Public Participation Form Instructions: Fill out all appropriate blanks. Please print or write legibly. NAME: HOME ADDRESS: HOME TELEPHONE: PLACE OF EMPLOYMENT: EMPLOYMENT TELEPHONE: Do you represent any particular group or organization? Ifyou do represent a group or organization, please state the name, address, and telephone number of such group or organization. Which agenda item (or items) do you wish to address? In general, are you for or against such agenda item (ori items)? Signature: NOTE: This Public Participation Form must be presented to the County Clerk prior to the time that the agenda item (ori items) you wish to address are discussed before the Court. Are request must be filed with and approved by at least one member oft the Commissioners Court and/or the County Judge by 12:00 p.m. (noon) on the Wednesday immediately preceding the next] Regular Meeting of the Commissioners Court.