2018 Participant Request Form

Name of Person Speaking at the Public Hearing: Name of Person Speaking at the Public Hearing: First Last
Name of Organization:
Contact Person: Contact Person: First Last
Address: Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone: Phone: - ### - ### ####
Type:

Type: Home Office Cell
Email:
Speaking Request Type:

Speaking Request Type: Funding Legislative Proposal Informational-Presentation
Topic of Discussion:
Public Hearing:
Monday, September 18, 2017
9:00 a.m. to 1:00 p.m.
Sunlake High School
3023 Sunlake Boulevard
Land O’Lakes, FL 34638
Click here for map and directions

Speaker Request Forms received by noon on Monday, September 11, 2017, will be considered for the agenda. Additional Speaker Request Forms will be available at the meeting. Speaking requests received after the deadline may be considered, should time remain available on the agenda. All speakers should email all handout materials to Jonathan Till for distribution to the delegation members.

Jonathan Till or (813) 780-0667

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