C I T Y   O F   V A L L E Y   P A R K

 

 

SPEAKER CARD

 

 

NAME _________________________________________

 

ADDRESS _____________________________________

 

 

 

I WOULD LIKE TO BE PLACED ON THE AGENDA TO

 

SPEAK ABOUT:

____________________________________________________

____________________________________________________

____________________________________________________

__________________________________________________________

 

 

 

 

SPEAKER  CARD

Date:  _____________________

Please Print Name:  ________________________________

Address:  ________________________________________

Topic that you wish to speak about:  ____________________

__________________________________________________________

__________________________________________________________

__________________________________________________________
 

 

 

 

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)

 

IN FAVOR _____ IN OPPOSITION _____ NEUTRAL _____