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PUBLIC PARTICIPATION BOARD OF COMMISSIONERS MEETING APPEARANCE FORM FOR COMPLETION BY PERSON/PERSONS DESIRING TO SPEAK TO THE BOARD OF COMMISSIONERS Please contact Hollis Barton, County Clerk to process this request form to appear before the Board [EMAIL REDACTED] or [PHONE REDACTED]. PHONE NUMBER: Organization, if any, on whose behalf you wish to appear Address of organization Subject matter which you wish to discuss and a statement as to what you desire to have done: Do you expect to make a complaint, or report of improper action on the part of any department or official or other employee? YES I__I NO I__I If yes, please list the name and title of that person or department Give reasons for your complaint or request. Give dates, places and what was done or not done and why you consider it to be improper or in need of improvements. APPROVED Board of Commissioner, County Administrator, or others form2018/publicparticipation SEE Sec. 2-109 Public Participation follows next page