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Citizen Participation Form

  1. Midlothianlogo 640 x 480

  2. Citizens Participation Form

  3. Citizens are encouraged to watch City Council meetings online rather than in person due to concerns related to the spread of COVID-19. Citizens wishing to address the City Council or Planning & Zoning Commission can submit comments on any topic or agenda item electronically by utilizing this Public Comment Form. All forms must be received by 5:00 p.m. on the date of the meeting and will be provided for the record.

  4. Meeting Type:*

  5. If you wish to be contacted please provide the following:

  6. Residence:*

  7. Speaker Status:*

  8. Type of Participation:

  9. Representing Applicant?

  10. (If not speaking under Citizens to be heard.)

  11. If applicable:

  12. Statements are limited to 3 minutes.

  13. Leave This Blank:

  14. This field is not part of the form submission.