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C I T Y O F V A L L E Y P A R K
SPEAKER CARD |
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NAME _________________________________________
ADDRESS _____________________________________
I WOULD LIKE TO BE PLACED ON THE AGENDA TO
SPEAK ABOUT: ____________________________________________________ ____________________________________________________ ____________________________________________________ __________________________________________________________
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SPEAKER CARD Date: _____________________ Please Print Name: ________________________________ Address: ________________________________________ Topic that you wish to speak about: ____________________ __________________________________________________________ __________________________________________________________
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C I T Y O F V A L L E Y P A R K 320 Benton Street Valley Park, Mo. 63088
SPEAKERS CARD
(PLEASE PRINT OR WRITE CLEARLY)
PETITION NUMBER: ___________________________________________
NAME:
______________________________________________________ ADDRESS: __________________________________________________
TELEPHONE NUMBER: ________________________________________
SPEAKING AS AN INDIVIDUAL (5 MINUTES) ____________
SPEAKING FOR A GROUP (10 MINUTES) ______________
PLEASE INDICATE NAME OF GROUP:
____________________________
(Please check one)
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