City Council Remote Public Comment Sign-In

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PLEASE READ BEFORE SUBMITTING FORM:
If you wish to provide oral public comment at an upcoming City Council meeting, please fill out this form to be added to the Speakers List. The deadline to sign up is by 6:30 p.m. the night of the meeting. Directions for how to participate remotely will be sent to you by 6:30 p.m. the evening of the meeting you have signed-up to speak at. If you have any questions, please contact the City Clerk at (206) 801-2231 or jsmith@shorelinewa.gov.

NOTICE: This survey will time out if this form has been open on your screen for more than 30 minutes. In this instance, please refresh the page before filling out and submitting.

THE CLERK WILL EMAIL YOU TO CONFIRM THAT YOUR FORM HAS BEEN RECEIVED. If you do not hear back by 6:30 the night of the meeting, please call 206-801-2231.

Please correct the fields below:

Please correct the field(s) marked in red below:

1

Meeting date:

November 25, 2024

2

First and Last Name:

First and Last Name:

3

Personal Pronouns (Ex. She/Her, He/Him, They/Them, Ze/Zir, etc.)

Personal Pronouns (Ex. She/Her, He/Him, They/Them, Ze/Zir, etc.)

4

Name Pronunciation (to be used when the Clerk calls your name):

Name Pronunciation (to be used when the Clerk calls your name):

5

Telephone # (that you will be using to call in):

Telephone # (that you will be using to call in):

6

Residential Address:

Residential Address:

7

Email Address:

Email Address:

8

Will you be providing comment on an agenda item, or on a topic that is not on the agenda (general comment)?

Will you be providing comment on an agenda item, or on a topic that is not on the agenda (general comment)?

Agenda Item

General Comment

9

If commenting on an agenda item, which one?

(Optional)

To receive a copy of your submission, please fill out your email address below and submit.
Email Address

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