Loading...
HomeMy WebLinkAbout2019-11-19 AppointmentItem Number: 16.a. r � � At + at1Mw��al +•ate_ CITY OF IOWA CITY www.icgov.org November 19, 2019 Board of Adjustment - One vacancy to fill a five-year term, January 1, 2020 - December 31, 2024. (Term expires for Constance Goeb) ATTACHMENTS: Description Vacancy Notice/Coversheet Board Demographics/Attendance Parker, Bryce -Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF ADJUSTMENT One Vacancy: Five -Year Term January 1, 2020 — December 31, 2024 • Duties: The Board of Adjustment is a citizen panel that reviews requests for special exceptions and variances. • The Board also considers appeals when there is a disagreement about an administrative decision made by the City. • Members of the board act like judges, making decisions about individual properties and uses that may have difficulty meeting a specific zoning regulation or to resolve disputes about administrative zoning decisions. • The Board is assisted in its work by planning staff and the City Attorney's office. Decisions made by the Board of Adjustment are binding upon all parties unless overturned upon appeal to District Court. • The Board meets the second Wednesday of each month at 5:15 p.m. Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, November 12, 2019. An application can be completed and submitted on the City of Iowa City website at www.icoov.ora or by contacting the City Clerk's office. Questions about the Iowa City Board of Adjustment Commission should be directed to Jessica Lile, Associate Planner at 356-5240. Board/Commission Application Cover Board/Commission: Adjustment, Board of One vacancy to fill a five-year term 01/01/2020-12/31/2024 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 10/1/2019 Application Deadline: 11/12/2019 Council Appointment Date: 11/19/2019 Date of Non -Gender Appointment: 12/30/2019 After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Gender Male 1 -Female Female:1 Male:3 Name and Address Parker, Bryce 517 S. Governor St. Adjustment, Board of Name Term ending resident of IC Occupation Gender Age* Country of Origin* Sexual Orientation* Religion* Disability* Ethnicity* Gender Identity* Race* Unique Identifiers* Ernie Cox 12/31/2020 -Unexpired 8.5 Public School Educator_ M 44 USA Heterosexual Unitarian Male White Zephan Hazell 12/31/2021 -Unexpired 1 Ecommerce Mgr M Gene Chrischilles 12/31/2022 -Unexpired 36 Retired pharmacist M 64 USA Male Caucasian Amy Pretorius 12/31/2023 -1st Term 11 Home Builder F 37 USA Heterosexual Caucasian Non -Hispanic White VACANT 12/31/2024 Please note: The information provided is the information provided on the application at the time of submission. * Information is voluntary BOARD OF ADJUSMENT ATTENDANCE RECORD YEAR 2018-2019 NAME TERM EXP. 2/14 5/9 6/13 8/8 12112 2/13 3/13 4/10 5/8 7/10 10/9 COX, ERNIE 12/31/2020 -- -- -- -- -- -- O/E X X O/E X GOEB, CONNIE 12/31/2019 O/E X X X X O/E X X X X X HALL, RYAN 12/31/2022 X X X X X X X X X O/E -- HAZELL, ZEPHAN 12/31/2021 -- -- -- -- -- X X X X X O/E PRETORIUS, AMY 12/31/2023 -- -- -- -- -- X X X X X X CHRISCHILLES, GENE 12/31/2022 X KEY: X = Present O = Absent O/E = Absent/Excused NM = No meeting --- = Not a Member r Advisory Board/Commission Application Form PAZsI; I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/7/2019 First Name BRYCE Last Name PARKER Home Address* 517 S. Governor Street City IOWA CITY State IA Zip Code* 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 7124907899 Email Address* bryprkr@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Adjustment, Board of Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 15 years Occupation: * Higher Education Administration/ Program Manager Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* Previous Board of Adjustment experience for —2 years. Had to relinquish role because of overseas service in Army for a year. Back in the USA and ready to serve my community once more. Some Masters Degree coursework in Urban Planning. What is your present knowledge of each advisory board you are interested in?* The Board of Adjustment reviews grievances brought on by City Council decisions. It also looks into community uniformity into building irregularities to decide to approve/ disapprove. Usually this involves an alternate use/ additional use for the site such as drive-thru. Also a sounding board for community interests in building code or compliance. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* iT Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 36 Country of Origin USA Sexual Orientation Straight Religion Lutheran Do you have a disability? No Ethnicity European/ WASP Race Human Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* E Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Item Number: 16.b. �r A�� CITY OE IOWA CITY www.iogov.org November 19, 2019 Climate Action Commission - Three vacancies to fill three-year term, upon appointment, ending December 31, 2022. (New commission) ATTACHMENTS: Description Vacancy Notice/Coversheet Board Demographics/Attendance Bradley, Madeleine -Application Grimm, Benjamin -Application Edwards,Todd -Application Hutchinson, Kasey -Application Kusiak, Eric -Application Nichols, Amanda - Application Rupe, Blake -Application Soglin, Becky -Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: CLIMATE ACTION COMMISSION Three Vacancies: Three -Year Term Upon appointment — December 31, 2022 • Duties of the Climate Action Commission include advising the City Council on climate issues; • researching, analyzing and promoting climate actions, with particular attention to equity; • educating and engaging with the public on climate action and the City's climate and sustainability goals; • assisting City staff, City Council, and members of the community with implementing approved initiatives that support the City's climate and sustainability goals, including the Climate Action and Adaption Plan and any related or updated plan here after. • The Climate Action Commission meets the first Monday of each month at 3:30 p.m. in the MPO (Metropolitan Planning Organization) Conference Room at City Hall, 410 E. Washington Street, subject to change. Iowa City -appointed members of boards and commissions must be at least 18 years of age and Iowa City residency is preferred, but members are not required to be Iowa City residents as long as they are residents of Johnson County and meet the requirements of knowledge and expertise for guiding climate objectives. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, November 12, 2019. An application can be completed and submitted on the City of Iowa City website at www.icgov.org or by contacting the City Clerk's office. Questions about the Iowa City Climate Action Commission should be directed to Brenda Nations, Sustainability Services Coordinator, at 887-6161. Board/Commission Application Cover Board/Commission: Climate Action Commission Three vacancies to fill a three-year term Upon appointment - 12/31/2022 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 10/1/2019 Application Deadline: 11/12/2019 Council Appointment Date: 11/19/2019 Date of Non -Gender Appointment: 12/30/2019 After date above Council may appoint without regard to gender Gender Balance Requirement: 3 -Female Current Gender Balance: Female: 2 Male: 6 Gender Female Male Male Name and Address Bradley, Madeleine 551 S. Linn Street #5 Edwards, Todd 811 S. Summitt St Grimm, Benjamin 1137 S Riverside Dr Female Hutchinson, Kasey 4 Ashwood Dr Male Kusiak, Eric 2953 Heinz Rd #8 Female Nichols, Amanda 2711 East Court St Female Female Rupe, Blake 1106 Marcy Street Soglin, Becky 65 Rita Lyn Ct Climate Action Commission Name Term ending # years IC resident Occupation Gender Age* Country of Sexual I Origin* Orientation* Religion* Disability* Gender Ethnicity* Identity* Race' Unique Identifiers* GT Karr 12/31/2020 Owner Sueppel Siding Remolding M Architect M 40 USA Heterosexual Caucasian European Male White Matt Krieger 12/31/2020 38 _ USA Heterosexual Unaffiliated Caucasian Male White Katie Sarsfield 12/31/2020 15 Engineer F 51 USA Straight Caucasian Straight John Fraser 12/31/2021 32 Mgmt Consultant M 76 USA_ Male_ Protestant_ USA White Male White Grace Holbrook 12/31/2021 _ 5 Student F 22 USA Heterosexual Lutheran White Female White Eric Tate 12/31/2021 8 Professor M 48 USA Heterosexual Christian Male Black VACANT 12/31/2022 VACANT 12/31/2022 M VACANT 12/31/2022 Jesse Leckband MiclAmerican Rep -- Stratis Giannakouros U of I Rep M - Please note: The information provided is the information provided on the application at the time of submission. * Information is voluntary I F— - Climate Action Commission October 7, 2019 CLIMATE ACTION COMMISSION ATTENDANCE RECORD 2019-2020 NAME TERM EXP. 0 John Fraser 12/31110 X Stratis Giumakouros U ofI representative X Grace Holbrook 12/31/21 X G.T. Karr 12/31/20 X Matt Krieger 12/31/!0 X Jesse Leekband biiMmerican representative X Katie Sarsfield 12/31010 X" Eric Tate 12/31/11 X KEY: X = Present O = Absent O/E = Absent/Excused NM = No meeting -- = Not a Member I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/2/2019 First Name Madeleine Last Name Bradley Home Address* 551 S. Linn Street #5 City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 5154238873 Email Address* madeleine-bradley@uiowa.edu Boards & Commissions Select a Board or Commission you are interested in: Climate Action Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 4 years Occupation:* Student Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* I am a 4th year student at the University of Iowa studying Global Health Studies and Environmental Science with a focus on hydrologic sciences. I have a strong interest in finding both equitable and sustainable ways to adapt to and mitigate the coming climate changes, specifically through the use of government means. I spent a year studying at the University of Oslo in Norway, named Europe's Green Capital of 2019. While there I spent time extensively studying the welfare state's policies and programs, specifically in relation to how they promoted sustainability and ensured equity across the population. As an undergraduate I have volunteered at Table to Table, a local environmental food organization, as well as with ICCompassion which aids the large population of immigrants and refugees in the city - an important population to take into account when making any sort of adaptation/mitigation plan. I also co-founded and was president of Iowa Students for Refugees, a student organization aimed at bridging the gap between the refugee community in Iowa City and the student population. I am currently a member of the Environmental Science club at Iowa and am working on a policy proposal through the Iowa Policy Research Organization to reduce nutrient pollution from agriculture in Iowa's waterways. I am planning to stay in Iowa City for the next three years to 1) Finish my undergraduate degree and 2) Complete a masters in the Sustainable Water Development Program. I believe that though I do not have expertise in the field, I am uniquely positioned to be an asset for this commission in terms of equity and sustainability due to both my undergraduate education and extracurricular experiences. Additionally, I bring perspectives as a college student and as a resident of Iowa City. What is your present knowledge of each advisory board you are interested in?* My current understanding of this commission is that it will succeed the steering committee for the Climate Action and Adaptation Plan. The commission will help to address and support the City's climate objectives by providing advice to the City council and by analyzing the effectiveness and equity of climate actions. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 21 Country of Origin United States Sexual Orientation Heterosexual Religion Atheist Do you have a disability? No Ethnicity White Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/28/2019 First Name benjamin Last Name grimm Home Address* 1137 S Riverside Dr City IOWA CITY State IA Zip Code 52246 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3195405398 Email Address* grimm.ben@iowacityschools.org Boards & Commissions Select a Board or Commission you are interested in: Climate Action Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 10 Occupation:* Grounds Manager for Iowa City Community School District Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* 20+ years horticulture industry experiance 10+ years as a manager in the horticulture industry 5 years working with reclaimed water system for greenhouses 20+ years working with Integrated Pest Management (IPM) 15+ years managing pesticide free lawns in City and Education municipalities Iowa City Community School District (ICCSD) Climate Action point person for • Good Neighbor Iowa Program • AmeriCorp contact for outdoor climate action work • ICCSD outdoor IPM program • ICCSD representative in the Corridor Tree Canopy Group Manage ICCSD Tree Canopy Initiative • Tree Canopy expansion • Monitor emission sequestering • Carbon sequestering • Energy savings on buildings from tree canopy Manage ICCSD outdoor conservation efforts • Forest, Prairie, and wetland program • Water retention and conservation Performed lectures on IPM and Pesticide Free Maintenance • Iowa Sports Turf Managers Association -State Conference • Good neighbor Iowa Program -Workshop • Kirkwood Community College -guest speaker Greenhouse Class • University of Iowa City Community School District -guest speak Sustainability Class What is your present knowledge of each advisory board you are interested in?* My understanding is the Climate Action Commission was recently authorized and is intended to advise City Council, for community outreach, and climate action promotion. Recent global attention on climate action has brought, and continues to bring, local climate action groups together for a concerted effort to reduce carbon footprints. Local Climate Action assemblies such as Ecopolis, Iowa City Climate Advocates, Sunrise Movement, Iowa City Climate Strikers, 100 grannies, Students strikers are working together and seeking greater climate action out of the City of Iowa City. The commission will help to engage the public on climate goals advise the council on climate issues and assist staff in achieving goals. Representation of ICCSD on the commission would be beneficial to the success of the commission. ICCSD representation would complement the other major represented agencies like the University of Iowa and City of Iowa City staff. Efforts and information could be more effectively coordinated on subjects related to Grounds, Facility design, Facilities energy conservation, etc. The addition of ICCSD representation could expand the outreach of the commission into the education system that impacts a large percentage of families within the community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 40 Country of Origin United States Sexual Orientation straight Religion Buddhism Do you have a disability? No Ethnicity european american Race White Gender identity male *nlnTG The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. r Advisory Board/Commission Application Form PAZsI; I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live vWthin city limits of Iowa City to apply Date of Application 11/12/2019 First Name Todd Last Name Edwards Home Address* 811 S. Summit Street City IOWA CITY State IA Zip Code* 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3126080466 Email Address* todd.j.edwards@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Climate Action Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 5.5 years Occupation: * Advisor, Research & Analytics (Climate Change) Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Dermgraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* I have been working in the field of energy, sustainability, and climate change since 2005. Presently, I am an advisor to a global NGO, www.Mission2020.global, that works closely with the United Nations and other global think tanks and NGOs. My resume is pasted below for reference. PROFESSIONAL EXPERIENCE Mission 2020 (www.Mission2020.global), Iowa City, IA (remote) September 2016 — Present Convened by Christiana Figueres, former Head of the United Nations Framework Convention on Climate Change (UNFCCC), Mission 2020 is an advocacy campaign to bend the curve of global greenhouse gas emissions by 2020 across governments, companies, investors, and civil society. Advisor and Coordinator — Research and Analytics • Manage collaborations on analytics and narratives for Mission 2020 reports such as our flagship report, 2020: The Climate Turning Point (2017), and its update report, Tracking Progress of the 2020 Climate Turning Point (2019). • Advise external stakeholders on analytics and narratives for third -party reports such as the America's Pledge report in 2017, 2018, and 2019, the Exponential Climate Action Report in 2018 and 2019, and various reports from NGOs and universities. • Co-chair the Climate Action Methodology, Data, and Analysis collaborative stakeholder group of 30+ NGOs for aggregating and communicating climate actions from international cooperative initiatives, sub -national governments, businesses, and investors. • Design and support strategic plans on climate actions across the international climate community, including co -organizing and co-chairing global stakeholder calls and workshops at venues throughout the world such as the University of Oxford and UNFCCC. • Engage with the philanthropic community to identify strategic imperatives for internal funding and across the climate community. • Support global summits, such as the Global Climate Action Summit and the UN Secretary General's Summit on Climate Action. The Stanley Foundation (www. Stan leyFoundation.org), Muscatine, IA April 2014 — July 2016 An operating foundation with programming on global governance for climate change, prevention of mass atrocities, and nuclear security. Policy Program Officer — Climate Change • Head of climate policy and designed the foundation's first climate change strategy and metrics toward achieving a 1.5°C world. • Managed the climate change team to establish the foundation's reputation as a leading voice on climate change policy. • Originated agendas and orchestrated cross -functional teams to convene multi -stakeholder roundtables with national governments, businesses, cities, universities and non-governmental organizations. • Chaired or moderated more than 20 roundtables and workshops across topics such as carbon pricing, the role of cities and businesses in climate action, geo-engineering, climate action mobilization, and analytics on achieving the Paris Agreement. Todd Edwards Sustainability and Energy Management, Various locations November 2010 — March 2014 Part-time consulting, primarily as a sub -contractor to Sieben Energy Associates, while completing a doctoral program. Principal Consultant • GHG accounting and CDP reporting for nine country markets at a Fortune 100 firm while advising their CSR strategy. • Informed the strategy behind an exhibit on the City of Chicago's energy future at a prominent science museum. • Identified and pursued new business development, responded to RFPs, and provided pro-bono consulting. Sieben Energy Associates (www. Sieben Energy.com), Chicago, IL April 2006 — October 2010 A pioneer energy and sustainability management consulting firm started in 1990 for an array of corporate and non-profit