TOWN OF VAN HORN Request to be placed on the AGENDA  For the Regular City Council Meeting to be held  NOTE: The City Council meets on the first and third Tuesdays of each month. All requests must be received Secretary before 4:00 p.m. on the WEDNESDAY oft the week prior to the meeting. Incomplete and the item will not be placed on the agenda. Requests not received by the deadiine will be placed requests on  will by the City be returned the next agenda,  Please print or type. DATE NAME ORGANIZATION ADDRESS SUBJECT:  PHONE  WHAT ACTION ARE YOU ASKING THE COUNCIL TO CONSIDER:  JUSTIFICATION (WHY?):  BACKGROUND INFORMATION: (Required):  Please submit all pertinent background information (petitions, reports, graphs, requests, documents, etc.) along with this form to be distributed to the Council for their information prior to the meeting.  Signature  To be completed by the City Secretary  Received  Date: Time:  Complete Returned  ITEM#  City Secretary