Privileges of the Floor Request Form

2. Individuals or groups wishing to speak under Privileges of the Floor at a regular Commission meeting shall submit a written request by 5:00 p.m. on Monday prior to the regular meeting date. There is a three (3) minute time limit per speaker. Please see Ordinance 2016-79 for additional Privileges of the Floor policy guidelines.

   Individuals or groups wishing to speak under Privileges of the Floor at a regular Commission meeting shall submit a written request by 5:00 p.m. on Monday prior to the regular meeting date. There is a three (3) minute time limit per speaker. Please see Ordinance 2016-79 for additional Privileges of the Floor policy guidelines.

4. Speaker's Name:*

   (Any person wishing to speak on behalf of a group shall so indicate and shall identify the name and address of the group or organization.)

6. Address:*

8. Phone #:*

9. Email:

11. Please mark the City Commission District of your Residence:*
    1. District 1-Commissioner Kevin Dorsey
    2. District 2-Commissioner Janasky Fleming
    3. District 3-Commissioner Albert Kirkland
    4. District 4-Commissioner John Ferguson
    5. District 5-Commissioner Beth Kenward
    6. District 6-Commissioner David Crutchfield
13. Topic to be addressed:*

Leave This Blank:


14. 1. Receive email copy
15. Email address

    This field is not part of the form submission.

16. Submit Submit and Print

* indicates a required field