Name of Meetings to Receive Notice of: __________________________________

Name: ______________________________________________________________ 
Print clearly the name of the person requesting to be placed on the notification list.

E-mail address: _______________________________________________________ 
(Print clearly exactly as it should appear. The Town is not responsible for errors in the
  address provided, or for any mistakes in reading or entering the address.)

Phone Number: ______ - ____________   Fax Number: _______ -_______________ 
                              (area code)                                                             (area code)

Mailing address: _______________________________________________________ 

                           _______________________________________________________ 
                               City                                            State                         Zip Code
If your physical address is different from the mailing address shown above, please complete below.

Physical address: ______________________________________________________ 

                            ______________________________________________________ 
                               City                                           State                          Zip Code

CONTACT PERSON: _________________________________________________ 

________________________________     _________________________________ 
Signature of person requesting notification               Date signed

________________________________     _________________________________ 
Received by                                                                Date received

In compliance with the Alabama Open Meetings Act 2005-40 the Town Council of the Town of Crossville has a policy regarding direct public meeting notices. Persons registered to receive notification will be notified via the internet. We will provide to you notice of any meeting that pertains to the following governmental entities: Crossville Town Council and any other board or sub-committee meeting that we are aware of that you have registered to receive. The Crossville Water Board is responsible for their notification list. The Town Clerk will electronically transmit meeting notices and or agendas to the above stated email address. If for technical reasons, the Town Clerk cannot submit by electronic mail the Town may make notification via facsimile and or telephone. If it is required to notify you by mail, it is required that printing and postage cost are paid prior to the notice being mailed. All meeting notices shall be posted regularly at Town Hall. Notification requirements are effective October 1, 2005 per the Alabama Open Meetings Act 2005-40.