Meeting information

First Name

Last Name

Name of the Organization (if any)

Date

Board meeting agenda item

Case #

Other Subject

I am a

complainant

respondent

attorney, representing

other witness responding

member of the public and I wish to speak on agenda item

member of the public who would like to address the Board during the call to the public

Speaking at the Board

I wish to speak

I do not wish to speak

I will speak only if necessary