Board Meeting Speaker Form

PLEASE COMPLETE THIS FORM BEFORE SPEAKING ON A DOCKET ITEM OR TOPIC:

First

Middle

Last

Suffix

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Contact Number

Whom Do You Represent (Other than Yourself)

Nature of Discussion Topic

Are you receiving compensation for this appearance before the ARHA Board of Commissioners?

YES

Are you an ARHA Resident?

YES

Individuals interested in speaking during the Public Discussion Period should contact ARHA at info@arha.us. Each speaker will be given three (3) minutes to speak. This form must be completed in its entirety no later than 12pm on the day of the meeting.

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@ Dec 31