTER SPRINGS, FLORIDA PUBLIC INPUT FORM — REQUEST TO SPEAK Please complete this form if you wish to address the Mayor and City Commission on any subject. ADDRESSING THE MAYOR AND CITY COMMISSION Please print clearly and neatly! - Date: Name: Address: LA City: State/Zip Code: '211 01� Email address: Z r l ;� v-V1` Phone number (optional): `V GUIDELINES ON WHEN TO SPEAK: • Consent(300's) and Regular(500's) Agenda Items and miscellaneous matters not on the Agenda should be addressed during the 1s'Round of Public Input • Public Hearings (400's) Agenda Items have separate and dedicated Public Input and any Public Input must be given during the applicable Public Hearing Agenda Item • Miscellaneous comments may be made during the 2nd optional Round of Public Input, if time permits. Would you like to address a topic that IS on this Agenda? 1. Which Agenda Item do you wish to comment on? UJ �1,} 1 �/?.fiP �2KkAt 2. For the Record, regarding the Agenda Item above, are you IN FAVOR ❑ OR OPPOSED ❑ ?aNmAz 3.a) Do you wish to verbally address the May nd City Commission on this Agenda Item? YES ❑ OR NO ❑ 3.b) If you said NO* to 3.a), but wish to submit a brief statement for the record of the meeting, please use the space below to note your comments (please print clearly): Would you like to address a topic that is NOT on this Agenda? Please use the space below for your comments (please print clearly): v\.cgrn� Revised 11/13/2017 For important information,please see other side -thank you for your input! CITY OF WINTER SPRINGS, FLORIDA PUBLIC INPUT FORM - REQUEST TO SPEAK It Please complete this form if you wish to address the Mayor and City Commission on any subject. ADDRESSING THE MAYOR AND CITY COMMISSION Please print clearly and neatly! Date: 11112 i Name: Address: ---- --- City: C1 its S �- State/Zip Code: Email address: Phone number (optional): C; 3 GUIDELINES ON WHEN TO SPEAK: • Consent (300's) and Regular (500's) Agenda Items and miscellaneous matters not on the Agenda should be addressed during the 111 Round of Public Input • Public Hearings (400's) Agenda Items have separate and dedicated Public Input and any Public Input must be given during the applicable Public Hearing Agenda Item • Miscellaneous comments may be made during the 2nd optional Round of Public Input, if time permits. Would you like to address a topic that IS on this Agenda? 1. Which Agenda Item do you wish to comment on? ' s5 L�-- 2. For the Record, regarding the Agenda Item above, are you IN FAVOR ❑ OR OPPOSED ❑ ? 3.a) Do you wish to verbally address the Ma or and City Commission on this Agenda Item? YES OR NO* ❑ 3.b) If you said NO* to 3.a), but wish to submit a brief statement for the record of the meeting, please use the space below to note your comments (please print clearly): Would you like to address a topic that is NOT on this Agenda? Please use the space below for your comments (please print clearly): Revised 11/13/2017 For important information,please see other side-thank you for your input! CITY OF WINTER SPRINGS FLORIDA PUBLIC INPUT FORM - REQUEST Please complete this form if you wish to address the M QUEST T O SPEA, Y rand City Commission on any subject. ADDRESSING THE MAYOR AND CIT Date: —— Please print clear/ Y COMMISSION Y and neat/y! Name: Address: -- _ _� _- tate/Zip�mall address: Code: Phone numbero ( ptional): • Consent(300's) and Regular 5 GUIDELINES ON WHEN TO addressed 00's) sr ) Agenda Items SPEAK: • Public Hearin s during the 7 Round of Public Input and miscellaneous g (400's)Agenda Items have se matters not on the Agenda should be be given during the applicable Public Hearin • Miscellaneous comments parade and dedicated Public In may be g Agenda Item put and any public In Y made during the 2"° put must Optional Round of Public Input if time p 1ermits. Would you like to address a topic that IS on this. Which Agenda Item do — his Agenda? you wish to comment on? Z. For the Record, regarding the Agenda Item above, - -- are you IN F— ❑ OR � 3,a) Do you wish to verbally address the Ma OPS ❑ ? YES Mayor a d City Commission on this A �OR Np Benda Item? 3.b) If you said NO'S to 3.a - � ❑ ), but wish to submit a brief statement for the rec the space below to note your comments (p/ease print clearly): ord of the meeting, please use� -- Would_ -- YOU like to address a to Please use the space beloyour comments pic that is ' NOT on this Agenda? W for (please print clear/y): I Revised 11/13/2o17 For important information,Please see other side- thank you CITY OF WINTER SPRINGS, FLORIDA PUBLIC INPUT FORM - REQUEST TO SPEAK Please complete this form if you wish to address the Mayor and City Commission on any subject. ADDRESSING THE MAYOR AND CITY COMMISSION Please print clearly and neatly! Date: ' Name: Address: 1> 6 ` , � C1 City: � �r -V, ,J State/Zip Code: F. , Email address: y Phone number(optional): Ll o-7 -'?C GUIDELINES ON WHEN TO SPEAK: • Consent(300's) and Regular(500's)Agenda Items and miscellaneous matters not on the Agenda should be addressed during the 1�Round of Public Input • Public Hearings (400's)Agenda Items have separate and dedicated Public Input and any Public Input must be given during the applicable Public Hearing Agenda Item • Miscellaneous comments may be made during the 2nd optional Round of Public Input, if time permits. Would you like to address a topic that IS on this Agenda? 1. Which Agenda Item do you wish to comment on? - 2. For the Record, regarding the Agenda Item above, are you IN FAVOR OR OPPOSED ❑ ? 3.a) Do you wish to verbally address the Mayor and City Commission on this Agenda Item? YES OR NO* ❑ 3.b) If you said NO*to 3.a), but wish to submit a brief statement for the record of the meeting, please use the space below to note your comments (please print clearly): Would you like to address a topic that is NOT on this Agenda? Please use the space below for your comments (please print clearly): 0 Are Revised 11/13/2017 For important information,please see other side-thank you for your input!