REQUEST TO SPEAK FORM <br />City of Eugene Planning Division-Hearings Official Public Hearing <br />The purpose of this form is to make sure that people wishing to testify have an opportunity to do so, as well as to make <br />sure that the names and mailing addresses of those testifying are correct and become part of the record. Anyone wish- <br />ing to testify should fill out this form. People speaking at the hearing as well as those submitting written testimony will <br />be notified of the decision by mail (if mailing address is provided) <br />Meeting Date: 9/12/18 <br />Project Name: U of 0 North Campus <br />Please Print clearly <br />Name: M ^ a V\ Ke ~ n I <br />Mailing Addre 'Y ,--S f <br />City, State, Zip: r~ „ s P .-7 Y <br />Are you (please check one) <br />❑ Speaking in favor <br />X Speaking Against <br />❑ Neutral <br />❑ Do not wish to speak but would like to be notified of the decision <br />