sectors. Director of Sustainability (2010) • Managed and conducted CSR reporting and strategic sustainability advising to executives at MNCs, including a Fortune 100 by leading a team from data collection, custom database analysis, and delivery of results. • Performed carbon pricing scenario planning for domestic and international businesses. • Managed project teams for 3.4 million ft2 of urban commercial LEED EBOM buildings. Energy and Sustainability Manager (2008 — 2009) • Certified Energy Manager: Program managed energy and sustainability grants for 14 hospitals in the Chicagoland area. • LEED AP: Completed the firm's first LEED EBOM project building of 0.6 million ft2. • Performed on-site energy audits, utility rate analysis, and GHG accounting for MNCs. Energy and Sustainability Consultant (2007) • Designed the firm's GHG accounting database and performed the firm's first GHG assurance audit for a national REIT. • Developed the firm's database -driven reporting framework for the energy commissioning team. Energy Analyst (2006) • Performed utility rate analyses and calculated energy and GHG metrics for REITs, museums, and retail stores. Corporate Executive Board (now Gartner, www. Gartner.com), Washington, D.C. October 2004 — July 2005 A membership -based research and consulting service for senior strategy executives at Fortune 500/Global 3000 firms. Research Associate, Corporate Strategy • Delivered industry specific benchmarking reports, short -answer strategy responses to members' questions, and created peer-to-peer knowledge networks; recognized by executive team for developing the #1 downloaded Excel -based M&A prioritization toolkit. EDUCATION Ph.D. Political Science (2010-2015), Vrije Universiteit Brussel, Economic and Social Sciences, Brussels, BE Dissertation: "The Climate Game Change: Solution Based Pathways for Unlocking Global Cooperation" Research Fellow: Brussels Institute of Contemporary China Studies M.A. International Relations (2002-2003), University of Kent, Brussels School of International Studies, Brussels, BE B.S. Economics (1998-2002), DePaul University, College of Commerce, Chicago, IL, USA IOWA VOLUNTEER EXPERIENCE Political Special Advisor to Cathy Glasson, Environmental Advisory Board, Cathy Glasson for Governor (2017-2018) Grassroots Early -Vote Canvasser, Johnson County Democrats — (Fall 2018) Alternate Delegate At -large, Johnson County Democrats (Winter/Spring 2018 Caucus) Delegate, Policy Platform Committee, Iowa City Democrats (Winter/Spring 2018 Caucus) Grassroots Canvasser, Iowa City, Hillary Clinton Campaign (2016) Lectures & Panels Lecture, Global Climate Change Policy: 1.5°C and the roles of states & regions, cities, businesses, investors, and civil society in UN climate change process, Department of Geographical and Sustainability Sciences, University of Iowa, Oct 19, 2018. Panel, Climate Change and Agriculture, Drake University Agricultural Law Center, Des Moines, IA 14 April 2016. Keynote, Iowa, the United Nations, and Climate Change, Iowa UN Association, Drake University, Des Moines, IA 23 October 2015. Keynote, Apres Paris: COP21 as the Climate Action Runway, Iowa City Foreign Relations Council, Iowa City, IA 20 October 2015. Lecture, Linking the 2015 Climate Talks in Paris and Iowa, Iowa UN Association, Central College, Pella, IA 25 April 2015. Lecture, Multilateral Climate Change Game: The Framework, the Negotiations, and the Stalemate, World _t- /l.._J n_u—I- IA ruidus wunLI Ui uie UUdu Unies, aeuenuun, w io rvuvernoer cv i'+. Publications Edwards, Todd J. and Matthew Russell, "Earth Friendly Agriculture for Soil, Water, and Climate: A Multijurisdictional Cooperative Approach," Drake Journal of Agricultural Law, Fall 2016, Vol. 21 No. 3. Edwards, Todd, "The Paris Agreement marks an unprecedented opportunity to quell the tide of climate change, and Iowans have a role to play," Little Village Magazine, 22 April 2016. Edwards, Todd, "A Groundswell in New York: Tackling climate change and sustainable development from the bottom-up," Little Village Magazine, 8 October 2015. OTHER VOLUNTEER EXPERIENCE International Energy Agency, EV30@30 initiative — Advisory Board (2017 -present) Galvanizing the Groundswell of Climate Actions — Co-founder and Steering Committee (2014 -present) Cambridge Institute for Sustainability Leadership, Climate Initiatives Database — Advisory Committee (2014- 2015) The Dill Pickle Food Co-op, Chicago, IL — Co-founder and Board of Directors (2006-2010) OTHER SELECT LECTURES & PANELS Co-chair, Enhancing Impacts of Climate Actions high-level event at SB50, UNFCCC, Bonn, Germany, June 2019. Co-chair, Climate Action Methodology, Data, and Analysis workshop, UNFCCC, Bonn, Germany, May 2018. Co-chair Sessions 3 and 4, 1 st Alliances and Coalitions Global Forum, Governments of Morocco and France with the UNFCCC, Rabat, Morocco, 23-24 June 2016. Panel Presentation, Mobilizing Non -state Actors for the Post-COP21 Agenda, World Climate Summit, Paris, France, 6 December 2016. Co -Chair, Putting a Price on Carbon: European and North American E)periences and Paths Forward, 14CE, Embassy of France to the United States, Washington, D.C., 9 November 2015. Co -Chair, Designing Elements for a Robust Carbon Pricing Club, 56th Strategy for Peace Conference, Climate Change Roundtable, Warrington, VA, 14-16 October 2015. Co -Chair, Global Research -Policy Interface Climate 2015, Bonn Climate Change Conference, Bonn, Germany, 9 June 2015. Lecture, China's Clean Technology Future, Seminar, Brussels Institute of Contemporary China Studies, Brussels, Belgium, 14 November 2011. What is your present knowledge of each advisory board you are interested in?* I was aware of the establishment of the first Climate Action Commission and the development of the city's Climate Action plan. I am also aware that the city is now committed to developing a more ambitious climate action plan. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age Country of Origin USA Sexual Orientation Religion Do you have a disability? No Ethnicity Race Gender identity *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/12/2019 First Name Kasey Last Name Hutchinson Home Address* 4 Ashwood Dr. City IOWA CITY State IA Zip Code 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-400-3340 Email Address* khutchinson@co.johnson.ia.us Boards & Commissions Select a Board or Commission you are interested in: Climate Action Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 18 years Occupation:* Soil and Water Conservation Coordinator Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* My personal interest of creating a sustainable future is a natural match for my professional role. With a technical background in Environmental Science and in Environmental Engineering, my professional career has been nested in water quality and stormwater, with a climate -focused element continually evolving with time. First, as a hydrologist with the US Geological Survey, I modeled the hydrology of Iowa watersheds to assess current conditions as well as the impacts of forecasted climate on hydrology and subsequently water quality. As Stormwater Coordinator for City of Cedar Rapids, my focus was stormwater quality improvements and protection through both policy implementation and public outreach and education, as well as writing grant applications, and developing and guiding the adoption of new rules, policy, and programs that facilitated widespread application of stormwater BMPs and water quality protection initiatives. In my current role with Johnson County Planning, Development, and Sustainability, I manage the stormwater and sensitive areas programs, reviewing post -construction stormwater management engineer designs and sensitive areas plans for residential, commercial, and industrial developments located in the County. As also responsible for compliance and enforcement, my job requires close project oversight and direct communication with developers, contractors, and builders. As such, I see the impacts from our changing climate first-hand on both the natural environment as well as on those who are trying to live and work in Johnson County. One of my responsibilities is to translate the need for a climate that is habitable into approaches to development projects that involve sustainable actions and decisions. Over the past year I have focused on revisions to the current ordinance that incorporate new approaches to both stormwater management and preservation of natural areas that reflect the fact that everything is connected; managing stormwater extends well beyond engineered practices to these natural resources that provide a whole host of ecosystem services for which it is imperative that we preserve and protect. Our engineered designs are based on a past climate, and our response to anticipated changes must extend to the connected environment. I currently represent Johnson County on both the Clear Creek Watershed Coalition Board and technical team, as well as on the English River Watershed Management Authority Board of Directors. Both have received funding through the Iowa Watershed Approach to implement stormwater practices on the landscape. The inevitable future of increased flooding in Iowa due to climate change has put focus first and foremost on building flood resiliency. Members of the technical team, especially, are charged with ensuring developed watershed management plans reflect actions and goals for flood resiliency in the context of a changing climate and with focus on vulnerable communities. As part of my work, I have had the opportunity to engage and exchange ideas with, and find exposure to those who are leaders in response to climate change, both locally and nationally. Most recently I have attended the Planning and Water Connect, The One Water Summit, and Growing Sustainable Communities conferences which all provided exposure to pragmatic and novel approaches that are broadly applicable, approaches for which dissemination of information and conversion to effective action rely on those taking them back home to their own communities. I find this to be both a professional and personal charge and am continually trying to learn effective approaches already in place that can be adapted to our community. Finally, I feel a personal obligation to be an active participant in effecting change to address the climate crisis. I have personally been living the climate action challenge for years, simply as someone who has a passion for the environment, but now also out of desperate necessity to retain a future for my daughters and all of our youth. I thoroughly enjoy working with others and would love an opportunity to take part in an effort that exemplifies why this community is the community my family calls home. What is your present knowledge of each advisory board you are interested in?* I understand that this commission is the result of over a decade of efforts and actions by the City to address climate change and create a more resilient future. I have followed the long history of Iowa City's climate crisis actions, from the first GHG reduction commitment made by the City in 2007, to the completed GHG inventories, to the formation of the Steering Committee that led to the development and adoption of the Climate Action and Adaption Plan in 2017, and the most recent GHG reduction goals. I understand that this commission is part of a multi -faceted approach by the City and that members are charged with assisting the implementation of the approved initiatives that support the goals of the Climate Action and Adaptation Plan, as well as to assist the City by advising on climate issues, researching, analyzing and promoting climate actions with particular focus on equity, educating and engaging the community, and recommending updates. I do believe this commission has a unique responsibility because adapting to and mitigating the effects of climate change is a community need that extends to absolutely every single resident. While requiring a monthly meeting commitment, viewing our community in the context of climate change in everything we do I believe is a necessary and daily responsibility to best serve through this commission, and I would be excited and honored to do so. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 41 Country of Origin United States Sexual Orientation Heterosexual Religion NIA Do you have a disability? No Ethnicity American Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/10/2019 First Name Eric Last Name Kusiak Home Address* 2953 Heinz Road #8 City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193839953 Email Address* erickusiak@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Climate Action Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 30 years Occupation:* Nu rse Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* My experiences as a former Iowa City Human Rights Commissioner and nurse at the University of Iowa Hospitals and Clinics qualify me to perform the duties of the Climate Action Commission. I view climate change under the lens of equity and social justice and my experiences fighting for social justice as a former Human Rights Commissioner illustrate this. The effects of climate change are a pressing human rights issue; institutionalized racism and systemic classism disproportionately impact vulnerable populations more adversely. In our community people with disabilities, the homeless, children, those who do not speak English, and individuals of color and stressed socioeconomic status are particularly vulnerable to weather emergencies and adaptive changes that would otherwise reduce their exposure to hazards. When it comes to access, information, and resources, many of these people in our community can fall through the gaps. My experiences and passion can be used to push forth ideas and assist the council in closing these gaps. I am particularly passionate about addressing the health-related threats posed by climate change, highlighted by my professional work as a staff nurse at The University of Iowa Hospitals and Clinics. I see firsthand daily respiratory illness, heat stress, vector-borne diseases, and the long-term consequences of unclean food and water— all of which are exacerbated by our changing climate. Many of my patient's life-threatening illnesses could be prevented by plant -rich diets which promote environmental sustainability and reduce greenhouse gas emissions. Although I am in a unique position where I get the privilege of encouraging and educating those most adversely affected, I am also positioned well in understanding their barriers to making these changes. Serving as a commissioner would allow me the opportunity and resources to address those barriers and challenges. I believe strongly The Climate Action Commission would benefit from having a healthcare professional such as a nurse to help implement Iowa City's Climate Action and Adaptation Plan and to offer the council bold and unique perspectives and solutions to combat our community's health-related threats posed by climate change. What is your present knowledge of each advisory board you are interested in?* Ever since Mayor Wilburn signed the U.S. Mayors' Climate Protection Agreement in 2007, Iowa City's commitment to combating climate change, evidenced our city's initiatives and actions, have grown exponentially. I understand that blueprint for the commission starts with the Steering Committee's Climate Action and Adaption Plan. After reading it in its entirety, I understand that to reach our 2025 and 2050 goals, our action plan requires we address buildings, transportation, waste, adaptation, and lifestyle. I understand that we must work closely with our partners such as MidAmerican Energy and The University of Iowa and build a stronger coalition with other businesses and institutions. I am excited that my qualifications articulated above align well with addressing the barriers and challenges associated with the actions laid out by the Climate Action and Adaptation Plan. Much of what the board and city accomplish now will set the precedent for our future endeavors and initiatives. As a brand new commission, this is an opportunity to hit the ground running. My present knowledge of this commission's plans, activities, and subsequent advisory obligations to the council is dwarfed in comparison by my thirst to continuing obtaining more knowledge; to continue learning. As a millennial, it is my generation that could suffer the worst consequences of this existential threat if Iowa City's 2025 and 2050 goals are not met. I feel the urgency and responsibility to lead by example for our city, local municipalities, Iowa, our nation, and even the world. January 1 st 2020 is an opportunity for us to set the stage; we as commissioners need to not only be enthusiastic, but inspire enthusiasm in our community as well. Thank you for your consideration. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 33 Country of Origin Canada Sexual Orientation Straight Religion Non -denomination Do you have a disability? No Ethnicity Polish Race White Gender identity Straight *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. r Advisory Board/Commission Application Form PAZIIS' I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/5/2019 First Name Amanda Last Name Nichols Home Address* 2711 East Court ST City IOWA CITY State IA Zip Code* 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196771153 Email Address* community-page@yahoo.com Boards & Commissions Select a Board or Commission you are interested in:* Climate Action Commission Preference on first choice If Tultiple boards are being applied for. Climate Action Commission How long have you been a resident of Iowa City?* 22 years Occupation: * Clerk III, CDD, UIHC Gender* *This question is rrandatory in order for the City to corrply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. F Male fJ Female Experience and/or activities which you feel qualifyyou for this position:* I am a long time citizen of Iowa City. I have been researching climate change since renewable energy was the topic for my West High Debate team 22 years ago. I am involved with the community and moderate a local action group with connections to many other organizations, including the student climate strikers and The Sunrise Movement. What is your present knowledge of each advisory board you are interested in?* I know that this is a new committee being formed to advise on the city's long term climate plan. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 36 Country of Origin United States Sexual Orientation Bi/Pan sexual Religion NA Do you have a disability? No Ethnicity White Race Caucasion Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ,�srrrl�rr�rl,�y��_fs�rvla' Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. r Advisory Board/Commission Application Form PAZsI; I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/21/2019 First Name Blake Last Name Rupe Home Address* 1106 Marcy Street City IOWA CITY State IA Zip Code* 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 6417996047 Email Address* blake-rupe@uiowa.edu Boards & Commissions Select a Board or Commission you are interested in:* Climate Action Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 10 years Occupation: * Program Manager, UI Office of Sustainability and the Environment Gender* *This question is mandatory in order for the City to corrply with the State's gender balance requirerrant, which treats gender as binary. "Gender Identity" may be provided in the Derrographics sectionof the application below. F Male rJ Female Experience and/or activities which you feel qualify you for this position:* As the Program Manager at the Office of Sustainability and the Environment and the University of Iowa, I would like the opportunity to connect the University and the City of Iowa City further in terms of discussing the bridge between the climate action and adaptation plan and University students. I would like to gather information from the University and present it to the city on efforts to disseminate and act on the plan, as well as inform the city of what is happening with the plan at the University. What is your present knowledge of each advisory board you are interested in?* I am aware that this is a new commission that is an evolution of the Steering Committee, formalized into a longer acting Commission to advance the Plan. It was recommended by a colleague that I apply for this Commission to serve as a bridge of connection between the University and City. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age Country of Origin Sexual Orientation Religion Do you have a disability? No Ethnicity Race Gender identity *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/30/2019 First Name Becky Last Name Soglin Home Address* 65 Rita Lyn Ct City IOWA CITY State IA Zip Code 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3194009798 Email Address* beckysoglin@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Climate Action Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* More than 20 years Occupation:* Sustainability Coordinator for Johnson County Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Dermgraphics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* I am very enthusiastic about this commission's work and would be honored to serve. I have been Johnson County's Sustainability Coordinator since 2012 and have a degree in urban planning with an emphasis on the environment and land use. I advise the County Board of Supervisors and create or manage sustainability programs, policies and projects. Throughout these efforts, I consider cost -benefit, effectiveness and equity. I've hosted more than 60 educational events on sustainable practices and understand people's concerns and hurdles about climate change. We will be successful only if we motivate others! I was the local lead for a solar group buy program that brought together six cities and added discounted solar to 180 households. I have written solar array RFPs and been involved in biocell and green roof installations. I have worked with others on public health intersections with sustainability, sustainable materials management, adaptation versus mitigation and alternative transportation (obtained County's Gold Bicycle Friendly Business designation). I know addressing climate change takes a lot of coordination and drawing in others while being respectful of their situations (economic, time demands, etc.). I conducted a greenhouse gas analysis and am a credentialed Green Associate with Leadership in Energy and Environmental Design. I have worked on five LEED projects and am familiar with energy, water, storm water, sustainable materials, etc. of building construction and use. I co -wrote a sustainable landscaping and lawn plan for County buildings to avoid use of pesticides and use more natural methods. I also have 20+ years of communications/outreach experience prior to becoming trained in sustainability. What is your present knowledge of each advisory board you are interested in?* I have read the Oct. 7, 2019, packet (resolution, draft by-laws, etc.). I was aware of the declaration of the Climate Crisis earlier this year, and how staff were tasked to make changes within 100 days. I have read the action and adaptation plan and progress reports and am impressed with the grants program. I followed the activities of the prior group –the Climate Action Steering Committee–and participated in an open house and filled out a survey. I've used the climate action checklist myself (and I think I submitted an outreach pledge a few years ago—sorry if I didn't!) Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age Country of Origin United States Sexual Orientation Religion Do you have a disability? No Ethnicity Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Item Number: 16.c. �r A�� CITY OE IOWA CITY www.iogov.org November 19, 2019 Human Rights Commission - Three vacancies to fill a three-year term, January 1, 2020 - December 31, 2022. (Term expires for Jeff Falk, Barbara Kutzko and Tahuanty Pena) ATTACHMENTS: Description Vacancy Notice/Coversheet Board Demographics/Attendance Boscaljon, Daniel -Application Bruss, Jessica -Application Builta, Zac -Application Copeland -Silver, Melissa -Application Coulter, Joe -Application Dalrymple, Kajsa -Application Dresser, Kasey- Application Feld, Jarrod -Application Garske, Caroline -Application Gerlach, Peter -Application Glass, Jason -Application Green, Arlene - Application Haider, Amna -Application Janakiraman, Venkatesh -Application Kay, Erin -Application Lindley, Ashley - Application Lomas, Laura -Application Mohammed, Wifag -Application Navarre -Jackson, Layana -Application Nichols, Amanda - Application Oladele-Ajose, Adedayo - Application Opal, Colleen -Application Pierce, James -Application Pries, Mark -Application Quigley, Meg -Application Swank, Ashley - Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION Three Vacancies: Three -Year Term January 1, 2020 — December 31, 2022 • Duties of the Commission include: Disseminating information to educate the public on illegal discrimination and civil rights, such as organizing and facilitating educational public forums that address one or more of the broad range of topics included within the rubric of human rights; • making recommendations to the City Council for such further legislation concerning discrimination as it may deem necessary and desirable; • cooperating within the limits of any appropriations made for its operation with other agencies or organizations both public and private whose purposes are not inconsistent with those of Title 2 of the City Code (Human Rights Ordinance) • planning programs and activities designed to eliminate racial, religious, cultural and other intergroup tensions including but not limited to sex, color, creed, disability, gender identity, sexual orientation, marital status, age, and national origin. • The Human Rights Commission meets the third Tuesday of each month at 5:30 p.m. in the Lobby Conference Room at City Hall, 410 E. Washington Street. Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, November 12, 2019. An application can be completed and submitted on the City of Iowa City website at www.icgov.org or by contacting the City Clerk's office. Questions about the Iowa City Human Rights Commission should be directed to Stefanie Bowers, Human Rights Coordinator at 356-5022. Board/Commission Application Cover Board/Commission: Human Rights Commission Three vacancies to fill a three-year term 1/1/2020 - 12/31/2022 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 10/1/2019 Application Deadline: 11/12/2019 Council Appointment Date: 11/19/2019 Date of Non -Gender Appointment: 12/30/2019 After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Gender Male Female Male Female Male Female Female Male Female 2 -Male, 1 -None Female:4 Male:2 Name and Address Boscaljon, Daniel 1210 Yewell Street Bruss, Jessica 2201 California Ave Builta, Zac 517 westwinds dr. Copeland -Silver, Melissa 1218 Yewell Street Coulter, Joe 1818 N. Dubuque Street Dalrymple, Kajsa 531 Clark St Dresser, Kasey 711 E Jefferson St Feld, Jarrod 1861 Muscatine Ave. Garske, Caroline 413 Iowa Avenue Male Gerlach, Peter 3346 Tulane Avenue Male Glass, Jason 1730 Windsor Ct. Female Green, Arlene 904 Benton DR, APT 12 Female Haider, Amna 100 Catlett Hall Male Janakiraman, Venkatesh 3101 Friendship St Female Kay, Erin 1513 McCleary Lane Female Lindley, Ashley 739 Perry Court Female Lomas, Laura 1301 S Gilbert Street Apt. 35 Female Mohammed, Wifag 758 Westwinds Dr Ap4 Female Navarre-Jackson, Layana 330 Camden Rd Female Nichols, Amanda 2711 East Court ST Male Oladele-Ajose, Adedayo 301 Hawk Ridge Dr. Female Opal, Colleen 807 Dearborn St. Male Pierce, James 200 South Summit Street Male Pries, Mark 1128 Denbigh Drive Female Quigley, Meg 3202 Friendship St. Female Swank, Ashley 2016 1/2 Davis St Human Rights Commission # years as Country of Sexual Gender Name Term ending resident of IC Occupation Gender Age* Origin* Orientation* Religion* Disability* Ethnicity* Identity* Race* Unique Identifiers* Cathy McGinnis 12/31/2020 -1st Term 23 Probation Officer F 42 USA Heterosexual Catholic Caucasian Regional Coordinator Fellow Fair Trade Spiritual/no Zachary Rochester 12/31/2020 -Unexpired 6 Campaigns M 23 USA Heterosexual n relig Caucasian Non-binar White Bijou Maliabo Non - (Vice Chair) 12/31/2020 -Unexpired 20 ACT F 36 DR of Congo Heterosexual Christian Hispanic Female Black Adil Adams 12/31/2021- 2nd Term 21 Unemployed M 59 Sudan Muslin Black Male Black Research Associate Jessica Andino 12/31/2021- 1st Term 5 Project Manager F 26 USA Heterosexual Caucasian Female Noemi Ford 12/31/2021- 2nd Term 3 Psychologist F 42 Hungary Female VACANT 12/31/2022 VACANT 12/31/2022 VACANT 12/31/2022 Please note: The information provided is the information provided on the application at the time of submission. * Information is voluntary Member Attendance Sheet Member Term 1/8 1/24 2/19 3/19 4/16 5/21 6/18 7/03 7/16 8/20 9/17 Maliabo 1/2021 Present Present Present Present Present Present Present Present Excused Present Present McGinnis 1/2021 Present Present Present Present Present Present Present Present Present Present Excused Munoz 1/2021 Excused Present Present Present Present Present Present Excused Excused Present Present Kutzko 1/2020 Present Present Present Present Present Excused Excused Present Present Present Present Falk 1/2020 Present Present Present Present Present Present Present Present Present Present Present Pena 1/2020 Present Present Excused Present Present Present Present Present Excused Present Excused Adams 1/2022 Excused Present Present Present Present Absent Present Excused Present Present Excused Ferdig 1/2022 Present Present Present Present Present Present Present Present Present present Present Ford 1/2022 Present Excused Present Excused LPresent I Present I Present I Excused Present present lExcused I ` - Advisory Board/Commission Application Form rY I This application is a public document and as such can be reproduced and distributed for �wYl®rm the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/4/2018 First Name Daniel Last Name Boscaljon Home Address* 1210 Yewell Street City IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196215117 Email Address* daniel.boscaljon@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission 2. How long have you been a resident of Iowa City?* 20 years 3. Occupation: Teacher 4. Gender* *This question is rrandatory in order for the aty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrngraphics sectionof the application below. V Male r Female 5. Experience and/or activities which you feel qualify you for this position:* My graduate work in Religion and Literature helped to develop an ethical position focused around humanism, with an awareness of some of the logics, structures, behaviors, beliefs and practices that lead to human rights violations. In my role as the moderator of "Coffee with Dan," and a consultant with the Green Room, I have been working as part of the community with educational initiatives and conversational forums designed to give people a non-partisan look at the political dimension of civic life. In general, my training has allowed me to think both critically and compassionately through a range of differing perspectives. I can translate among perspectives, describing the relative merits and issues with each, and am able and willing to ask critical questions concerning uses of power. 6. What is your present knowledge of each advisory board you are interested in?* My knowledge at present is limited to the information on the web page of the council. But I'm deeply familiar with and passionate about humanism, and the need for communities to balance the justifiable claims of the most vulnerable within society as important and I would like to serve my community in this way. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission? No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 41 10. Country of Origin united states 11. Sexual Orientation heterosexual 12. Religion agnostic 13. Do you have a disability? No 14. Ethnicity euro-american 15. Race Mite 16. Gender identity male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I ` - 1 Advisory Board/Commission Application Form rY I This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/8/2018 First Name Jessica Last Name Bruss Home Address* 2201 California Ave City IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-621-1950 Email Address* jrbruss@yahoo.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Select a Board or Commission you are interested in: Parks and Recreation Commission 2. How long have you been a resident of Iowa City?* 19 years 3. Occupation: * Client Services Professional 4. Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. F Male V Female 5. Experience and/or activities which you feel qualify you for this position:* I was born and raised in the Iowa City Area. I participated in Iowa City Kickers and Iowa City Girls Softball as a youth. My children both participated in Iowa City Kickers. I recently graduated with a BLS from the University of Iowa with an Organizational studies emphasis. My husband had disabilities and my son has disabilities. 6. What is your present knowledge of each advisory board you are interested in?* I understand that each advisory board meets one time per month. The parks and recreation board is responsible for policies and budgets related to the parks and recreation department. The human rights commission develops policies and information to help prevent discrimination. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission? No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 38 10. Country of Origin USA 11. Sexual Orientation Heterosexual 12. Religion Agnostic 13. Do you have a disability? No 14. Ethnicity European -American 15. Race Caucasian 16. Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form ' - rY I This application is a public document and as such can be reproduced and distributed for �wYl®gym the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/1/2019 First Name Zac Last Name Builta Home Address* 517 westwinds dr. City IOWA CITY State IA Zip Code 52242 Is your home address (listed above) within the corporate limits of Iowa City?* Not Sure Contact Phone Number* 3193319581 Email Address* zbuilta@healthcare.uiowa.edu Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* nine years Occupation:* research assistant/lab manager Gender* *This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. V Male F Female Experience and/or activities which you feel qualify you for this position:* I have been a been a member of the community for nine years, I went to school here, and now work here. I have a strong desire to help make an impact on the well being of everyone, especially those who may not have been given the best chance thus far in their life or come from disadvantaged backgrounds. I myself have had these sorts of struggles in my life and I feel an obligation to help others who may need help the most. What is your present knowledge of each advisory board you are interested in?* The human rights commission to my knowledge helps create and plan events that help impact the city on personal and city wide scales with regards to advocacy, equality, social justice, and recognizing the inherent rights each of us have as citizens of Iowa City. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 27 Country of Origin USA Sexual Orientation Religion Do you have a disability? No Ethnicity Race Gender identity *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/5/2019 First Name Melissa Last Name Copeland -Silver Home Address* 1218 Yewell Street City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3195416077 Email Address* melissacopelandsilver@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 20 years Occupation:* Business Development Specialist for Iowa Vocational Rehabilitation Services Gender* *This question is rrandatory in order for the City to corrply with the State's gender balance requirerrant, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. F Male rJ Female Experience and/or activities which you feel qualify you for this position:* Experience: *For over 20 years I have worked with many diverse populations experiencing a variety of barriers. Some examples are homelessness, domestic violence, sexual assault, disabilities, returning citizens, and ELL. Activities: *Currently working at IVRS. *Current member of diversity committee with the Eastern Iowa Human Resources Association. *Current member of Inclusion ICR, a committee that focuses on Diversity, Inclusion, and Equity throughout the Corridor. *Past volunteer at RVAP. 'Past employee of Shelter House and outreach on behalf of Shelter House at DVIP. *Past employee of Youth Services through Goodwill. What is your present knowledge of each advisory board you are interested in?* I am interested in the process of educating the public through program planning and activities in the areas of discrimination and civil rights. I want to learn more about how the government acknowledges discrimination and civil rights while balancing the interests of all the parties involved. I don't know what the "rubric of human rights" is, and I would like to learn more. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 40 Country of Origin United States Sexual Orientation n/a Religion none Do you have a disability? Yes Please explain: I do not require any accommodations for my disability. Ethnicity Caucasian Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form ' - 1 rY I This application is a public document and as such can be reproduced and distributed for �wYl®gym the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/2/2019 First Name Joe Last Name Coulter Home Address* 1818 N. Dubuque Street City IOWA CITY State IA Zip Code* 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319 354-7492 Email Address* coulter.joe.d@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 33 years Occupation: Professor Emeritus, College of Public Health, Caver College of Medicine, The Uni Gender* "This question is rrandatory in order for the aty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. V Male r Female Experience and/or activities which you feel qualifyyou for this position:* See attached. What is your present knowledge of each advisory board you are interested in?* Previous service on the Iowa City Ad Hoc Diversity Committee, and the Human Rights Commission. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 75 Country of Origin U.S. Sexual Orientation Male Religion Native Do you have a disability? No Ethnicity Race White/ Native American Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Joe Dan Coulter, Ph.D. Professor Emeritus College of Public Health Carver College of Medicine The University of Iowa Dr. Coulter received the Ph.D. in Biological Psychology from the University of Oklahoma Medical Center and completed post -doctoral training at the University of Texas Medical Branch, Galveston, the Universita de Pisa, Italy, and the University of Edinburgh, Scotland. He came to The University of Iowa as Head of the Department of Anatomy and subsequently served as Director, Neuroscience Graduate Program, as Associate Provost for Diversity and Director, Opportunity at Iowa, and as Associate Dean for Diversity in the College of Public Health. Dr. Coulter is an enrolled member of the Citizen Potawatomi Nation of Oklahoma and currently active in teaching, research/scholarship, and community service in American Indian/Alaskan Native health. He has conducted collaborative research and scholarship in the areas of children's oral health in Northern Plains tribal communities, tribal preparedness and emergency response, establishing working relations in clinical and translational research in partnership with Federally Qualified Community Health Centers, and development/evaluation of biomedical research programs in tribal colleges and communities. Dr. Coulter is a member of the External Advisory Committee of the Montana State University (MSU) Idea Networks for Biomed Research Excellence (INBRE) program, an NIH program to improve biomedical research infrastructure for Montana's higher education system and tribal colleges. He also serves MSU` on the External Advisory Committees of the NIH supported American Indians int©,Research:7 Program, Center for Native Health Partnerships, and the Culturally Connected-6mmtrnity Goals programs. In 2008, he was appointed to the External Advisory Committee of the Nortf:Tern Plains Tribal Epidemiology Center of the Great Plains (Aberdeen Area) Tribal Chairman's Health Board. He has served on the Association of Schools of Public Health (ASPH) Diversity Committee, and the ASPH-Indian Health Service Taskfor�,Qt , _ ! )n Dr. Coulter is an advisor to the Historical Preservation Proj�ect=of'Yhe'M6skwaki Nation of Iowa, served on the Iowa Governor's Equal Employment OpplgtunWiQs-La�IJTI"-aei(and has served three terms on the Iowa Advisory Committee of the United states Commission on Civil Rights. In 2008, Dr. Coulter was appointed to the Iowa Commission Irmstili American Affairs, State Department of Human Rights, In 2011, he began service to the Governance Board of the Heartland Regional Health Equity Council, and serves as a member of the American Indian/Alaskan Native Caucus of the National Partnership for Action (NPA) to End Health Disparities of the Office of Minority Health, U.S. Department of Health and Human Services. Joe D. Coulter, Ph.D. Professor Emeritus College of Public Health Carver College of Medicine 200 Newton Road, 5147 Westlawn -the University of Iowa Phone (319) 335-7700 Iowa City, Iowa 52242 1r?e Dan Coulter L 1 d3J M1 I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/8/2019 First Name Kajsa Last Name Dalrymple Home Address* 531 Clark Street City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 6082124796 Email Address* kedalrymple@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 8 years Occupation:* Associate Professor Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Dermgraphics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* As the graduate director of the UI School of Journalism and Mass Communication, I have have been committed to improving diversity, equity, inclusion, and justice (DEIJ) efforts at the university. I was the head of the steering committee on DEIJ for our department and have been very engaged in the "Building University of Iowa Leadership for Diversity (BUILD)" program. Specifically, on the DEIJ steering committee, I spearheaded the creation of a DEIJ strategic plan and mission statement. I have also played a large role in the implementation of that plan. In addition to my committee work, I have completed the BUILD certificate and gone on to teach a course regarding media representation in the UI BUILD program. I have also completed LGBTQ Safe Zone training. I believe that the most pressing issues facing our country today are those that deal with intersectional human rights. It would be an honor to work with the IC Human Rights Commission to develop new initiatives that address these types of issues and help elevate the voices of those who may feel marginalized in our community. What is your present knowledge of each advisory board you are interested in?* I have emailed with Stefanie Bowers and she filled me in on the general commitments and responsibilities of the board. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 36 Country of Origin USA Sexual Orientation cis -gender woman Religion Do you have a disability? No Ethnicity Race White Gender identity cisgender woman *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* W191IFW"(1- Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I ` - Advisory Board/Commission Application Form rY I This application is a public document and as such can be reproduced and distributed for �wYl®rm the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/2/2018 First Name Kasey Last Name Dresser Home Address* 711 E Jefferson St City IOWA CITY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 760-710-1592 Email Address* kdresser98@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission 2. How long have you been a resident of Iowa City?* 2 3. Occupation: * Student/ Public Relations Assistant UI CGRER 4. Gender* *This question is rrandatory in order for the Oty to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" rray be provided in the Derrngraphics sectionof the application below. r Male V Female 5. Experience and/or activities which you feel qualify you for this position:* A large number of Iowa City's population is comprised of students from all walks of life. In order to fully understand their needs it takes a student to be able to represent that part of the population. As a socially active and involved member of the University of Iowa, I believe I am the student for the job. I am a Political Science student with a passion for fairness, equality, and safety. I am originally from San Diego and understands the behavior of city heavily centered around civil understanding. I am fluent in sign language and have experience working with the disabled population in Iowa City. 6. What is your present knowledge of each advisory board you are interested in?* I understand the importance of a human rights commission and the needs to effectively carry out change in the community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 20 10. Country of Origin United States 11. Sexual Orientation 12. Religion 13. Do you have a disability? No 14. Ethnicity 15. Race 16. Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for _ the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/24/2019 First Name Jarrod Last Name Feld Home Address* 1861 Muscatine Ave. City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 712-210-6709 Email Address* jr_feld@hotmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 16 months; also 1996-99 Occupation:* IRB Analyst, Human Subjects Office, U of Iowa Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* From 2008-9 1 was an Americorps VISTA with the Iowa Human Rights Commission out of the Fort Dodge Human Rights Commission office. In this role I educated new HRC members about the commission's process, created a 501 c3 nonprofit, and organized community events and outreach to educate the public. From 2012-2018 1 was a grant writer/manager with nonprofit organizations that served homeless youth. I currently work at the University of Iowa's Human Subjects Office, working to protect the health and well-being of human subjects involved in research projects. I've worked extensively with and for people from marginalized and at -risk communities who have frequently experienced discrimination, as well as with the landlords, employers, and other community entities who may be discriminatory. What is your present knowledge of each advisory board you are interested in?* I am familiar with protected classes/categories as well as the process of filing complaints, fact-finding, and the Iowa Civil Rights Commission's role at the statewide level. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 41 Country of Origin United States Sexual Orientation Heterosexual Religion NIA Do you have a disability? No Ethnicity European descent Race White Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ,Telr-od' A? Felon Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form ' - 1 rY I This application is a public document and as such can be reproduced and distributed for �wYl®gym the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 9/30/2019 First Name Caroline Last Name Garske Home Address* 413 Iowa Avenue City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 6363464806 Email Address* caroline-garske@uiowa.edu Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 5 years. Occupation: * Undergraduate Program & Outreach Coordinator, UI Geography & Sustainability Dept Gender* "This question is rrandatory in order for the aty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" xray be provided in the Derrographics sectionof the application below. F Male rJ Female Experience and/or activities which you feel qualifyyou for this position:* As an involved member of the Iowa City community for over five years with deep interests and involvement in the ongoing struggle for human rights, inclusivity, equity, I feel I would be a qualified addition to the City of Iowa City Human Rights Commission. During my time as an undergraduate at the University of Iowa, I was committed to academic research in the areas of racial equity, just foreign policy, and Pan-Africanism. I graduated with an honors B.A. degree in history and political science with a minor in international relations. My honors thesis examined the racial intentions and consequences of the 1986 Anti -Drug Abuse Act and I acted as a research assistant under Professor Keisha N. Blain, historian and scholar of black nationalist women's activism. As a student I also served as an assistant to the UI Office of Equal Opportunity of Diversity and then as an assistant to the UI departments of communication studies and cinematic arts. I was also a Johnson County Democrats fellow in the 2014 mid-term elections. Since graduation in May of 2018, 1 have been working as the Undergraduate Program & Outreach Coordinator for the UI Department of Geographical & Sustainability Sciences. In my current role I am responsible for administrative tasks such as course planning, website management, and communications and outreach and engagement efforts with current students, alumni, and the greater UI and Iowa City community. Outside of my professional role, I am a volunteer with the Campus Conversation Partner program in which I spend an hour a week meeting with an international member of the UI community to discuss cultural traditions, differences, and similarities and also help them adjust to life in Iowa City by navigating the education, housing, and health systems. I also am a volunteer with the Women's Resource and Action Center (WRAC) where I serve on the "WRACtivists" committee that is dedicated to social justice issues in Iowa City and on the UI campus. By engaging in outreach, education, and lobbying efforts, the group looks to forward the progress of women and underrepresented groups, combating rape culture, and fighting for a more just community. All the growth that I have experienced as an individual, an activist, and a scholar in Iowa City motivates me to continue learning, improving, and fighting on the behalf of others to better our community and larger culture. What is your present knowledge of each advisory board you are interested in?* As a subscriber to the email newsletters and a follower on social media, I do my best to stay engaged with the commendable activity of the Human Rights Commission. I have kept up with the ongoing efforts to combat housing discrimination and educate the community of their rights. As a five-year tenant in Iowa City, I'm deeply aware of the issues in the housing system and greatly invested in the ongoing need to educate the public of their rights in handling these issues. These issues are even more acutely felt in traditionally oppressed communities who are exploited further by discriminatory practices in housing. I also have kept up with events sponsored and organized by the Human Rights Commission around town such as the Human Rights Awards, PrideCon, the Latino Festival, employment job fairs, and other public talks and seminars that engage with the public for the purpose of educating and advocating for underprivileged members of our community. The commission's partnerships with other local organizations such as United Action for Youth, CIVIC, and the Refugee and Immigrant Association is another outlet for change I am aware of. I believe these partnerships and intersectional approaches are critical in tackling the issues our community is facing. I also am aware of the efforts to reach and engage Iowa City youth, especially at -risk youth, in programming and other events. Another issue I know the committee has collaborated on is sustainability and our present climate crisis. In my current professional position, I am constantly researching, discussing, and engaging with issues of climate change and sustainability. The committee's joint efforts with the Iowa City Climate Action and Adaption Plan are crucial in building bridges across groups and organizations to tackle the issue that every individual and institution is currently facing. I also am familiar with the Social Justice and Racial Equity Grant program as I disseminated the information to my department's students and faculty. The grant is an incredible example of the Human Rights Commission and the City of Iowa City's efforts to fund and promote an equitable community and build up relationships and programs to work toward this goal. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 24 Country of Origin United States Sexual Orientation Heterosexual Religion N/A Do you have a disability? No Ethnicity Not Hispanic or Latino Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/31/2019 First Name Peter Last Name Gerlach Home Address* 3346 Tulane Avenue City IOWA CITY State IA Zip Code 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193255631 Email Address* peter. a. gerlach@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 6 years Occupation:* UI program coordinator and adjunct professor Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Dermgraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* I have a range of experience that would serve me well on this committee. I have served as a volunteer with the AmeriCorps NCCC (10 mo.) and US Peace Corps (27 mo.) and been educated in a doctoral program, Cultural Foundations of Education, a critical social justice -focused program focused on topics such as race, class, gender, sexuality, and national origin. I have held positions in international education and in an office of diversity and inclusion. Currently, I serve on the board of the Refugee and Immigrant Association and in spring will teach a community engaged learning (cel) course centered on the lived experiences of refugees and immigrants. My record, then, is long with personal and professional experiences in which diversity, inclusion, internationalism, and empathy are central. I am a father and husband. I care deeply about helping make Iowa City a more welcome and safer community for all its residents. I have been fortunate in life and have privileges as a white, middle class, able-bodied, heterosexual, educated, male from the US - all of which I do not take for granted and all of which compel me to give what time, effort, and money I can to help make the world a little better place. What is your present knowledge of each advisory board you are interested in?* I am aware of the 4 duties, as outlined below, and feel I am ready and willing to take on each. I have communicated with Jessica Ferdig, who encouraged me to apply. Disseminating information to educate the public on illegal discrimination and civil rights, such as organizing and facilitating educational public forums that address one or more of the broad range of topics included within the rubric of human rights Making recommendations to the City Council for such further legislation concerning discrimination as it may deem necessary and desirable Cooperating within the limits of any appropriations made for its operation with other agencies or organizations both public and private whose purposes are not inconsistent with those of Title 2 of the City Code (Human Rights Ordinance) Planning programs and activities designed to eliminate racial, religious, cultural and other intergroup tensions including but not limited to sex, color, creed, disability, gender identity, sexual orientation, marital status, age and national origin. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 39 Country of Origin Us Sexual Orientation Heterosexual Religion Unitarian Universali Do you have a disability? No Ethnicity German Race White Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I ` - 1 Advisory Board/Commission Application Form rY I This application is a public document and as such can be reproduced and distributed for �wYl®rm the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/9/2018 First Name Jason Last Name Glass Home Address* 1730 Windsor Ct. City IOWA CITY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193217405 Email Address* glass01 @icloud.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission 2. How long have you been a resident of Iowa City?* 4 Years 3. Occupation: * Human Resources 4. Gender* *This question is rrandatory in order for the aty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrngraphics sectionof the application below. V Male r Female 5. Experience and/or activities which you feel qualify you for this position:* I have over 18 years of experience in human resources roles (16 in the Iowa City/Cedar Rapids area) in a variety of industries including public and private, for profit and not for profit, service and manufacturing. I have been the top human resources leader for my respective organization for the past six years. A significant portion of these roles have been focused on equal opportunity and diversity in the workplace. I have investigated and resolved dozens of workplace harassment and discrimination claims. I have strived to make the workplaces I support more welcoming and supportive. I have delivered training to employees and leaders on these topics, both within and outside of my organization. I am a past Board Member and President of Professional & Technical Diversity Network (PTDN), a non-profit focused on welcoming and supporting a diverse workforce in The Corridor. Before ceasing operations in 2010, we held dozens of events. During my two years as Board President, I developed and led the creation of the Corridor Welcome Receptions, which have continued to this day under the leadership of the chambers in Iowa City and Cedar Rapids. I was the lead speaker at a few of the events as well. I was appointed by Governor Branstad as a public member of the Iowa Human Rights Board. I served a four year term ending in 2016 supporting the Iowa Department of Human Rights and their mission. I led the development of strategic priorities for the board, attended meetings and events in Des Moines, and collaborated with state legislators on the department's mission. I am also actively serving in the Iowa Army National Guard as a member of the 34th Army Band based in Fairfield (my hometown). In my nearly 25 years of service, I have served the state in several ways. I am the Equal Opportunity leader for my unit. As part of this role I conduct training for the soldiers in my unit and help facilitate resolution to any issues that arise. I have attended several training classes as part of this role, including a two-week resident course on Equal Opportunity where I finished 2nd in a class of 30 soldiers. I have consulted at the state level and participated in activities outside of my unit, utilizing the civilian career experience. I have a BBA and MBA from the University of Iowa, both with an emphasis in management/human resources. I also have past certifications in human resources and change management. I believe my experience and passion for human and civil rights would make me an acceptable candidate for the commission. I look forward to the opportunity to discuss my interest and potentially serve Iowa City. Thank you for your consideration. 6. What is your present knowledge of each advisory board you are interested in?* I am aware of the Iowa City Human Rights Commission, but have not been actively involved. My application is an effort to be more actively involved in the Iowa City Community since moving into town few years ago from North Liberty. I have read past meeting minutes and agendas to get a better sense of the work they have done and are doing. I have also occasionally seen the Commission referenced in news articles as the work they have done has been promoted. I look forward to opportunity to learn more about their work. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission? No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 42 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Roman Catholic 13. Do you have a disability? No 14. Ethnicity Caucasian 15. Race White 16. Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/26/2019 First Name Arlene Last Name Green Home Address* 904 Benton DR, APT 12 City IOWA CITY State IA Zip Code 52246 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3194307699 Email Address* arlenegreen1708@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 17 years Occupation:* General labor Warehouse Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* I've have been living in Iowa City for almost 17 years and I witnesses and experienced a lot of activism. I would like to campaign to raise awareness about them. What is your present knowledge of each advisory board you are interested in?* Human rights activists are people who, individually or with others, act to promote or protect human rights. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 37 Country of Origin United States Sexual Orientation Heterosexual Religion Non denominational Do you have a disability? No Ethnicity Black Race African American Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant6. * 11�-A--- Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/12/2019 First Name Amna Last Name Haider Home Address* 100 Catlett Hall #614 City IOWA CITY State IA Zip Code 52242 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 4023200639 Email Address* amna-s-haider@uiowa.edu Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 1.5 years Occupation:* Undergraduate Student at the University of Iowa/Resident Assistant Gender* *This question is rrandatory in order for the City to corrply with the State's gender balance requirerrant, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. F Male rJ Female Experience and/or activities which you feel qualify you for this position:* I believe all these experiences and activities have moderately or significantly contributed to my capacity in being able to serve on the Iowa City Human Rights Commission. Frankly, it is a long list of activities, but I often tend to think about how every single one of my activities can even slightly contribute to my passions and plans to promote human rights in any way I can. Perhaps the most beneficial experience that makes me feel qualified for this position was my time volunteering and interning at Omaha's one of two refugee resettlement agencies, the Refugee Empowerment Center, over this past summer. My time there consisted of leading ESL classes for 15-20 adults who spoke a total of 4-5 different languages, searching employment opportunities that our clients qualified for in Omaha, and directly assisting refugees by taking clients to and from appointments and picking up newly arrived clients from airports. All of this has definitely sharpened my soft skills in communication and critical cultural competency. I also gained an insider's perspective of how to protect and promote refugee rights within both the federal U.S. system and local state systems. I am aware that there is an increasing number of refugees who reside in Iowa City, so my experience with this agency has given me how-to knowledge of making sure Iowa City is a safe, inclusive place for refugee families. I am on track to receive a Certificate in Human Rights from the University of Iowa. I have taken classes from this department that I believe bring value to my position such as how to most effectively practice human rights promotion and what I can do to contribute to social and policy change. These classes include Introduction to Human Rights and Human Rights Advocacy. Besides my Certificate, my academic career has involved other classes that sharpened my leadership skills and experience within the community. For example, the President's Leadership Class has given me the opportunity to learn about leadership and successful tactics through the President of the University of Iowa. His experiences and knowledge have informed my own understanding of approaches to leadership through effective team building and communication. The Writing and Community Outreach Class that I am taking this semester has given me a fresh perspective on social and diversity issues within Iowa City's own education system. Through this class, I volunteer at Tate Alternative High School on a weekly basis to help lead a creative writing class; I have worked with students who come from many different backgrounds of different adversities and experiences. This has informed me of the types of issues that families in Iowa City encounter. As a Resident Assistant this year, I serve as an ally and advocate for University of Iowa students, a significant population in the Iowa City community, living within the residence halls. This experience has allowed me to develop the skills to hone and sustain an inclusive community. I am going through the process of having difficult conversations about social justice and implied human rights with my residents, in order to reduce and modify implicit biases that students bring with them to Iowa City. I also mediate conflict between residents and offer solutions, as well maintain personal relationships with students from a diverse set of backgrounds. Since November 2018, I've interned at the Iowa City Foreign Relations Council where I assist in organizing weekly luncheons for Iowa City community members that included educational presentations on pertinent international issues which are mostly human -rights related; I've sat in on almost all presentations on a weekly basis and I've seen how human -rights education can effectively get across to the Iowa City community; I also observe how many guests attend each event, giving me some information on what Iowans particularly care about. Since early -Fall 2019, 1 have been associated with a University of Iowa student organization called Iowa Students for Refugees, in which we put on educational and philanthropic events to raise awareness and funds for refugees worldwide and within Iowa City. One of the principal events we have facilitated was a food/hygiene product drive at Hyvee, where we raised money and collected many donations of food and hygiene products that we donated to the Iowa City food bank. I visited the Iowa City food bank and helped organize the donated products. I was also in charge of promoting our organization on social media by creating event notices and posting photos. I am now in charge of the Clothing Drive committee and other volunteering events, in which I help mobilize our student organization members in volunteering for human rights -related causes in Iowa City. As a member of ASA, I helped organize an event in Fall 2019 that created awareness of Arabian culture while also raised funds for UNICEF's mission towards Syrian refugees. We also set up an event called the "Palestine Gala", where we set up a forum with Iowa City locals who have worked within Palestine and advocate for Palestinian rights. As a member of the Walk -it -Out Multicultural Fashion Show, I witnessed how one can effectively practice and express cultural appreciation through performing arts programming, while also raising money for an AIDS relief organization. I am now the Finance Director of this organization, in which I apply for and pursue different forms of funding for our events. I am an at -large senator for University of Iowa's Student Government. I represent 24,000 undergraduate students who come from a myriad of backgrounds, and I particularly serve on the External Relations and Justice&Equity Committees. Being on these committees, I have the access to work closely with the City Liaison and to help establish relationships between campus and Iowa City. Being on both committees simultaneously, my goal in student government is to plan programs designed to outreach to both students AND the Iowa City community about human rights issues, diversity, and inclusion. My role in student government is to work on initiatives and pass legislation to make Iowa a more equitable and inclusive campus, or at least advocate to do so. On External Relations, I am responsible for disseminating information to students and Iowa City, so I am already building skills in educating the public on civil rights and illegal discrimination. Last year, I participated in the LeaderShape Institute, which was a week-long intensive leadership training program where I learned how to facilitate discussion, implement and plan long-term goals for my community, and fine-tune communication skills. I volunteered to help set up and manage the 2019 Iowa Network of Human Rights Academics Annual Research Conference. I helped facilitate a conference -wide activity that allowed for all participants who were both students and guests to express which human rights issues they cared about the most, especially considering what they want to see from the 2020 Presidential candidates. This experience has taught me how to best approach platforms for human rights protection like community discussions and public forums. Back in high school, I also had the opportunity to tutor Syrian refugee children in elementary English and math skills for one year. I also translated school announcements for their family. This experience gave me direct experience with refugees and allowed me to observe adversities they faced while in the United States such as lack of English and lack of sufficient resources to go through the American public school system. Another high school experience that shaped me was when I was a delegate for Nebraska Girls State, where I was trained to understand the workings and benefits of political and civil engagement in a democratic society. I gained much more insight and appreciation on how local government functions and the value of political positions in the city such as Board of Education, City Planning, and City Council. What is your present knowledge of each advisory board you are interested in?* Right now, I know that the Human Rights Commission has several duties in serving the Iowa City community, but their overall goal is to do outreach on human rights. The Commission distributes educational information to the public on civil rights and illegal discrimination, and one of the many ways to do so is through facilitating public forums. The Commission also makes recommendations to the City Council regarding further legislation about discrimination, and funding on the Social Justice and Racial Equity Grant. Members also collaborate with other human rights -based agencies and organizations in promoting civil rights in the city. The Commission also plans programs and activities designed to promote city-wide inclusion and diversity, while eliminating cultural tensions. I know that the Human Rights Commission was established around the 1960s to address racial discrimination, especially in housing which was very inequitable. Members of the Commission also enforce anti -discrimination laws while also investigating complaints of discrimination and educate individuals on what is considered unlawful discrimination. On average, the Commission receives forty to forty-five complaints annually regarding discrimination in employment based on race, disability, or sex. I understand that the committee has primarily been focused on racial equity initiatives in Iowa City (which I would love to get involved with). I learned all this knowledge through my visit to City Hall with my Introduction to Human Rights class from the University of Iowa. We sat in on a presentation given by Stefanie Bowers, who serves as the Equity Director on the Commission (I spoke to her regarding my interest). I understand that serving on the Commission is on a volunteer basis, and we would meet once a month in the evening, or when there are special meetings scheduled. Currently, there are five men and three women serving on the Commission, but the law requires the Commissions to be balanced according to gender. As of right now, I know there are little -to -no students who serve on the Commission. As students hailing from Kirkwood Community College or the University of Iowa make up a significant portion of the Iowa City community, I believe we need more representation from students with different backgrounds to serve on a board that helps promote and protect human rights of our citizens. Moreover, I don't think that the Commission does not have any Arabic -speaking students. There is a significant Sudanese student population in Iowa City (along with other Arabic speaking students), and I believe I can practice outreach to these communities and assist with potential translations with non -speaking individuals. My strengths involve ideation and connecting the dots, so I believe I can offer unique perspectives on how to best recommend legislation that prescribes and enforces human rights in Iowa City. All in all, I believe I have a capacity to be one of the students who serve on the Human Rights Commission, as the duties of the commission parallel with my own approaches to contributing to social change and recognizing human rights. Thank you for your consideration. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 19 Country of Origin United States Sexual Orientation Heterosexual Religion Muslim Do you have a disability? No Ethnicity Iraqi Arab Race White Gender identity Cisgender Woman *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 0° Wim," Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I ` - 1 Advisory Board/Commission Application Form rY I This application is a public document and as such can be reproduced and distributed for �wYl®rm the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/6/2018 First Name Venkatesh Last Name Janakiraman Home Address* 3101 Friendship St City IOWA CITY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 6088867639 Email Address* venkJ@hotmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission 2. How long have you been a resident of Iowa City?* 1 year 3. Occupation: * Software Engineer 4. Gender* *This question is rrandatory in order for the aty to corrply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" rray be provided in the Derrngraphics sectionof the application below. V Male r Female 5. Experience and/or activities which you feel qualify you for this position:* Travel to several countries with documented human rights violations; growing up in a developing nation; passion for making sure that all humans are treated with respect and dignity. 6. What is your present knowledge of each advisory board you are interested in?* As an immigrant who has lived in multiple countries and traveled to multiple countries with documented histories of human right violations, I have some understanding of the challenging work that lies ahead of us. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 36 10. Country of Origin India 11. Sexual Orientation Straight 12. Religion Hindu 13. Do you have a disability? No 14. Ethnicity Asian/Indian 15. Race Asian/Indian 16. Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/4/2019 First Name Erin Last Name Kay Home Address* 1513 McCleary Lane City IOWA CITY State IA Zip Code 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3197594632 Email Address* enoon25@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. Human Rights Commission How long have you been a resident of Iowa City?* 3 years Occupation:* National Alliance on Mental Illness Walk Manager Gender* *This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. F Male rJ Female Experience and/or activities which you feel qualifyyou for this position:* Professional Experience Access 2 Independence Member Board Member Oct. 2018 -Present • Organized lucrative, engaging fundraisers and events for the organization. • Created lasting partnerships between NAMI Johnson County and Access 2 Independence. • Lead effort to recruit members for the Iowa City Americans with Disabilities Act Celebration. NAMI Walk Manager Iowa City, IA December 2016 -Present • Fundraised over $350,000 for the National Alliance on Mental Illness of Johnson County through the NAMIWalks Program and other fundraising events. • Managed all aspects of the implementation of the local NAMIWalks program including marketing, branding, finances, and built partnerships with community partners. Collaborated with Executive Director, National NAMIWalks staff, team members, local Walk Chair and Walk Committee Members. • Recruited sponsors and in-kind sponsors, exceeding financial goals and objectives for Walk www.namiwalks.org/johnsoncounty. • Maintained partnerships with over 150 Iowa City & Cedar Rapids businesses and organizations. • Organized a Team Captains' Kickoff Luncheon Event for team captains and other supporters. • Maintained complete records relating to the Walk in Donor Drive & Salesforce. • Managed up to 75 volunteers regularly for the Walk & related events. • Managed all NAMI Johnson County social media campaigns including Instagram, Facebook, Twitter, etc. WellCare of Iowa, Inc. West Des Moines, IA October 2015 -March 2016 Quality Improvement Care Gap Coordinator (State Contract Terminated) • Direct experience with low-income Medicaid populations and individuals with a variety of disabilities. • Serves as an advocate for individuals with disabilities through effective communication skills, sharing first hand experiences, and collaboration with community partnerships /Educates the member and their family about preventive health screenings while identifying barriers to care. Assembled a QI work plan for state contractual purposes. Outreach, Inc. Des Moines, IA November 2014 -July 2015 Hunger -Free Iowa Initiative AmeriCorps VISTA Leader • Organized, facilitated, and managed more than 25 hunger -related public presentations for civic groups, governmental agencies, religious organizations and non-profit sectors while providing community resources for the formation of leadership teams/committees. • Recruited/supervised AmeriCorps VISTAs/ more than 55 volunteers for Hunger -Free Iowa Initiative and Days of Service. • Responsible for grant research, writing, grant follow up work, and program budgets, businesses plans, and executive summaries. • Maintained AmeriCorps grant reporting requirements, time -off forms, personal days, office calendars, and creates comprehensive meeting agendas. Regional Office of Education #33 Monmouth, IL August 2012-September2014 AmeriCorps VISTA Leader • Organized and managed more than 35 career -oriented presenters for classroom presentations with local community partnerships for at -risk youth. • Organized service -learning projects for grant opportunities /Worked closely with PASS Coordinator and Assistant Coordinator in planning/preparing college field trips and presentations. Education Iowa Wesleyan University -Bachelor of Science/Educational Foundations — May 2012 Minors: History/English (Mt. Pleasant, Iowa) What is your present knowledge of each advisory board you are interested in?* Disseminating information to educate the public on illegal discrimination and civil rights, such as organizing and facilitating educational public forums that address one or more of the broad range of topics included within the rubric of human rights Making recommendations to the City Council for such further legislation concerning discrimination as it may deem necessary and desirable Cooperating within the limits of any appropriations made for its operation with other agencies or organizations both public and private whose purposes are not inconsistent with those of Title 2 of the City Code (Human Rights Ordinance) Planning programs and activities designed to eliminate racial, religious, cultural and other intergroup tensions including but not limited to sex, color, creed, disability, gender identity, sexual orientation, marital status, age and national origin Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission? No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 30 Country of Origin United States Sexual Orientation Female Religion N/A Do you have a disability? Yes Please explain: I have Cerebral Palsy and use a walker. Ethnicity White Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* CAA Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form ' - 1 rY I This application is a public document and as such can be reproduced and distributed for �wYl®gym the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 12/12/2018 First Name Ashley Last Name Lindley Home Address* 739 Perry Court City IOWA CITY State IA Zip Code* 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-883-9316 Email Address* ashekae@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 7 years Occupation: * Volunteer Coordinator Gender* *This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. r Male rJ Female Experience and/or activities which you feel qualify you for this position:* I am a graduate from One Iowa's LGBTQ Leadership Institute and currently serve on One Iowa's Eastern Iowa Advisory Council. The goal of my work on the council is to: help educate Iowans about the LGBTQ community; train professionals and community members to ensure LGBTQ Iowans are respected in every facet/stage of their lives; promote policies within the state and locally that protect the civil rights, health, and safety of LGBTQ Iowans; empower tomorrovJs LGBTQ leaders; and connect LGBTQ Iowans with vital resources. I have also previously worked as a victim advocate for survivors of sexual violence in conjunction with the Rape Victim Advocacy Program; served as a campus dating violence educator for the Domestic Violence Intervention Program; and mentored and empowered struggling youth through after-school, transitional living, and teen parent program initiatives at United Action for Youth. I believe in helping people because it is the right thing to do, and there are so many oppressed populations in need of someone who will help make their voices heard. It is for these reasons that I am applying to join the Human Rights Commission. What is your present knowledge of each advisory board you are interested in?* It is my understanding that the Human Rights Commission works toward creating a more equitable community within Iowa City. The commissioners play a valuable role in not only keeping human rights and social justice as a high priority for Iowa City but also addressing issues infringing upon those rights. Members of the commission help plan events, activities, and programs within Iowa City that promote equity and work to eliminate discrimination while also serving as representatives and ambassadors at similar events throughout the community. I would like to assist in these efforts and serve the public as a commissioner on the Iowa City Human Rights Commission. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 30 Country of Origin United States Sexual Orientation Bisexual Religion Christian Do you have a disability? No Ethnicity White, Non -Latino Race Caucasian Gender identity Cisgender Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* * L6V( J Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form ' - 1 rY I This application is a public document and as such can be reproduced and distributed for �wYl®gym the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 9/30/2019 First Name Laura Last Name Lomas Home Address* 1301 S Gilbert Street Apt. 35 City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 515-5192132 Email Address* laura.t.lomas@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If rrultiple boards are being applied for. Human Rights Commission, Public Art Advisory How long have you been a resident of Iowa City?* 4 years Occupation: * Paralegal Gender* "This question is mandatory in order for the Oty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" xray be provided in the Demographics sectionof the application below. F Male r1 Female Experience and/or activities which you feel qualifyyou for this position:* As a woman of color, I have been privy to the necessity to advocate for myself on many occasions. I have a great interest in understanding other cultures and in society in general. I have an interest in helping people become established in underrepresented areas which has the potential to be many areas. What is your present knowledge of each advisory board you are interested in?* I have read the description of the Human Rights advisory board, and am aware that state law requires a balance of men and women, and currently the board sits at 4/5. The board, as I understand it, implements law, assists with advocacy, monitors progress in areas of minorities including, people of color, LGBTQ, and disabled among the many other people that need advocacy (elderly, immigrants etc.). Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 36 Country of Origin USA Sexual Orientation Straight Religion n/a Do you have a disability? No Ethnicity African American Race Black Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. r Advisory Board/Commission Application Form PAZsI; I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 5/13/2019 First Name Wifag Last Name Mohammed Home Address* 758 Westwinds Dr Ap4 City IOWA CITY State IA Zip Code* 52246 Is your home address (listed above) within the corporate limits of Iowa City?* Not Sure Contact Phone Number* 9733937738 Email Address* mohammedwifag@yahoo.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission Select a Board or Commission you are interested in: Civil Service Commission Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Preference on first choice If rrultiple boards are being applied for. Human rights How long have you been a resident of Iowa City?* 2 years Occupation:* Hospitality double tree hotel Gender* `This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Demographics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* Have workexperience for 10 years of activist of human rights in sudan What is your present knowledge of each advisory board you are interested in?* It's inter cultural and biolangular community as I used to live with and communicate during my life in the USA Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 41 Country of Origin Sudan Sexual Orientation Female Religion Muslim Do you have a disability? No Ethnicity Black Race African Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ila� Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form ' - rY I This application is a public document and as such can be reproduced and distributed for �wYl®gym the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/13/2019 First Name Layana Last Name Navarre -Jackson Home Address* 330 Camden Rd City IOWA CITY State IA Zip Code 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-936-4601 Email Address* layana.nj@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 17 years Occupation:* College Instructor & Day Laborer Gender* *This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. r Male rJ Female Experience and/or activities which you feel qualify you for this position:* As a sociologist, I have a specialization in social stratification, so I am extremely familiar with issues related to discrimination and civil rights. I also have a professional background in teaching with plenty of experience educating others and facilitating discussions of sensitive topics. Moreover, I have participated in committees in the past while I was a graduate student at The University of Iowa, a full-time employee of Ashford University, and a full-time faculty member of Morningside College. I had experience with leadership roles in those institutions and I have a long history of volunteering experience as well. What is your present knowledge of each advisory board you are interested in?* I am aware that the Human Rights Commission is responsible for educating the public with regard to civil rights and discrimination, in addition to making recommendations to the City Council regarding legislation related to discrimination. I realize the importance of the position on the commission as it is imperative that members of the Iowa City community be knowledgeable about the various issues related to human rights and work towards lessening the conflict that can arise during some interactions, especially when there is discrimination or restriction of individuals' civil rights. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 45 Country of Origin United States Sexual Orientation heterosexual Religion Christian Do you have a disability? No Ethnicity African-American Race Black Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 1�A=ar 1�-c,f Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/30/2019 First Name Amanda Last Name Nichols Home Address* 2711 East Court ST City IOWA CITY State IA Zip Code 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196771153 Email Address* amanda-nichols@uiowa.edu Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Select a Board or Commission you are interested in:* Civil Service Commission Select a Board or Commission you are interested in: Housing and Community Development Commission(HCDC) Do you receive rental assistance? (?) r Yes r No Do you have expertise in construction?*(?) r Yes r No Do you have expertise in finance?*(?) r Yes r No Preference on first choice If multiple boards are being applied for. Human Rights Commission How long have you been a resident of Iowa City?* 19 years Occupation:* Nursing Unity Clerk Gender* "This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demmgraphics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* I have been a resident of Iowa City for 17 years and a University employee for 13. 1 have a vested interest in the community and I network local nonprofit and activist organizations. What is your present knowledge of each advisory board you are interested in?* I have thoroughly read the descriptions of each board's responsibilities that are available on the City of Iowa City government web site. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 36 Country of Origin USA Sexual Orientation Bi/Pan sexual Religion NA Do you have a disability? No Ethnicity White Race Caucasion Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* -��1� 04 14 Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I ` - 1 Advisory Board/Commission Application Form rY I This application is a public document and as such can be reproduced and distributed for �wYl®rm the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/4/2018 First Name Adedayo Last Name Oladele-Ajose Home Address* 301 Hawk Ridge Dr. City IOWA CITY State IA Zip Code 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196711057 Email Address* ddayoajose@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission 2. How long have you been a resident of Iowa City?* 5 years 3. Occupation: Nurse Assistant 4. Gender* *This question is rrandatory in order for the aty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrngraphics sectionof the application below. V Male r Female 5. Experience and/or activities which you feel qualify you for this position:* I was a presenter at the Human Rights Conference, presenting about the violation of Human rights frisking infringes among the colored community. Being a black individual in America, I have been a victim of discrimination and would love the opportunity to educate the public about illegal discrimination. Being able to intern alongside former councilman Kingsley Botchway gave me insight on how to increase equity and proficiency among the Iowa City community. I would like to use these experiences and work together with other organizations to improve individuals Human rights. 6. What is your present knowledge of each advisory board you are interested in?* The information I was given was: the position would give the applicant the opportunity to educate the public on illegal discrimination, meet with other organizations to terminate tensions between inter -groups, and this job must be neutrally gendered. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 23 10. Country of Origin United States 11. Sexual Orientation Male 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity African American 15. Race Black 16. Gender identity *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form ' - 1 rY I This application is a public document and as such can be reproduced and distributed for �wYl®gym the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/9/2019 First Name Colleen Last Name Opal Home Address* 807 Dearborn St. City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-325-3689 Email Address* cmopal@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 5 years Occupation: * Program Coordinator, UI Center for Human Rights Gender* *This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrographics sectionof the application below. r Male rJ Female Experience and/or activities which you feel qualify you for this position:* I work at the UI Center for Human Rights currently and am a strong advocate of social justice in all forms including rights to housing, healthcare, education, and social services. I have been working in higher education for over 10 years as a program coordinator and academic advisor. I am fluent in Spanish and English As a former renter both in Iowa City and Chicago, I have dealt with a variety of incidents in which my landlords violated my tenant rights. These experiences forced me to educate myself on the legal protections for tenants and my options for recourse. What is your present knowledge of each advisory board you are interested in?* I am aware of the meeting dates and times, the mission, and the board members. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* Me Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 36 Country of Origin U.S. Sexual Orientation Religion Do you have a disability? Ethnicity white Race white Gender identity female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* &A 014 (2r Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Kellie Fruehling From: Stefanie Bowers Sent: Tuesday, October 29, 2019 1:32 PM To: Kellie Fruehling Subject: FW: Interest in Human Rights commission Attachments: C. Opal Resume 102819.pdf From: cmopal@gmail.com <cmopal@gmail.com> Sent: Tuesday, October 29, 2019 11:39 AM To: HumanRights <HumanRights@iowa-city.org> Subject: Interest in Human Rights commission AA WI K Hello, I am trying to contact the Human Rights Commission members to express my interest in joining the commission. If this email does not go directly to the commission members, could you please forward it to them. I applied for the commission vacancy online and wanted to follow up to provide my resume and share some additional details. My experiences as a tenant in Chicago and Iowa City have given me the first hand experience of the challenges of being a tenant, and feeling confused and concerned about the landlords rules and consequences. Additionally, my educational and professional background have prepared me to understand issues of discrimination and social justice in the context of the wider society. I believe I have meaningful insight to contribute and I also look forward to working with other community members to examine and address human rights issues in Iowa City. Thank you for your time. Please let me know if you have any questions. Sincerely, Colleen Opal Colleen M. Opal 807 Dearborn St. Iowa City, IA 52240. 319.325.3689 • cmopal@gmail.com PROGRAM DEVELOPMENT EXPERIENCE Program Coordinator September 2019 — present Centerfor Human Rights, University of Iowa • Coordinate book selection for One Community, One Book program through collaboration with stakeholders • Plan and oversee events related to OCOB program including book discussions, movie screenings, and advocacy • Supervise undergraduate interns to facilitate their experiential learning and professional development • Manage website content and make updates as needed • Develop and implement communication plan for office across web and print • Perform reconciliation of Center expenses and verify use of appropriate funds Assistant Director, Experiential Learning & Professional Development October 2014 — September 2019 Undergraduate Program Office, Tippie College of Business, University of Iowa • Through a collaborative process, defined then created criteria and procedures for experiential learning requirement • Communicate experiential learning requirement through multifaceted marketing plan: print, web, and multimedia • Track completion of Tippie RISE through customized reports and regular monitoring • Manage program budget and supervise student worker supporting student outreach efforts • Design and maintain all Tippie RISE and Tippie internship websites • Teach online internship course each semester to encourage goal setting, reflection, and career development • Provide guidance to students on how to select appropriate internship and advocate for learning opportunities Co -Coordinator, Special Populations May 2011— September 2014 First and Second Year Advising, Loyola University Chicago • Implemented three-week residential Bridge program of workshops, retreat, service, speakers, and extra-curriculars • Collaborated with Bridge program faculty to intentionally connect study skills workshops to class content • Hired, trained, and supervised student workers and graduate interns to support completion of job responsibilities • Directed Bridge to Loyola's online presence by managing program's website and Facebook page • Evaluated and assessed CIEP 112 and Bridge program for annual report and continual curricular improvement Study Abroad Graduate Intern & Volunteer May 2007 — May 2008 Office of Study Abroad, Michigan State University • Organized various presentations and excursions for summer study abroad programs and orientations. • Advised prospective study abroad students by explaining the various program types, identifying students' needs and preferences, and aiding their exploration of the relevant program details. • Assisted with special events including parent and student study abroad orientations, study abroad fairs, and the Seminar for Health and Safety Abroad; Set-up, guided attendees and presenters, and performed other logistics. • Served on committee to increase the number of students of color in study abroad by changing marketing strategies and allocation of departmental resources. • Presented at various departmental events including study abroad orientations and study abroad alumni panel. Sexual Assault Program Graduate Intern January 2007 — May 2007 Sexual Assault Program Qfice, Michigan State University • Managed logistics of and promoted events aimed to raise sexual assault awareness on campus • Participated in 52 hour sexual assault hotline training to have the theoretical foundation of sexual assault and also to develop the practical skills to assist callers in crisis • Created and led judicial advocacy training for volunteers supporting survivors through the campus judicial process • Collaborated with the director to complete various projects and initiatives Assistant Hall Director July 2006 — May 2008 Department of Residence Life, Michigan State University • Supervised RAs by setting goals and expectations, evaluating performance, and giving ongoing feedback. C. Opal 1 • Created, publicized, and implemented training and educational programs that addressed staff members' and residents' needs as determined by both formal and informal assessments. ■ Diagnosed and responded to student conduct issues and emergency situations according to departmental protocol. • Facilitated goal -oriented programming in the Spanish Language and Multicultural Living -Learning communities. • Guided student -led organizations including an international student group, Hall Government, and Black Caucus by promoting personal initiative, team -work, and consideration of multiple perspectives. • Oversaw budget and taught the officers to appropriately navigate University procedures and policies. ACADEMIC ADVISING EXPERIENCE Academic Advisor October 2014 — Present Undergraduate Program Office, Tippie College of Business, University of Iowa • Guide students in learning to accurately interpret and confidently navigate academic requirements and procedures • Encourage and assist students to integrate study abroad and internships into their plans in order to develop personally and professionally • Orient new first-year and transfer students to college expectations and relevant resources and opportunities • Intervene with students on academic probation to help identify academic difficulties, strategies, and resources • Teach multiple sections of first year seminar course using interactive discussions and activities to build peer community and to transition to college expectations • Coordinated College Business Week with over 1,000 attendees and 20 events: reserving rooms, booking outside speakers, coordinating event schedule, promoting to all new and returning students, and tracking attendance Academic Advisor, Special Populations May 2010 — September 2014 First and Second Year Advising, Loyola University Chicago • Facilitated the growth of students' problem solving skills through developmental advising • Presented academic overview and individual course recommendations to guide and assist students at orientation • Assisted students' major selection through exploration of how their skills and interests fit with various programs • Outreached to students struggling academically to address challenges, then identify strategies and resources • Explained students' various study abroad options and how they can fit with and complement their academic plans. • Created FSYA study abroad resource website to guide students in their academic planning for studying abroad. • Represented FSYA at initiatives by partner offices such as Study Abroad Diversity Committee and fairs. • Taught multiple sections of first-year seminars and academic success seminars. Professional Academic Advisor September 2008 — May 2010 Counseling, Advising & Transfer Center, College of Lake County • Provided preliminary admissions and financial aid advice to facilitate enrollment of prospective students • Communicated college procedures through individual and group advising sessions and new student orientations • Determined students' educational and career goals and communicated the various pathways to attain those goals • Connected students to relevant campus resources and taught applicable skills to support their academic success • Advised international students and served as liaison to International Student Admissions and Advising staff. EDUCATION Master of Arts in Student Affairs Administration Bachelor of Arts: Spanish, Women's Studies minor ADDITIONAL SHILLS & EXPERIENCES Michigan State University, East Lansing, MI May 2008 San Diego State University, San Diego, CA May 2006 • Fluent in Spanish, written and spoken • Volunteer Coordinator Certificate, Kirkwood Continuing Education, Spring 2018 • Building Our Global Communities Certificate, University of Iowa • BUILD (Building University of Iowa Leadership for Diversity) Certificate • Studied at Pontificia Universidad Catolica in Santiago, Chile; July 2004 -July 2005 • Additional college courses in non-profit management, psychology, counseling, and environmental sciences • Proficient with Microsoft Office, Qualtrics, and website development software such as Drupal & Terminal 4 C. Opal 2 I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/30/2019 First Name James Last Name Pierce Home Address* 200 South Summit Street City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3194611569 Email Address* jimmypierce1 @gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* Since August 2017. Occupation:* Student Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* I am a student at Kirkwood Community College pursuing a paralegal degree and hope to use that degree to work in the field of immigration law or a related human rights area. I identify as a gay queer man and my experience as a member of the LGBTQIA community has significantly shaped my worldview. I previously served on the city's Telecommunication Commission until having to resign earlier this year in order to pursue other opportunities. I currently serve as Secretary of the Board of Directors for The River City Housing Collective and have been in that position since May of this year. I consider myself someone who is very engaged in my community and follow the goings on of local affairs closely. I hope to use this opportunity to find a larger role for myself in that community where I can use my skills to the community's benefit. What is your present knowledge of each advisory board you are interested in?* The Human Rights Commission works to educate the public on matters of civil rights and illegal discrimination and make recommendations to City Council regarding legislation to work against discrimination and with regard to social equity grants. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 25 Country of Origin United States Sexual Orientation Gay/Queer Religion Non -religious Do you have a disability? No Ethnicity White Race White Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Iry Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/7/2019 First Name Mark Last Name Pries Home Address* 1128 Denbigh Drive City IOWA CITY State IA Zip Code 52246 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193215263 Email Address* pries. mark@gmaii.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 12 years Occupation:* Lutheran Pastor, retired Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* Graduate of Wartburg College with a BA in communication. Graduate of Wartburg Seminary including a year of internship in Muskegon Heights, MI Served as pastor in South Tacoma, WA at the end of the Vietnam War ('75-77) Serving on the Dubuque Human Rights Commission ('79-84) Retired pastor from Zion Lutheran in Iowa City (07-17) Developing member of the Johnson County Inter -faith Coalition (JCIC) Spiritual Leader for NAMI-Johnson County (2017) Active member of the Consultation of Religious Communities (CRC), Iowa City Past Shelter House Board member What is your present knowledge of each advisory board you are interested in?* I have attended educational events provided by the Human Rights Commission; I have encouraged Zion Lutheran staff to participate in these events. So I am aware that the HR Commission prepares programs and events to educate the public and employers as to the City's Human Rights ordinance. I'm understand that the HR Commission is advisory to the Iowa City City Council Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 70 Country of Origin United States of America Sexual Orientation Hetrosexual Religion Christian Do you have a disability? No Ethnicity German -American Race Caucasian Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I ` - 1 Advisory Board/Commission Application Form rY I This application is a public document and as such can be reproduced and distributed for �wYl®rm the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/7/2018 First Name Meg Last Name Quigley Home Address* 3202 Friendship St. City IOWA CITY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 859-630-8966 Email Address* mquigley721 @gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission 2. How long have you been a resident of Iowa City?* 1 year, 3 months 3. Occupation: Social Worker 4. Gender* *This question is rrandatory in order for the aty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Derrngraphics sectionof the application below. r Male V Female 5. Experience and/or activities which you feel qualify you for this position:* I grew up in a small town in Kentucky, where most people, my family included, do not venture out. I, however, was anxious to see and experience other places. After completing my undergraduate degree at the University of Kentucky, I moved to Arizona where I served two years with AmeriCorps VISTA. Throughout my AmeriCorps service, I was given the experience I had been seeking; to work, collaborate with, and learn with people from various cultures, backgrounds, social classes, and with varying life experiences. In my second year of service at a poverty -relief center, I worked predominantly with families to assist them in meeting their basic human needs including food, shelter, and clothing. I earned a Master's Degree in Social Justice & Human Rights in 2013; during graduate school I studied the intersections of identity, power, and privilege, the prison industrial complex, immigrant rights, globalization, housing rights, and the history of violence against women. After completing graduate school, I lived and worked in Washington D.C. at a national violence prevention organization, followed by Denver, Colorado where I worked with college students with disabilities. I currently work with teenagers (and their families) at United Action for Youth and am both humbled and empowered by the resiliency and strength they so often show throughout our programming. Additionally, I am an Adjunct Instructor at the University of Iowa; I teach an empowerment -based sexual assault resistance course for students who identify as women. I am passionate about working toward a more equal society; a society where people from different cultures, backgrounds, and/or identities can voice their opinions and make contributions to their community, while enjoying equal space and representation as those who regularly enjoy those unearned privileges. Though I am new(er) to Iowa City, this community feels like home to me. I would love to join the efforts of the Human Rights Commission. 6. What is your present knowledge of each advisory board you are interested in?* To my understanding, the Human Rights Commission is a committee that works closely with the Office of Equity and Human Rights to educate our community members of what human rights are, and to work toward diminishing divisiveness and discrimination in our community. Additionally, the Human Rights Commission makes recommendations to the City Council for Social Justice and Racial Equity Grant funding, as well as for additional local legislation as it relates to discrimination. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 31 10. Country of Origin United states 11. Sexual Orientation Gay 12. Religion NIA 13. Do you have a disability? No 14. Ethnicity Caucasian 15. Race White 16. Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 1/9/2019 First Name Ashley Last Name Swank Home Address* 2016 1/2 Davis St City IOWA CITY State IA Zip Code 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193836358 Email Address* swank.ashley@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City?* 5+ Years Occupation:* Senior Training Specialist at ACT Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* I've volunteered on other boards. I have experience working with non -profits and collaborating with community members and various organizations. I have a passion for equality and human rights. I meet people where they're at and get to know who they are. Lots of administrative and customer service experience. I was the child of a single teenage mother, so I have experience on issues of poverty and women's rights. I've organized around food justice, political issues, and environmental issues. What is your present knowledge of each advisory board you are interested in?* I have some basic knowledge. My friend Bijou is on the commission and often tells me about the things the commission does. There's always more I can learn though! Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* VIP Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 30 Country of Origin USA Sexual Orientation Strait Religion Atheist Do you have a disability? Yes Please explain: ADHD,cPTSD Ethnicity Caucasian? Race Caucasian Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* r� 1V Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Item Number: 16.d. �r "m J IM% CITY OE IOWA CITY www.iogov.org November 19, 2019 Public Art Advisory Committee - Two vacancies to fill a three-year term, January 1, 2020 - December 31, 2022. (Term expires for Wendy Brown, Andrea Truitt) ATTACHMENTS: Description Vacancy Notice/Coversheet Board Demographics/Attendance Finlayson, Jan -Application Purington, Nancy L.- Application Truitt, Andrea - Application Wilson, Katie -Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMITTEE: PUBLIC ART ADVISORY COMMITTEE Two Vacancies: Three -Year Term January 1, 2020 — December 31, 2022 • Duties of the Public Art Advisory Committee include: developing by-laws and procedures for the Iowa City Public Art Program; administering the Public Art Program by determining the placement of public art, the type of art to be used in a specific project, and the artist to be engaged; • overseeing the acceptance of gifts of art; • overseeing the maintenance and disposition of public art; ■ overseeing expenditures of the Public Art Program budget; • overseeing the Poetry in the Public Program. • The Public Art Advisory Committee meets the first Thursday of each month at 3:30 p.m. Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, November 12, 2019. An application can be completed and submitted on the City of Iowa City website at www.icgov.org or by contacting the City Clerk's office. Questions about the Iowa City Public Art Advisory Committee should be directed to Marcia Bollinger, Neighborhood Outreach Coordinator at 319- 356-5237 or Marcia-Bollin er iowa-ci .or Board/Commission Application Cover Board/Commission: Public Art Advisory Committee Two vacancies to fill a three-year term 01/01/2020 - 12/31/2022 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 10/1/2019 Application Deadline: 11/12/2019 Council Appointment Date: 11/19/2019 Date of Non -Gender Appointment: 12/30/2019 After date above Council may appoint without regard to gender Gender Balance Requirement: 1 -Female, 1 -None Current Gender Balance: Female: 1 Male: 2 Gender Name and Address Female Finlayson, Jan r 2365 Cae Dr Female ; Purington, Nancy L. 1706 Prairie du Chien Rd Female Truitt, Andrea Serving unexpired term ending 12/31/19 815 N Johnson St r Female Wilson, Katie 1718 California Ave Public Art Advisory Committee Name Term ending # years as resident of IC Occupation Gender Age* Country of Origin* Sexual Orientation* Religion* Disability* Ethnicity* Gender Identity* Race* Unique Identifiers* Vero Rose Smith (Art or Design Professional) 12/31/2020 -1st Term 3 Curator F 26 USA Straight-ish Atheist White Steven Miller (Art or Design Professional) 12/31/2020 -1st Term Architect M 35 USA Heterosexual Caucasian Edward Boyken (Art or Design professional) 12/31/2021-1st Term 31 Prep Cook M 31 USA Heterosexual Agnostic White Cis Male White VACANT 12/31/_2022 VACANT 12/31/2022 i Please note: The information provided is the information provided on the application at the time of submission. * Information is voluntary Public Art Advisory Committee Attendance Record 2018-2019 Name Term Expires 10/4 11/1 12/6 1/10 3/7 4/4 5/2 6/6 7/11 8/1 9/5 Wendy Brown 1/1/2020 x x O/E O/E x x x x x x x Erin Fitzgerald 1/1/2020 x Ron Knoche x x x x x x x x x x x Jul! Seydell- Johnson x x x x O/E x x x x x x Vero Rose Smith 1/1/2021 x x x x x O/E x i x x x x Steve Miller 2/1/2021 x x x x x x x x x x x Andrea Truitt 1/1/2022 -- -- x x x x x x -- x x Eddie Boyken 1/1/2022 -- -- -- x x x x x x x x Key: X = Present O = Absent O/E = Absent/Excused --- = Not a member r Advisory Board/Commission Application Form PAZsI; I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/11/2019 First Name Jan Last Name Finlayson Home Address* 2365 Cae Dr City IOWA CITY State IA Zip Code* 52246 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193217360 Email Address* jan@theluxezone.com Boards & Commissions Select a Board or Commission you are interested in:* Public Art Advisory Committee Public Art Advisory Committee Category* Art or Design Professional Preference on first choice V rrultiple boards are being applied for. How long have you been a resident of Iowa City?* 30+ Occupation:* Interior Designer Gender* `This question is mandatory in order for the City to corrply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" rray be provided in the Gerrngraphics sectionof the application below. F Male rj Female Experience and/or activities which you feel qualifyyou for this position:* I have been an interior designer since 1990 in this area. I have worked with local as well as national artists for years for placement of work in clients' homes and offices. I also feature local art in my shop, Luxe Interiors. In addition I have served on the board for Iowa Arts Festival (prior to merging with Summer of the Arts). What is your present knowledge of each advisory board you are interested in?* I previously served on the Public Art Advisory board about 10 years ago. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 50 Country of Origin us Sexual Orientation Heterosexual Religion Christian Do you have a disability? No Ethnicity American Race White Gender identity female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Jolwall". Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. �r Advisory Board/Commission Application Form rY ..��,�, aThis application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/5/2018 First Name Nancy L Last Name Purington Home Address* 1706 Prairie du Chien Road City IOWA CITY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3195946789 Email Address* nancyLpurington@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Public Art Advisory Committee Public Art Advisory Committee Category* Art or Design Professional 2. How long have you been a resident of Iowa City?* 4o years 3. Occupation:* Art & Design Consultant 4. Gender* *This question is rrendatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Demographics sectionof the application below. F Male V Female 5. Experience and/or activities which you feel qualifyyou for this position:* BFA Painting, Kansas City Art Institute, Master of Fine Arts Design Ul. Art Education Certificate K-12, Taught K -graduate levels art, art, textiles and architecture histories. Professional Art Consultant 25 years, Woman -Owned Small Business Member, Board Member and Director of of Arts Iowa City for 40 years. 6. What is your present knowledge of each advisory board you are interested in?* Was a Co-author of the Public Art Proposal via the Arts/Business Committee at the Iowa City Area Chamber of Commerce. This 1997 proposal is the foundation of the Public Art Advisory Committee that exists today. It is an important element in municipal government and community arts advocacy. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 71 10. Country of Origin United States 11. Sexual Orientation Female 12. Religion Buddhist 13. Do you have a disability? No 14. Ethnicity lowaish 15. Race mixed 16. Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 31 C cIIr..r�td- Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form PAZ�`_.--..®�,�, rY s��' �+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 10/23/2019 First Name Andrea Last Name Truitt Home Address* 815 N Johnson St City IOWA CITY State IA Zip Code 52245 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-359-8388 Email Address* andrea.m.truitt@gmaii.com Boards & Commissions Select a Board or Commission you are interested in: Public Art Advisory Committee Public Art Advisory Committee Category* At -Large Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 5 years, 5 months Occupation:* Volunteer & Community Relations Manager Gender* `This question is mandatory in order for the City to corrply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" rray be provided in the Gerrngraphics sectionof the application below. F Male fJ Female Experience and/or activities which you feel qualifyyou for this position:* I am a current member of the Public Art Advisory Committee, filling an unexpired term in 2019. 1 have worked with fellow committee members to create a strategic plan for PARC, with the hope to approve a larger budget in order to provide more public art, more financial support to artists for their projects, and more support for the maintenance and upkeep of the public art Iowa City has. With fellow committee members, I have also selected organizations and projects to which to disperse funds. I enjoy the committee, and it is an exciting time for PARC, given the strategic plan and possible increase in funding. I would like to be appointed to a full term in order to see the strategic plan through the approval process and to further engage with and support Iowa City's vibrant artistic community. In my professional life, I work for Summer of the Arts, an arts organization that produces free arts and cultural programs in downtown Iowa City. In my role as Volunteer & Community Relations Manager, I meet and interact with community members of all stripes that participate in the arts in a variety of ways: attendees/art appreciators, volunteers of all ages who support the mission, visual artists and musicians, fellow art organizations and nonprofits, sponsors/donors, and interns. The work that I do has made me comfortable with the many different relationships with art that people have. I also truly believe that art—namely public art—is, and should be, a community activity in which everyone participates. This knowledge and belief is crucial to PARC, and I believe I am qualified to continue on this committee. What is your present knowledge of each advisory board you are interested in?* As a current member of PARC, my knowledge of what the committee does is up-to-date. The PAAC oversees a current budget of $25,000 and uses this funding to support artists in creating art. This art includes Tim Adams' new City Hall sculpture, as well as interactive light and sound projections, children's art camps, physical/permanent works, and ephemeral performances/experiences. New to 2019 is a separate fund for performance art. The need for specific, performance -related funding was high, as there were 11 applicants. This year, the committee has drafted a new strategic plan to increase its budget to $50,000. This process has included input meetings for professionals and the public and a survey to assess the community's definitions and expectations of public art. The plan will be presenting to City Council next month. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 35 Country of Origin USA Sexual Orientation Heterosexual, maybe a whiff of queerness? Religion I don't practice. Do you have a disability? No Ethnicity Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. �r Advisory Board/Commission Application Form rY ..��,�, aThis application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/12/2018 First Name Katie Last Name Wilson Home Address* 1718 California Ave City IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 515-450-6619 Email Address* katiemayme@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Public Art Advisory Committee Public Art Advisory Committee Category* At -Large 2. How long have you been a resident of Iowa City?* 2 years 3. Occupation:* SEIU Office Manager 4. Gender* *This question is rrendatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Demographics sectionof the application below. F Male V Female 5. Experience and/or activities which you feel qualifyyou for this position:* My father is an artist who ran an art studio through our home when I was growing up, and also started and ran the Biological and Pre -Medical Illustration program at Iowa State University. I grew up surrounded by art, and was taught how to draw, paint, and throw pottery by my father an my art instructors. In college, I pursued an education in written and performance art, majoring in both English and Theatre with an emphasis in creative non-fiction writing. I chose to stay in the Iowa City area after graduating largely because of the vibrant culture of arts and music here. I am qualified for this at -large position because I am passionate about keeping our tradition in the arts alive and well in Iowa City. 6. What is your present knowledge of each advisory board you are interested in?* I know that the Public Art Advisory Committee oversees decisions such as making by-laws for the Public Art Program, where public art will be put, which artist will be chosen to create the art, and maintaining the budget for public art. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 31 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Agnostic 13. Do you have a disability? No 14. Ethnicity Caucasian 15. Race Caucasian 16. Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* LG ......... ......... Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Item Number: 16.e. CITY OIF IOWA CITY www.icgov.org November 19, 2019 Parks and Recreation Commission - Two vacancies to fill a four-year term, January 1, 2020 - December 31, 2023. (Term expires for Cara Hamann, Joe You n ker) ATTACHMENTS: Description Vacancy Notice/Coversheet Board Demographics/Attendance Bruss, Jessica -Application Orozco, Hellecktra -Application Penandjo Lemiupa, Boniface -Application Serenda, Melissa -Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: PARKS AND RECREATION COMMISSION Two Vacancies: Four -Year Terms January 1, 2020 — December 31, 2023 The duties of the members of the Parks and Recreation Commission are; to recommend and review policies, rules, regulations, ordinances, CIP (Capital Improvement Program) funds and budgets relating to parks, playgrounds, recreation centers, and cultural functions of the City and make such reports to the City Council as the Commission deems in the public interest; to exercise broad responsibility for the development of parks, recreation centers, playgrounds, and cultural facilities to serve the City --including the creation and appointment of advisory groups to make studies. The Parks and Recreation Commission meets the second Wednesday of each month at 5:00 p.m. Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, November 12, 2019. An application can be completed and submitted on the City of Iowa City website at www.icgov.org or by contacting the City Clerk's office. Questions about the Iowa City Parks and Recreation Commission should be directed to Juli Seydell- Johnson, Parks & Recreation Director at 356-5104. Board/Commission Application Cover Board/Commission: Parks and Recreation Commission Two vacancies to fill a four-year term 01/01/2020 - 12/31/2023 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 10/1/2019 Application Deadline: 11/12/2019 Council Appointment Date: 11/19/2019 Date of Non -Gender Appointment: 12/30/2019 After date above Council may appoint without regard to gender Gender Balance Requirement: 1 -Male, 1 -None Current Gender Balance: Female: 4 Male: 3 Gender Name and Address I Female Bruss, Jessica 2201 California Ave Female Orozco, Hellecktra 2627 Rushmore Drive jMale Penandjo Lemoupa, Boniface 923 E College St apt 10 Female Serenda, Melissa 1607 Vesti Lane Parks & Recreation Commissions j Name Term ending # years asCountry resident of IC Occupation Gender of Sexual Age* Origin* Orientation* Religion* Disability* Ethnicity* Gender Identity* Race* Unique Identifiers' Suzanne Bentler 12/31/2020 - 2nd Term 23 Asst Research Scientist F 45 USA Heterosexual Caucasian Jamie Venzon 12/31/2020 -1st Term 28 Event Director F M 28 USA Heterosexual Catholic Caucasian Stephen Bird 12/31/2021-1st Term _ 1 UI Supply Mgr 44 USA Straight Methodist Caucasian Ben Russell 12/31/2021-1st Term 21 Bank Officer M South 31 Korea Male Catholic Asian 12/31/2021-1st Term + Angie Smith unexpired 16 Psychologist F 43 USA Blake Winter 12/31/2022 -Unexpired 6 1 Personal Banker M_ 25 USA Male Catholic Caucasian Male White Brianna Wills 12/31/2022 - 1st Term 7 Non Profit Manager F 40 USA VACANT 12/31/2023 _ VACANT 12/31/2023 Please note: The information provided is the information provided on the application at the time of submission. * Information is voluntary PARKS AND RECREATION COMMISSION August 7, 2019 PARKS AND RECREATION COMMISSION ATTENDANCE RECORD NAME ao 00 o�0+ TERM � �{ ~ a C EXPIRES H ,Ny N P►J !}' to � � � Suzanne 12/31/20 X X K X X NM X O/E X LQ X X Bentler Steve Bird X X X X X NM X X X LQ O/E X Wayne Fett P12131/22 X O/E X X Lucas * * * * x NM X X 0/E LQ X Foelsch Cara X O/E X O/E X NM X X -X -Q X X Hamann Lucie 12/31/18 X X X O/E Laurian Ben Russell 12/31/21 X X X X X NM X X XLQ X X Angie Smith 12/31/21 X X X X X NM X X X LQ X O/E Jamie 12/31/20 X X O/E X X NM X 0/E 01E LQ X O/E venzon Brianna 12/31/22 * * * * O/E NM X X X LQ X O/E Wills Joe Younker 12/31/19 X X X X X NM X X X J=X X KEY: X = Present O = Absent OJE = Absent/Excused NM = No meeting LQ = No meeting due to lack of quorum * = Not a member now �r Advisory Board/Commission Application Form rY ..��,�, aThis application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/8/2018 First Name Jessica Last Name Bruss Home Address* 2201 California Ave City IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-621-1950 Email Address* jrbruss@yahoo.com Boards & Commissions Select a Board or Commission you are interested in: Human Rights Commission Select a Board or Commission you are interested in:* Parks and Recreation Commission 2. How long have you been a resident of Iowa City?* 19 years 3. Occupation:* Client Services Professional 4. Gender* *This question is rrendatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Demographics sectionof the application below. F Male V Female 5. Experience and/or activities which you feel qualifyyou for this position:* I was born and raised in the Iowa City Area. I participated in Iowa City Kickers and Iowa City Girls Softball as a youth. My children both participated in Iowa City Kickers. I recently graduated with a BLS from the University of Iowa with an Organizational studies emphasis. My husband had disabilities and my son has disabilities. 6. What is your present knowledge of each advisory board you are interested in?* I understand that each advisory board meets one time per month. The parks and recreation board is responsible for policies and budgets related to the parks and recreation department. The human rights commission develops policies and information to help prevent discrimination. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure orfor one yearthereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 38 10. Country of Origin USA 11. Sexual Orientation Heterosexual 12. Religion Agnostic 13. Do you have a disability? No 14. Ethnicity European -American 15. Race Caucasian 16. Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 0A% ,?a 06d'f Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down r Advisory Board/Commission Application Form PAZsI; I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 3/25/2019 First Name Hellecktra Last Name Orozco Home Address* 2627 Rushmore Drive City IOWA CITY State IA Zip Code* 52246 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 2103810525 Email Address* poneloyagirl@hotmail.com Boards & Commissions Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in: Parks and Recreation Commission Preference on first choice If Tultiple boards are being applied for. CPRB How long have you been a resident of Iowa City?* 3 yrs Occupation:* Student Gender* 'This question is rrandatory in order for the City to conply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the Demographics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* I have worked in Emergency Management and Public Safety and currently working on a degree in Criminal Justice with a concentration in Homeland Security. What is your present knowledge of each advisory board you are interested in?* I have read through meeting minutes of previous meetings. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 39 Country of Origin Nicaragua Sexual Orientation Religion Christian Do you have a disability? No Ethnicity Latin/Hispanic Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. r Advisory Board/Commission Application Form PAZsI; I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 1/21/2019 First Name Boniface Last Name Penandjo Lemoupa Home Address* 923 E College St apt 10 City IOWA CITY State IA Zip Code* 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 2405348917 Email Address* penandjoyannick@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Parks and Recreation Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 3 months Occupation: N/A Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. V Male F Female Experience and/or activities which you feel qualifyyou for this position:* I was once a soccer coach in my community in Gaithersburg, MD. I coached the ages 3-4 and college level which the college level was my personal team. I believe applying is a plus for me since I already have experience in this area What is your present knowledge of each advisory board you are interested in?* Parks and Recreation is one the most important part in the community because as an athlete I have strong ties with various sports and I have participated in. I keep current event on every sport activity in the area but am still new to Iowa City and this will get me acquainted to the area more. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 22 Country of Origin Cameroon Sexual Orientation Heterosexual Religion Catholic Do you have a disability? No Ethnicity Bamileke Race Black African Gender identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Rt �-A Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. r Advisory Board/Commission Application Form PAZsI; I+z This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE If appointed to a Board/Commission, all other applications will be removed from consideration. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 8/13/2019 First Name Melissa Last Name Serenda Home Address* 1607 Vesti Lane City IOWA CITY State IA Zip Code* 52240 Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193332505 Email Address* msserenda@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Parks and Recreation Commission Preference on first choice If Tultiple boards are being applied for. How long have you been a resident of Iowa City?* 16 years Occupation: * Program Specialist 11 at ACT, Inc. Gender* *This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray be provided in the I)errugraphics sectionof the application below. F Male V Female Experience and/or activities which you feel qualifyyou for this position:* For the past several years I have photographed, written about, and promoted Iowa City's Sycamore Greenway as a way to engage community members in the natural world outside their doors (via the Sycamore Greenway Friends Facebook page and blog). I have also promoted the importance of municipal parks and trails and feel they are important parts of our shared experience; making green space available to people of all ages and income brackets is a necessary part of any successful culture. I am an Iowa Master Naturalist and have served on the Publicity Committee for Bur Oak Land Trust for the past several years, with a commitment to making our natural areas and public spaces places where people feel welcome and eager to visit. A city that values its parks and recreational facilities is a city that values its people, and I believe it is incredibly important to advocate for continued investment in these resources. Our city does an amazing job in supporting Parks & Recreation and I would be honored to be a part of it. What is your present knowledge of each advisory board you are interested in?* I follow email updates from the city and review the minutes/agendas for the monthly meetings as available. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of Interest?* No Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 42 Country of Origin USA Sexual Orientation Hetero Religion none Do you have a disability? No Ethnicity Polish/Greek/German Race White Gender identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* V,44LM 5a" Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving.