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2. Please Read:

   Please complete this form if you would like to provide a general citizens' comment to be distributed to the City Council members before the scheduled council meeting.

   We respectfully request that all comments be expressed in a courteous manner. If you choose to submit a comment, please remember to follow the rules:

   • Citizen comments submitted in written form must be 500 words or less.
   • Comments should be addressed to the Council as a whole, not an individual member.

   Please Note: Comments must be received no later than 3:30 PM (two hours before the scheduled regular meeting). Your comments will be distributed to the Council for review.

4. First Name*
5. Last Name*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Email Address*
16. Public Comment
18. Permission to use phone number or email for contact*

    1. I agree
    2. I do not agree

    By checking the "I agree" box above I agree that the City of Kinston can use this phone number or email to contact me on this subject.
20. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
22. Electronic Signature*
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field