City of Leoti, Kansas

Regular City Council meetings are scheduled for the 1st and 3rd Monday night at 6:30 p.m. excluding City holidays in the Council Chamber at City Hall. In the event a City Council meeting falls on a Holiday the Council meeting will be the following day. This form must be received in the City Hall by 12:00 noon on the Thursday prior to the Council meeting at which you desire to be heard.

I/We request to be placed on the Council Agenda.

First Name:

Last Name:

Address:

City:

State:

Zip Code:

Phone Number:

Email Address:

Fax Number:

Topic to be Addressed:

Amount of Time
Requested:

Date of Council Meeting Requesting to Attend:

Written Materials to be Provided to Council?:

If yes, I have provided the materials to the City Clerk:

Submitter's Name:

Date:

At least one of the following signatures (City Clerk, Mayor, Council Member) are required to be placed on the agenda for the City Council meeting:

Approver's Name:

Date:

Request for Agenda Placement