REQUEST TO BE
PLACED
ON THE CITY
COUNCIL AGENDA
The City Council would like to hear issues of importance brought by citizens of Pooler as it is in the best interest of the City
that the Mayor and Council be well informed and prepared to address topics placed on the agenda. To better ensure that
this process is efficient and effective, the City requires that citizens/vendors submit a written form outlining the subject
matter about which they would like to speak. The Mayor may rule out of order personal, abusive, or indecorous language
or matters that the City has no purview over. Completion of this form does not entitle the Speaker to be added to the
agenda. A request must be received by the Clerk of Council. Depending on the presentation additional information and
materials may be requested.
Request Submittal Date: ____________________
Name of Person to Speak: ____________________________________________________________________________
Title: Business/Organization: __________________________________________________________________________
Address: __________________________________________________________________________________________
City/State/Zip: _____________________________________________________________________________________
Telephone Number: _________________________________________________________________________________
Email Address: _____________________________________________________________________________________
Have you addressed your issue(s) with City staff? Yes No
Have addressed your issue(s) with the City Manager? Yes No
City Council Meeting Date: ____________________________________________________________________________
PURPOSE:
Brief Summary/paragraph of topic: ______________________________________________________________________
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Signature Date
