Request to Speak at Board Meeting
By Members of the Public
This form should be submitted to the FPUA Director of Utilities’ Executive Assistant before the Board Meeting; early submission is appreciated.
Director of Utilities’ Executive Assistant
206 S. 6th Street
Fort Pierce, FL 34950
Phone: (772) 466-1600, Ext. 3201
Amount of Time to Address the Board: 5 Minutes
Amount of Time for Public Comments: 5 Minutes
Subject to be Discussed:
Do you support this?
FOR INDIVIDUALS -
Do you designate a representative to speak on your behalf?
If “Yes,” please give name of representative?
FOR GROUPS -
Groups in attendance may choose representatives to speak on their behalf. The FPUA Board reserves the right to limit the number of speakers when a large number of individuals wish to be heard.
Name of Representative(s):
Express Consent to Contact
I expressly consent and authorize Fort Pierce Utilities Authority (FPUA), its Authorized Agents and assignees to contact me by telephone, text message, e-mail or via the internet at any telephone number, e-mail address or website associated with my account, whether obtained from me or from third parties including a cell phone, which could result in charges to me.
I have read this disclosure and agree that FPUA and its Authorized Agents may contact me as described above.
Do Not Fill This Out