Virtual Public Comment Card

2. Date of Meeting
   Date of Meeting

   Date of Meeting

4. Name (First and Last)

5. Email (Required)

6. Organization (Optional)

8. Address (Optional)

10. City

11. State

12. Zip Code

14. Are you requesting to submit your comment verbally or provide a written comment to be entered into the record?

    1. Requesting to speak via teleconference. Verbal comments are limited to three minutes per agenda item.
    2. Submitting written comments to be entered into the record.

16. Under which section(s) of the agenda will your comment(s) be made?

    Select all that apply.

    1. General Public Comment - subject(s) not listed on the meeting agenda.
    2. Presentations
    3. Public Hearings
    4. Closed Session
    5. Consent Calender
    6. Action Item
    7. Other
17. Phone Number or Email (If providing verbal comments via teleconference during the meeting)

    If you will be providing verbal comments during the meeting, please provide your email address or phone number above. If participating via Zoom, login details to speak will be sent to the email address submitted.

19. Other

21. Submit Written Comments

    If you are providing comments in writing only, please include in the field above your specific comments to be entered into the record. Comments are limited to 350 words per item. All comments from one person to be provided under the Public Comment section (non-agenda items) are considered a single item with a 350 word limit. NOTICE: If you complete this box, you will NOT be called on to speak at the meeting. Do not complete this box if you would like to provide your comments verbally during the meeting.

Leave This Blank:


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

    This field is not part of the form submission.

25. Submit Submit and Print

* indicates a required field