Request For Agenda Item (Digital Request)

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If you have a specific topic that you would like the Village Board to discuss at a board meeting, please complete all of the fields below as specifically as possible. The item will be placed on the agenda for the next regular Village Board Meeting unless matter is resolved prior to the meeting. This form will be given to the board members for review.

Things to note:

1) Public Forum is no longer listed on the agenda. To bring an item before the Village Board you must complete the Request For Agenda Item form.
2) Request For Agenda Item forms must be completed and returned by 12:00 PM (noon) the Friday prior to the regularly scheduled Village Board Meeting.
3) Individuals may speak on any item; however, the item must be listed on the agenda.
4) Request For Agenda Item paper copy forms are available at the Fairmont Village Hall, the Fairmont Library, and available for printing on the Village of Fairmont's web page : www.fairmont-nebraska.org. A digital copy to complete and submit is also accessible on the Village of Fairmont's web page or at:

First and Last Name: *

Address: *

Telephone #: *

E-mail Address:

(Not a required field)

Date of Request *

The day you are submitting this request - not a future date

YYYY

Description of Requested Topic: *

Please be as descriptive as possible

Suggested Remedy: *

Please be as descriptive as possible

Please acknowledge the statements below: *

I acknowledge all information listed is true and correct to the best of my knowledge.

I understand that any Requests For Agenda Items must be received no later than 4:00PM the Friday before any regularly scheduled Village of Fairmont Board Meeting.

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms