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ELECTRONIC ATTENDANCE REQUEST <br /> I hereby request to electronically attend the meeting of the City Council on <br /> , 20 , at p.m. <br /> I am eligible to participate electronically because of (check one): <br /> (1) personal illness or disability <br /> (2) employment purposes or business of the City Council <br /> (3) a family or other emergency. <br /> During the meeting I will be at the following location: <br /> and reachable at the following telephone number: <br /> Signature of Member Date <br /> OR <br /> Request received by telephone e-mail fax other <br /> Signature of City Clerk Date <br /> 3 <br />