SPIN2011-44 Email from Applicant - Meeting Request Form.docxLori Payne
From: Alison Ortowski
Sent: Wednesday, November 09, 2011 1:19 PM
Subject: SPIN #8 Meeting Inquiry - 200 N. Kimball
Attachments: SPIN Meeting Request Form.pdf; SPIN Applicant Packet.pdf
Julianne,
Thank you for your phone message regarding your project at 200 N. Kimball Avenue. The first step in
the SPIN Meeting process is to speak with the SPIN Representative who will then make a
recommendation on whether or not a meeting is needed. Your project is located in SPIN #8 whose
representative is Pattie Minder. You can reach her at 817-481-7492.
Mrs. Minder will speak with you about your project and then make a meeting
recommendation. Following that recommendation, if you wish to schedule a meeting, please fill out
and return the attached SPIN meeting request form prior to the submittal deadline for your desired
SPIN meeting date. Please note that I cannot schedule a meeting without a recommendation from
the SPIN Representative.
The next available SPIN Meeting dates and corresponding submittal deadlines are:
Meeting Date
Submittal Deadline
December 5, 2011
November 10, 2011
December 12, 2011
1 November 17, 2011
Please let me know if you have any questions.
Alison Ortowski
Assistant to the City Manager
19 SOUTHLAKE
(817) 748-8261 - Office
Follow The City:
www. C ityof South lake. com
www.MySouthlakeNews.com
www.VisitSouthlakeTexas.com
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Southlake Program for the Involvement of Neighborhoods
Meeting Request Form
Applicant Contact Information:
Name:
Business:
E-mail:
Work Phone:
Alternate Phone:
Proposal Description:
(Short, 2-3 sentence description of propose project. This information will be used on the advertising for the meeting. EX: 11,000 sq. ft
office building on 2.5 acres located at 100 Southlake Boulevard.)
Project Location:
Exact Street Address:
Nearest Cross Streets:
SPIN Neighborhood:
Additional Location Information:
SPIN Neighborhood Representative Recommendation:
(Please indicate Yes or No)
❑ Yes ❑ No
SPIN Meeting Request:
(Please indicate Yes or No)
17'[T1 0 0 0 M■0C•7
Desired SPIN Meeting Date:
For office use only:
SPIN Case No.:
Initial Contact:
Recommendation:
Form Received:
Website:
Connect-CTY:
Southlake Program for the Involvement of
Neighborhoods
Applicant Information Packet - Draft
Procedures: SPIN Forum Guidelines
Source: City Council / SPIN Standing Committee / Administrative
Category: SPIN Town Hall Forum Procedures
Effective Date: October 1, 2003
Revised Date: 08/10/2010
1. Purpose
The purpose of these procedures includes the following objectives:
■ To effectively communicate the role that the SPIN Program plays in the
public process and how it works;
■ To efficiently and effectively process participation requests;
■ To efficiently and effectively notify residents of upcoming events in order
to maximize participation and increase value to all stakeholders;
■ To provide follow-up communication that is useful for City Council, City
Boards and Commissions, Program Participants, and City Residents.
2. Definitions
2.1. SPIN Staff Liaison: City -appointed staff member who is designated as the
SPIN Standing Committee's liaison and schedules all SPIN Town Hall
Forums.
2.2. SPIN City-wide Forum: Meetings held for developments located on SH
114 or Southlake Boulevard that impact the city as a whole.
3. SPIN Town Hall Forum Scheduling Process
3.1. Step 1: First Contact with Applicant — Typically, the initial contact with an
applicant occurs with a member of the Planning and Development
Services Department. During these meetings, staff:
3.1.1. Highlights SPIN meeting criteria which is included in the
development application
3.1.2. Advises the applicant that, depending on meeting availability, at
least a three-week timeframe is required to schedule a meeting
(see Section 4 for more information), and
3.1.3. Directs the applicant to contact the SPIN Staff Liaison to discuss
scheduling a meeting
3.1.4. Notify SPIN Staff Liaison via email of meeting and potential SPIN
Meeting request
SPIN Forum Guidelines
3.2. Step 2: Applicant Contacts SPIN Staff Liaison — The applicant contacts
the SPIN Staff Liaison,
or designee, who:
3.2.1. Provides
the applicant with the SPIN Information Packet which
includes:
3.2.1.1.
SPIN Meeting Procedures Document
3.2.1.2.
SPIN Neighborhood Map
3.2.1.3.
SPIN Neighborhood Representative Contact Sheet
3.2.1.4.
SPIN Town Hall Forum Schedule with Submittal
Deadlines
3.2.1.5.
SPIN Meeting Form:
3.2.1.5.1. Applicant Contact Information
3.2.1.5.2. Proposal Description
3.2.1.5.3. Project Location (Address or nearest cross -
streets and existing landmarks and SPIN
Neighborhood)
3.2.1.5.4. SPIN Neighborhood Representative
Recommendation
3.2.1.5.5. Applicant's SPIN Meeting Request (Yes/No)
3.2.1.5.6. Desired SPIN Meeting Date
3.2.2. Instructs the applicant to contact the applicable SPIN
Representative(s) within three business days in relation to the
proposed development or community issue.
3.2.2.1. If contacting the SPIN representative is problematic, or a
vacancy is present in the appropriate SPIN
Neighborhood(s), the applicant may be directed by staff
to contact a member of the SPIN Executive Committee,
of which a copy of the individuals that comprise this body
will be included in the packet materials provided to the
petitioner.
3.2.3. Notifies, via email, the appropriate SPIN Neighborhood
Representative as well as the SPIN Executive Committee following
the meeting with the applicant that a SPIN Meeting Request is
pending and provides contact information for the applicant.
3.2.3.1. If SPIN Neighborhood Representative is not contacted by
applicant within three business days, the SPIN
Neighborhood Representative shall notify SPIN Staff
Liaison via email.
3.2.4. Creates an electronic file for the request that may be referenced as
the request moves through the process, as well as by those
needing information at some future date.
SPIN Forum Guidelines
3.3. Step 3: Applicant Contacts SPIN Representative — The applicant contacts
the appropriate SPIN Neighborhood Representative and discusses the
proposed project with him/her.
3.3.1. The purpose of this contact is to familiarize the SPIN Neighborhood
Representative with the proposed project so that he/she may make
a recommendation as to whether or not a SPIN Meeting is
necessary.
3.3.2. If SPIN Neighborhood Representative has not responded to
applicant's request within three business days of meeting with SPIN
Staff Liaison, the applicant shall notify the SPIN Staff Liaison who
will:
3.3.2.1. Direct applicant to contact a member of the SPIN
Executive Committee, and
3.3.2.2. Notify, via email, SPIN Executive Committee member of
pending SPIN Meeting request
3.4. Step 4: Review of Meeting Requests — The decision to recommend a
SPIN meeting to discuss and review a particular issue is at the discretion
of the SPIN Neighborhood Representative who shall consider these
Project Consideration Guidelines:
3.4.1 Circumstances where a meeting may be recommended is generally
measured by the amount of visual impact or change in use it will
have on the existing character of a property and would include the
following:
3.4.1.1 Zoning changes and major site, concept or development
plans
3.4.1.2 Where new development is proposed (i.e. new building
construction, new residential homes, new
streets/infrastructure, etc.); or
3.4.1.3 Where the character of existing development is
dramatically changed, either visually or by use (i.e. major
fagade changes to an existing building or a zoning
change to add a use to an existing development); or
3.4.1.4 Where the property is residentially adjacent and/or
located along a major corridor such as Southlake Blvd or
SH 114.
3.4.1.5 Specific use permits where the use may have
considerable impact on adjacent properties
3.4.1.6 Comprehensive Plan Amendments
SPIN Forum Guidelines
3.4.1.7 Ordinances
3.4.2 Circumstances where a meeting may not be necessary include:
3.4.2.1 Plats, for their legal limitations on timing and fact that
zoning and/or development plan will reflect the same
design as the plat
3.4.2.2 Minor site plans where changes are being made to
existing structures
3.4.3 Other Meeting Review Considerations
3.4.3.1 The SPIN Staff Liaison will not call a SPIN meeting
without the consent of the SPIN Representative
and/or a member of the Executive Committee unless
directed by the City Manager, the full City Council, or
a meeting request is remanded back to SPIN from the
Planning and Zoning Commission.
3.4.3.2 In instances where a City Department is seeking input on
an ordinance, comprehensive plan element or other non -
development case, meetings may be called without the
consent of a SPIN Neighborhood Representative.
However, staff shall ensure that the Executive Committee
as well as any representatives in neighborhoods affected
by the proposal is notified about potential impact to the
neighborhood.
3.4.3.3 The SPIN Executive Committee is solely responsible for
the orderly management of the SPIN meeting agenda.
3.4.3.4 In instances where the issue has citywide implications,
the SPIN Standing Committee (in conjunction with the
SPIN area representative) is responsible for coordinating
the neighborhood communication efforts to host a
citywide meeting.
3.5. Stea 5: SPIN Neiahborhood Representative Meetina Recommendation
The SPIN Neighborhood Representative reviewing the meeting request
makes a recommendation as to whether or not a SPIN Meeting is
necessary. This recommendation is communicated by the SPIN
Neighborhood Representative to:
3.5.1. The SPIN Staff Liaison, via email, who will enter the
recommendation into the request's record, and
3.5.2. The applicant
3.5.2.1. If the SPIN Neighborhood Representative does not
recommend a meeting and the applicant feels that a
SPIN Forum Guidelines
meeting is necessary, the applicant may be directed by
staff to contact a member of the SPIN Executive
Committee for a second review and recommendation of
the proposal. The communication procedure for this
recommendation will be the same as with the initial
recommendation as described above.
3.5.2.2. If the SPIN Neighborhood Representative does
recommend a meeting, the applicant is not bound by that
recommendation, as SPIN Meetings are not a
requirement, and the applicant may choose not to move
forward with such recommendation.
3.6. Step 6: Applicant Decision — The applicant, having received the SPIN
Neighborhood Representative's recommendation, returns the completed
SPIN Meeting Form to the SPIN Staff Liaison. On this form, the applicant
will indicate whether or not a meeting is requested and the desired SPIN
meeting date. The SPIN Staff Liaison will also record the SPIN
Neighborhood Representative's recommendation on this form, referencing
any applicable email communication on the topic.
3.7. Step 7: Meeting Coordination — If the applicant requests a SPIN Meeting
be scheduled,
3.7.1. The SPIN Staff Liaison will:
3.7.1.1. Post meeting information on City Website (SPIN
Meetings page and Events Calendar)
3.7.1.2. Send meeting information to SPIN Standing Committee
via Weekly Email Update
3.7.1.3. Order signage
3.7.1.4. Record/send Connect-CTY phone call
3.7.1.5. Prepare posted agenda and send to City Secretary for
posting
3.7.1.6. Prepare meeting materials (program, sign -in sheet)
3.7.2. The SPIN Neighborhood Representative will:
3.7.2.1. Notify SPIN Neighborhood of upcoming meeting utilizing
additional communication tools that may be available to
each SPIN Neighborhood Representative such as email
communication with neighborhood homeowner
associations.
3.7.2.2. Comply with the SPIN Code of Conduct
3.7.2.2.1. SPIN Representatives are held accountable to
a Code of Conduct. In situations where a
SPIN Representative does not wish to host a
meeting in accordance with the Code, the
SPIN Forum Guidelines
SPIN Representative may ask his/her Alternate
Representative to host the meeting. The
Executive Committee also reserves the right to
host or coordinate with another SPIN
Representative to substitute host a meeting for
the applicable SPIN area(s) in the event that
an Alternate Representative is not appointed or
if the Alternate Representative does not wish to
host a meeting in accordance with the Code.
3.7.3. SPIN Standing Committee Members will:
3.7.3.1. Notify SPIN Neighborhood of upcoming meeting utilizing
additional communication tools that may be available to
each SPIN Neighborhood Representative such as email
communication with neighborhood homeowner
associations.
See Section 5 for more information about Meeting Agendas and Format.
3.8. Step 8: Meeting Follow -Up
3.8.1. Documentation of SPIN Meetings — The City of Southlake staff
member who attended the forum will generate a report following
each meeting. Reports are general observations of SPIN Meetings
by City staff and SPIN Representatives. The report is neither
verbatim nor official meeting minutes; rather it serves to inform
elected and appointed officials, City staff, and the public of the
issues and questions raised by residents and the general
responses made. Responses as summarized in this report should
not be taken as guarantees by the applicant. Interested parties are
strongly encouraged to follow the case through the Planning and
Zoning Commission and final action by City Council.
3.8.2. Distribution and Posting of Reports on City Website -
3.8.2.1. The SPIN Staff Liaison will:
3.8.2.1.1. Post report on the SPIN website under "SPIN
Meeting Reports" for access
3.8.2.1.2. Include report in electronic meeting file
3.8.2.1.3. Distribute report to SPIN Standing Committee
members via Weekly Email Updates
3.8.2.1.4. Include in Planning and Zoning Commission
meeting packets
3.8.2.1.5. Include in City Council Meeting Packets
3.8.2.2. SPIN Standing Committee Members will:
SPIN Forum Guidelines
3.8.2.2.1. Distribute report to SPIN Neighborhood
utilizing additional communication tools that
may be available to each SPIN Neighborhood
Representative such as email communication
with neighborhood homeowner associations.
3.8.2.2.2. Follow project through development process by
monitoring Planning and Zoning Commission
and City Council meeting agendas and
communicate to SPIN Neighborhood as
necessary
4. SPIN Town Hall Forum Meeting Schedule
4.1. Regular Meeting Timeline — SPIN holds two (2) Citywide / Neighborhood
forum nights on a monthly basis, the second and fourth Mondays of the
month. If a meeting is requested, the meeting request must be submitted
through the proper channels, as described in Section II, by the required
deadline of three weeks in advance of the requested meeting agenda
(please refer to the SPIN Meetings and Submittal Deadline Schedule
included in this packet for meeting dates) in order to allow for adequate
advertisement and notification of residents. All SPIN Meeting Forms must
be submitted to the SPIN Staff Liaison in the City Manager's Office (CMO)
by 5:00 p.m. on the required meeting submittal date.
4.2. Designated Overflow Meeting Date — If both the second and fourth
Monday meeting schedules are full and/or if there are extenuating
circumstances to consider when scheduling a project, a SPIN Town Hall
Forum may be scheduled on the last Thursday of the month provided the
following conditions are met:
4.2.1. The request is made no less than ten days from the meeting date;
4.2.2. The SPIN Neighborhood Representative and a majority of the SPIN
Executive Committee recommend the meeting or the meeting is
requested by the Planning and Zoning Commission or the City
Council; and,
4.2.3. A City-wide Connect-CTY phone call is made in order to account
for the inability to post signage throughout the city advertising the
meeting.
4.2.3.1. If the meeting is requested due to a full schedule on the
second and fourth Monday meeting nights, and the three-
week notification timeframe can still be met, normal
notification procedures will be followed as outlined in
Section 5 of this document.
SPIN Forum Guidelines
5. Meeting Notification Procedures — The SPIN Representative(s) and the
Executive Committee will work with the SPIN Staff Liaison to publicize the
meeting. Notification for upcoming SPIN meetings occur via a variety of
communication mechanisms (see list below), coordinated through the CMO.
SPIN Neighborhood Representatives are also expected to communicate meeting
information to their SPIN Neighborhoods. Applicants may choose to
communicate meeting information as well; however, use of the SPIN name or
logo on an applicant -initiated mailing is prohibited unless the mailer is reviewed
and approved through the CMO.
Staff Communication
Means
City-wide Meeting*
Neighborhood Meeting
Agenda Posting
X
X
Cable Channel
X
X
Connect-CTY
X
X
Facebook
X
X
Media Tips
X
X
Signage
X (14 placed City-wide)
X (4 placed at key locations
near proposed
development)
SPIN Weekly Email Update
X
X
Twitter
X
X
Website
X
X
*Developments located on SH 114 or Southlake Boulevard that impact the city as a
whole shall be deemed city-wide meetings.
6. SPIN Meeting Agenda / Format
6.1. Arrival Time — Applicants are requested to meet the SPIN Neighborhood
Representative at the meeting location thirty (30) minutes prior to the
scheduled start time (typically SPIN meetings start at 6:00 p.m., 7:00 p.m.
and 8:00 p.m.). This allows for discussion about the meeting, to review
handouts and/or presentation materials to be provided during the meeting,
and to provide an opportunity to review the ground rules and address
questions.
6.2. Useful Information — Petitioners should present the following information
during their meeting presentations:
6.2.1. Concept / Site Plan (copies for handouts, if development related);
6.2.2. Possible tenants for development;
6.2.3. Vision of development / issue;
6.2.4. Time frame for completion of development / issue;
6.2.5. Elevations of buildings; and
SPIN Forum Guidelines
6.2.6. Estimated date(s) for placement on City Boards and Commissions
and/or City Council meeting agendas so participants may continue
participating in the public review process.
