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* 1. Please briefly describe the topic for which you would like to provide public comment at the meeting.

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* 3. First and Last Name

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* 4. Email Address. The meeting link will be sent to this address.

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* 5. Please provide your address.

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* 6. Check the box below to acknowledge that you agree to the following:

  1. I understand that my public comment will be limited to three (3) minutes.
  2. I understand that any information I provide in this form may be subject to disclosure under the Virginia Freedom of Information Act (FOIA).
  3. I understand that I may also submit my public comment by emailing cityclerk@fallschurchva.gov.

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* 7. Would you like your email to be added the mailing list for the following newsletters? (Not required. This question will not affect your ability speak at the meeting.)

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