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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.
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:


15. 1. Receive an email copy of this form.
16. Email address

    This field is not part of the form submission.

17. Submit Submit and Print

* indicates a required field