Speaker/Comment Registration Card

2. In an effort to take precautionary measures to contain the spread of COVID-19 and still fulfill necessary government functions with full transparency, the City of Cleburne is providing the ability to fill out and submit the following speaker/comment registration card. If submitted no later than an hour before the start of the meeting, your public comments/questions will be considered during the specified item's discussion on the agenda. This will allow for continued public participation remotely while mitigating the spread of COVID-19 in public gatherings.

4. First Name*

5. Last Name*

6. Today's Date*
   Today's Date

8. Company Name and/or Address*

10. City*

11. State*

12. Zip Code*

14. Phone # (optional)

15. Email (optional)

17. Meeting Date*
    -- Select One --No meetings scheduled at this time.

18. Posted Agenda Item?*
    -- Select One --YesNo

19. Agenda Item #

21. I do not wish to speak on this item, but please record my:

    1. Support
    2. Opposition

22. I am the petitioner/vendor for this item and only wish to speak if requested

    1. Yes

24. Questions/Comments*

    If you have questions or need further assistance contact the City Secretary at citysecretary@cleburne.net or 817-645-0908.

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

* indicates a required field