JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
WLASNC Public Comment and Speaker Card
Public comment and speaker cards are also available at meetings.
NOTICE OF LOBBYING REGISTRATION:
If you are receiving compensation to make this appearance, the City's municipal lobbying ordinance (L.A.M.C. Section 48.01 et seq., as amended) may require you to register and report your lobbying activity. For more information about the City's lobbying law, contact the City Ethics Commission at (213) 978- 1960, by fax at (213) 978-1988, or at 200 N. Spring Street, Rm 2410, Los Angeles, CA 90012. Information about lobbying the City of Los Angeles may also be found on the Internet by accessing the Ethics Commission Web site on the City of Los Angeles Home Page at
http://www.lacity.org
.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
First and last name
Your answer
Date of Meeting
*
MM
/
DD
/
YYYY
Agenda Item #
*
Type N/A if you are not speaking on an agenda item.
Your answer
Please select:
*
I want to speak in favor of this agenda item.
I want to speak in opposition of this agenda item.
I want to provide general comments regarding this agenda item.
I do not want to speak but want to be recorded as in favor of this agenda item.
I do not want to speak but want to be recorded as in opposition of this agenda item.
I want to speak during Public Comment time on issues not on the agenda but which are within the Board's jurisdiction
Required
Business or Organization Affiliation
(if applicable)
Your answer
Business or Organization Address
(if applicable)
Your answer
Business or Organization Phone
(if applicable)
Your answer
Representing:
(if applicable)
Your answer
Email
Your answer
Are you a paid speaker?
*
If yes, you must provide client information below.
Yes
No
Required
Client Name
(if applicable)
Your answer
Client Phone
(if applicable)
Your answer
Client Address
(if applicable)
Your answer
COMMENTS FOR THE RECORD:
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of westlasawtelle.org.
Report Abuse
Forms