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2. First Name
3. Last Name
4. Date
   Date
6. Address
8. City
9. State
10. Zip Code
12. Phone Number
14. Agenda Item?

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    2. I will speak on an agenda item
15. I will speak on Agenda Item #:
17. I will speak...

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    2. in opposition
    3. or I have a question/comment
18. I do not wish to speak, but please record my...

    1. support
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