6.3. Meeting Protocol — The SPIN Representative / Host will open the meeting
with a review of the SPIN Program, the meeting format and the SPIN
meeting ground rules. The host will then introduce the applicant and/or
presenters. A question and answer session will follow the presentation.
Applicants are asked to provide information on the merits of their proposal,
and are asked to avoid any comments or references to other
developments or proposals pending with the City.
6.4. Policy on Follow -Up Meetings — SPIN will agree to host ONE meeting with
a petitioner. Should a petitioner wish to hold a follow-up meeting with
specific neighborhoods or Homeowner Associations, they will do so only
at their own expense and initiative. Developer -initiated meetings should
be communicated to the SPIN Representative so that information may be
made available and advertised through appropriate channels. Meetings
should not be offered under the guise of the SPIN program, and use of the
logo or SPIN name is prohibited unless expressly permitted by the
Executive Committee.
SPIN Forum Guidelines
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SPIN STANDING COMMITTEE MEMBERS
August 2010
Public Info
SPIN #1
SPIN #5
SPIN #9
Amy Brandt
Wendi Carlucci, Vice -Chair
Ray Tremain
533 Coyote Road
2000 N. Peytonville Ave.
1410 Kensington Ct.
H: 817-490-9056
H: (817) 488-5640
H: 817-421-1180
spinl@ci.southlal<e.tx.us
spin5@ci.southlake.tx.us
spin9@ci.southlake.tx.us
Term expires 05/31/11
Term expires 05/31/11
Term expires 05/31/11
SPIN #10
SPIN #2
Ronald Evans, Chair
David Alexander, Secretary
930 Parkview Lane.
904 Quail Creek Court
SPIN #6
H: (817) 912-0096
H: 817-251-1156
Mike Terry
spinl0@ci.southlake.tx.us
spin2@ci.southlake.tx.us
1710 Wild Rose Way
Term expires 05/31/12
Term expires 05/31/12
H: (817) 251-8851
spin6@ci.southlal<e.tx.us
Term expires 05/31/12
SPIN #11
Monique Schill
SPIN #3
162 Jellico Circle
Jan Francis
H: 817-821-6539
1211 Ashmoore Ct.
SPIN #7
spinll@ci.southlake.tx.us
H: (817) 481-6757
Vic Awtry
Term expires 05/31/11
spin3@ci.southlaket.us
775 Lakewood Dr
Term expires 05/31/11
H: (817) 481-4972
spin7@ci.southlal<e.tx.us
Term expires 05/31/11
Senior Representative
David Baltimore
1368 Holland Hill
H: (817) 488-3593
SPIN #4
spinsenior@ci.southlal<e.tx.us
Lou Hillman
Term expires 05/31/12
603 N. Kimball Ave.
SPIN #8
C: (817) 247-3392
Pattie Minder
spin4@ci.southlake.tx.us
223 Eastwood Dr.
Youth Representative VACANT
Term expires 05/31/12
H: (817) 481-7492
Name:
spin8@ci.southlal<e.tx.us
Address:
Term expires 05/31/12
H:
C:
Term expires 05/31/10
H = Hoare phone C = Cell phone ff' = [Fork Phone F = Fax
SPIN STANDING COMMITTEE MEMBERS
August 2010
Public Info
SPIN #1 Alternate VACANT
SPIN #5 Alternate
SPIN #9 Alternate
Name:
Barbara Schlauch
Ned Ahearn
Address:
1605 Mockingbird Lane
1400 Kensington Court
H:
H: 817-416-0289
H: 817-251-8716
C:
spin5alt@ci.southlal<e.tx.us
spin9alt@ci.southlake.tx.us
Email:
Term expires 05/31/11
Term expires 05/31/11
Term expires 05/31/11
SPIN #10 Alternate
Name: Michael Forman
Address: 1307 Normandy Dr.
SPIN #2 Alternate VACANT
SPIN #6 Alternate
H: 817-416-7809
Name:
Name:
spinl0alt@ci.southlake.tx.us
Address:
Address:
Term expires 05/31/12
H:
H:
C:
C:
Email:
Email:
Term expires 05/31/12
Term expires 05/31/12
SPIN #11 Alternate
James E. Cox
2904 Bristol Glen Ct.
H: 817-379-0377
SPIN #3 Alternate
SPIN #7 Alternate
spin1lalt@ci.southlake.tx.us
Randy Williamson
Sue Cullen
Term expires 05/31/11
705 Castle Rock Drive
725 Bentwood Lane
H: 817-421-3457
H: 817-421-0163
spin3alt@ci.southlake.tx.us
spin7alt@ci.southlal<e.tx.us
Term expires 05/31/11
Term expires 05/31/11
Alternate Senior Representative
Name:
Address:
H:
C:
Email:
SPIN #8 Alternate
Term expires 05/31/12
SPIN #4 Alternate VACANT
John Logan
Name:
221 Eastwood Drive
Address:
H: 817-329-2907
Alternate Youth Representative
H:
spin8alt@ci.southlal<e.tx.us
Name:
C:
Term expires 05/31/12
Address:
Email:
H:
Term expires 05/31/12
C:
Term expires 05/31/10
H = Hoare phone C = Cell phone if'- iPorkPhone F = Fax
SPIN Forum Meeting Dates and Submittal Deadlines
Meeting Date
Submittal Deadline
January 11, 2010
December 17, 2009
January 25, 2010
December 31, 2009
February 8, 2010
January 14, 2010
February 22, 2010
January 28, 2010
March 8, 2010
February 11, 2010
March 22, 2010
February 25, 2010
April 12, 2010
March 18, 2010
April 26, 2010
Aril 1, 2010
May 10, 2010
Aril 15, 2010
May 24, 2010
Aril 29, 2010
June 14, 2010
May 20, 2010
June 28, 2010
June 3, 2010
July 12, 2010
June 17, 2010
July 26, 2010
July 1, 2010
August 9, 2010
July 15, 2010
August 23, 2010
July 29, 2010
September 13, 2010
August 19, 2010
September 27, 2010
September 2, 2010
October 11, 2010
September 16, 2010
October 25, 2010
September 30, 2010
November 8, 2010
October 14, 2010
November 15, 2010
October 21, 2010
December 6, 2010
November 11, 2010
December 13, 2010
November 18, 2010
November 15th date is irregular to account for Thanksgiving.
December 6th date is irregular to account for the Christmas holiday.
2011 SPIN Forums - Meeting Dates and Submittal Deadlines
mesum a.
January 10, 2011
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December 16, 2010
January 24, 2011
December 30, 2010
February 14, 2011
January 20, 2011
February 28, 2011
February 3, 2011
March 14, 2011
February 17, 2011
March 28, 2011
March 3, 2011
April 11, 2011
March 17, 2011
April 25, 2011
March 31, 2011
May 9, 2011
April 14, 2011
May 23, 2011
April 28, 2011
June 13, 2011
May 19, 2011
June 27, 2010
June 2, 2010
July 11, 2011
June 16, 2011
July 25, 2011
June 30, 2011
August 8, 2011
July 14, 2011
August 22, 2011
July 28, 2011
September 12, 2011
August 18, 2011
September 26, 2011
September 1, 2011
October 10, 2011
September 15, 2011
October 24, 2011
September 29, 2011
November 7, 2011
October 13, 2011
November 14, 2011
October 20, 2011
December 5, 2011
November 10, 2011
December 12, 2011
November 17, 2011
November 7th date is irregular to account for Thanksgiving.
December 5th date is irregular to account for Christmas
Approved by SPIN Standing Committee - November 9, 2010
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4 PINS
i'V#4
Southlake Program for the Involvement of Neighborhoods
Meeting Request Form
Applicant Contact Information:
Name:
Business:
E-mail:
Work Phone:
Alternate Phone:
Proposal Description:
(Short, 2-3 sentence description of propose project. This information will be used on the advertising for the meeting. EX: 11,000 sq. ft
office building on 2.5 acres located at 100 Southlake Boulevard.)
Project Location:
Exact Street Address:
Nearest Cross Streets:
SPIN Neighborhood:
Additional Location Information:
SPIN Neighborhood Representative Recommendation:
(Please indicate Yes or No)
❑ Yes ❑ No
SPIN Meeting Request:
(Please indicate Yes or No)
17'[T1 0 0 0 M■0C•7
Desired SPIN Meeting Date:
For office use only:
SPIN Case No.:
Initial Contact:
Recommendation:
Form Received:
Website:
Connect-CTY: