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2. 
4. Middletown Town Council Meeting Public Participation Form

   Welcome -- Your Town Council Wants To Hear From You!

   Remember To Complete This Online Form & Submit It To The Town Clerk Or Deputy Town Clerk No Later Than 5 PM The Day Of A Town Council Meeting.

6. Name:*
7. Address:*
9. Phone Number:*
10. Email:*
12. Please CHOOSE ONE Of The Following Categories Below (1 Or 2) & Complete That Section
14. 1) Public Forum (The Topic I'm Speaking About Is Not On The Meeting Agenda):

    1. Public Forum
16. The Item I Will Speak About During Public Forum Is:*

18. During the Public Forum section of the meeting, you're welcome to speak up to five (5) minutes on one topic that's not part of the Town Council's agenda. 

    Remember that comments about personnel and/or job performance are NOT allowed (See the policy at the bottom of this form for more details)

20. 2) The Topic I'm Speaking About Is On The Meeting Agenda:

    1. Agenda Item
22. Agenda Item Number:
23. Agenda Subject:
25. Position On The Item Before The Town Council:

    1. Support

    1. Oppose

    1. Looking For More Information
27. Please Choose One Of The Following (A or B):

    1. A) The Agenda Item IS Listed As A "Public Hearing"

29. The Town Council will formally open the Public Hearing & indicate when those in attendance can speak. You are welcome to speak for up to five (5) minutes.

31. 1. B) The Agenda Item IS NOT Listed As A "Public Hearing"

33. The Town Council will call you to speak by name when the group is ready to hear your feedback. You are welcome to speak up to five (5) minutes.

35. Supporting Documents You'd Like The Town Council To Consider
39. PUBLIC FORUM POLICY

    1) The Public Forum period shall be at the beginning of the meeting and shall be no longer than fifteen (15) minutes total.

    2) Citizens may address the Council on one subject only and for no longer than five (5) minutes.

    3) Issues shall be related to substantive Town business and must not include items discussed during the regular meeting. NO COMMENTS REGARDING PERSONNEL OR JOB PERFORMANCE ARE ALLOWED.

    4. An Online Public Participation Form must be submitted to the Council Clerk or Deputy Town Clerk NO LATER THAN 5 PM THE DAY OF THE TOWN COUNCIL MEETING.

Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field