The Racine County Board of Supervisors is interested in hearing from members of the public. In order to facilitate this process, a period of time has been set aside at the beginning of each County Board meeting to allow members of the public to provide comment to the board on any item.

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Date Submitted:

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Date:

Date of County Board Meeting:

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Date:

Name - First and Last:

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Name - First and Last:

First Name:

Last Name:

Address:

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Address:

Street Address:

City:

State:

Zip Code:

County of Residence:

Phone Number:

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Phone Number:

Daytime Phone #:

Evening Phone #:

Topic of Presentation or Comments:

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Comments:

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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