Meeting Request Form

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Meeting Request Form - Ward 1

Use this form to request a meeting to schedule a face-to-face meeting to discuss issues you feel are important to the Ward and to the City of Clarksivlle. I am generally available to meet after school, starting at 3:30 unless there is conflict with other City Council or Committee meetings. I am willing to meet with any residents of Clarksville, but will prioritize residents of Ward 1.

Email *

Salutation

Name:

Address:

Preferred date and time to meet:

Preferred meeting location:

How would you like to be contacted to confirm our appointment?

Phone

Text Message

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Phone Number (will be used to contact you if this is your preferred method of contact)

Topic you would like to discuss during our meeting.

Send me a copy of my responses.

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