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HomeMy WebLinkAbout2023-07-11 AppointmentAttachments:Vacancy Announcement & Coversheet.pdf Board Demographics & Attendance.pdf Campbell-Martin, Selena - Application.pdf Earnhart, Benjamin - Application.pdf Hartig, Connor - Application.pdf Mohamed, Lubna - Application.pdf Mohammed, Wifag - Application.pdf Subramanian, Saranya - Application.pdf Tran, Catherine - Application.pdf Item Number: 11.a. July 11, 2023 Ad Hoc Truth & Reconciliation Commission - Two vacancies to fill an unexpired term, from appointment date to December 31, 2024. (Mohamed Traore and Kevo Rivera resigned). Submit Date: Jun 27, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 3 Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Selena E Campbell-martin 1550 Deerfield Dr. North Liberty IA 52317 Home: (708) 310-0218 helphopeandlovefoundation@gmail.com Entrepreneur Selena E Campbell-martin Which Boards would you like to apply for? Ad Hoc Truth and Reconciliation Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) TRC Interests & Experiences Experience and/or activities which you feel qualify you for this position: Community Leader & Humanitarian What is your present knowledge of each advisory board you are interested in? I have attended a number of meetings for the TRC. I am familiar and aware of the primary functions and goals related to the TRC. Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. Selena E Campbell-martin List your answers here: My Personal Nonprofit Help Hope and Love Foundation Founder, President & CEO 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 serve on another Iowa City board or commission? Yes No (Optional) 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 51 Country of Origin US Sexual Orientation Heterosexual Religion Christian Do you have a disability No Ethnicity African American Selena E Campbell-martin 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Selena E Campbell-martin Preference on first choice If multiple boards are being applied for. How long have you been a resident of Iowa City? 25 years Occupation: investor 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 Demographics sectionof the application below. Male Female Experience and/or activities which you feel qualify you for this position: MA in Sociology from the U of Iowa, then worked for them for a decade. Involvement in diversity activities, consciously or unconsciously, treated everybody a full human being. What is your present knowledge of each advisory board you are interested in?* Not much, I have seen in the news that it has been complicated. 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. Submit Date: Mar 14, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 2 years, 9 months Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Male Boards & Commissions Connor Hartig 108 S. Linn Street Apt 25 Iowa City IA 52240 Home: (563) 845-1232 connorhartig1232@gmail.com Service Manager at Chipotle Mexican Grill Connor Hartig Which Boards would you like to apply for? Ad Hoc Truth and Reconciliation Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Ad Hoc Truth and Reconcilliation Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: Political Science B.A., Philosophy in Philosophy, Human Rights Certification, Pre -Law (expected May 2024) Leadership and Non -Discrimination Training (2022/23 through Chipotle) Academics and Professionalism Committee Member of Phi -Alpha Delta (Pre -Law Fraternity) (2021-present) Dubuque Caucus Precinct Captain & County Democrats Committee Member (2020) What is your present knowledge of each advisory board you are interested in? The knowledge I have pertaining to each advisory board is limited to the content provided on the Advisory Board/Commission site, as I just recently heard about the opportunity from the instructor of my "Governance and Human Rights" course. Although I do not have a thorough understanding of the work that each commission has done, I am eager and willing to put in the work to establish that knowledge. Potential Conflicts of Interest 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. 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. Connor Hartig Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 20 Country of Origin United States Sexual Orientation Gay Religion Agnostic Connor Hartig 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Connor Hartig Submit Date: Jun 29, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 10 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Lubna D Mohamed’s 1905 Gleason Ave Iowa city IA 52240 Mobile: (319) 330-1421 Home: (319) 333-1613 mohamed.lubna@iowacityschools.org Para substitute - Arabic interpreter Lubna D Mohamed’s Which Boards would you like to apply for? Ad Hoc Truth and Reconciliation Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I’m from Sudan and we have a lot of people from Sudan in Iowa city, Coraville and north liberty, I deal with issues and also I’m a member at the NAACP, I usually work closely with Mr Sanders and reported to him the issues and discrimination issues in my community. What is your present knowledge of each advisory board you are interested in? As a member of NAACP i have an experience about the discrimination in housing, educations and different area addition to my Sudanese community racial discrimination issues. Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. Lubna D Mohamed’s List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 Ethnicity Race Gender Identity Lubna D Mohamed’s *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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Lubna D Mohamed’s Attachments:Notice of Vacancy & Coversheet - At Northside.pdf Board Demographics & Attendance.pdf Thomann, Deanna - Application.pdf Item Number: 11.b. July 11, 2023 Historic Preservation Commission (Northside) - One vacancy to fill a thee-year term, July 1, 2023 - June 30, 2026. (Deanna Thomann's term expired on June 30, 2023) Submit Date: May 29, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 21 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Deanna Thomann 208 Fairchild Street Iowa City IA 52245 Home: (319) 330-7441 deanna.thomann@gmail.com copy editor Deanna Thomann Which Boards would you like to apply for? Historic Preservation Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Question applies to Historic Preservation Commission Board Member Information Historic Preservation Commission Category * Northside Interests & Experiences Experience and/or activities which you feel qualify you for this position: I live in and own a house that is a contributing historic property within the Northside. I care for and maintain my old home and am interested in issues that affect my house and other historic properties. What is your present knowledge of each advisory board you are interested in? I am about to finish two years of service as a commissioner on the Historic Preservation Commission. I am applying for a new term. Potential Conflicts of Interest 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. 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. Deanna Thomann Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 44 Country of Origin United States Sexual Orientation Religion Do you have a disability no Deanna Thomann 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Deanna Thomann Attachments:Vacancy Notice & Coversheet.pdf Board Demographics & Attendance.pdf Beltre, Ines - Application.pdf Burr, Darla - Application.pdf Cellman, Christie - Application.pdf Covington, Mike - Application.pdf Dedeaux-Norris, T. J. - Application.pdf Fennell-Chametzky, Aaron - Application.pdf Hagerla, Denise - Application.pdf Hall, Ryan - Application.pdf Halley, Michael - Application.pdf Hartig, Connor - Application.pdf Hawthorne, Thorn - Application.pdf Hobart, Jessica - Application.pdf Kiche, Anne - Application.pdf mohammed, wifag - Application.pdf Parker, James - Application.pdf Kreger, Grace - Application.pdf Pries, Mark - Application.pdf Pries, Mark - Correspondence.pdf Qadoura, Viana - Application.pdf Stevenson, Holly - Application.pdf Tran, Catherine - Application.pdf Item Number: 11.c. July 11, 2023 Human Rights Commission - One vacancy to fill an unexpired term, upon appointment - December 31, 2025. (Badri Kuku resigned) Correspondence included in Council packet. II I 1 „�� �IIl� wCity Council Supplemental Meeting Packet CITY OF IOWA CITY July 10, 2023 Information submitted between distribution of packet on Thursday and 4:00pm on Monday. Late Handout(s): 6. Consent Calendar - Resolutions and Motions Item 6.1 North Gilbert Street Reconstruction - See correspondence from Eric Gidal and Jacqueline B 11. Council Appointments Item 11.c Human Rights Commission - See revised attendance sheet. July 10, 2023 City of Iowa City AD HOC TRUTH & RECONCILIATION ATTENDANCE RECORI YEAR 2023 111r1antinv 1na#M NAME TERM EXP. 1/5 1/19 2/2 3/2 4/6 5/4 18 6/1 6/15 Dillard 12/31/24p P p P P P Gathua 12/31/24 A P P P p Harris 12/31/24 P p p P A P Johnson 12/31/24 p p A P Krebs 12/31/24 P P P P P P Merritt 12/31/24 P p P p p Nobiss 12/31/24 P A P P A P Rivera 12/31/24 p P P P p P Vacant 12/31/24 KEY: = Present A =Absent r Advisory Board/Commission Application FormrYppr° i y This application is a public document and as such can be reproduced and distributed for the 25 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: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application 8/30/2022 First Name* Ines Last Name* Beltre First Name ( Phonetic spelling ) Optional Last Name ( Phonetic spelling ) Optional Home Address* 984 Westside 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* 787-426-1037 Email Address* beltrei@yahoo.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? around 2.5 years (6 years in Iowa) Occupation: * Employment Manager (HR) 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 Demographics sectionof the application below. Male Female Experience and/or activities which you feel qualify you for this position: * Currently part of the Diversity and Inclusion Committee for Johnson County. Also part of LULAC in Iowa City. I try to be on every activity regarding human rights, diversity and inclusion as well as keep up to date with news and changes, participate in symposiums and conferences. What is your present knowledge of each advisory board you are interested in?* it currently has 8 members, the Chair is Jason Glass. I read the minutes to keep tracking what the commission is doing for our 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 Optional) 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 Dominican Republic Sexual Orientation Religion Do you have a disability? Yes Ethnicity Race 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 FormrYppr° i y This application is a public document and as such can be reproduced and distributed for the 25 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: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application 6/28/2022 First Name* Darla Last Name* Burr First Name ( Phonetic spelling ) Optional Last Name ( Phonetic spelling ) Optional Home Address* 784 Mission Point 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* 707-290-1984 Email Address* Darlaburr20l4@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? One week Occupation: Transitioning teacher 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 Demographics sectionof the application below. Male Female Experience and/or activities which you feel qualify you for this position: Teacher in a title 1 school for 4 years in CA with extensive experience advocating for students and their families. Living with a chronic illness since birth and I help run several support groups, as well as an ambassador for the Oley Foundation. What is your present knowledge of each advisory board you are interested in?* Human rights are a passion of mine and I would love to be a part of a commission that helps ensure human and civil rights are not violated. To be a part of community and educational programs for 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 Optional) 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 United States Sexual Orientation Female Religion Do you have a disability? 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* r 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. Submit Date: Jan 09, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? Iowa City Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Christie Cellman 128 Arabian Ct Iowa City IA 52240 3199306177 christie-cellman@uiowa.edu Graduate Research Assistant and DEI Director at the Daily Iowan Christie Cellman Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am a current MSW candidate, a graduate research assistant at the Law, Health Policy, & Disability Center, the DEI Director at the Daily Iowan, and I am heavily involved in the community - giving several public speeches and rallying for the greater good. Public speeches include a voter inauguration ceremony in 2018 call hosted by the NAACP, and two public speeches regarding the overturning of roe versus wade this year - one in Iowa city and 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 and making recommendations to City Council. Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. Christie Cellman List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 United States Sexual Orientation Pan Religion Atheist Do you have a disability Yes Ethnicity Christie Cellman Race White Gender Identity Non-binary *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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Christie Cellman Submit Date: Jun 07, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 5 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Mika J Covington 2401 Highway 6 East, Apt 40-106 Iowa City IA 52240 Mobile: (712) 314-8258 mika.j.covington@gmail.com Nonprofit President Mika J Covington Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am the co-founder and President of Next Generation of Cystinosis. NGC is a nonprofit org, run for and by adults living with the ultra-rare disease called cystinosis. We work to represent the interests and needs of adults living with cystinosis, provide support to the community, lobby the state legislature to pass a Rare Disease Advisory Committee and help locate resources. I have worked with the ACLU of Iowa on a lawsuit to establish civil rights for transgender people in Iowa. The decision from the IA Supreme Court this last May. I currently serve on the UIHC Patient and Family Advisory Board. I volunteered with the Iowa Pride Network from 2010 to 2013 on their College Leadership Team organizing and leading IPN's Southwest Iowa Regional Gay-Straight Alliance Coalition. Finally, I have been involved with organizations focused on protecting people's civil rights. I am not an attorney. Finishing my BA in psychology and German (language, culture, history, politics). I speak English and intermediate German. I am proficient in Microsoft Word, Excel, PowerPoint, and Google Apps. What is your present knowledge of each advisory board you are interested in? I understand that the Human Rights Commission ensures that the Iowa Civil Rights Code is enforced. They help employers and residents understand the law and participate in events such as Juneteenth and Pride, which I would volunteer to help at those events. Potential Conflicts of Interest 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. 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. Mika J Covington Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: I serve on the Board of Next Generation of Cystinosis. I am not paid for that position. I do not believe there would be a financial interest issue. 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 serve on another Iowa City board or commission? Yes No (Optional) 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 32 Country of Origin USA Sexual Orientation Queer Religion Methodist Mika J Covington Do you have a disability Yes Ethnicity Race White Gender Identity Transgender 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Mika J Covington Submit Date: Jan 09, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 6 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions T.J.Dedeaux-Norris 332 S Linn St 418 Iowa City IA 52240 8184005236 tj-dedeaux-norris@uiowa.edu Associate Professor/ Artist T.J. Dedeaux-Norris Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: T.J. Dedeaux-Norris is a mixed -media artist who employs painting, fiber, performance, video, and music to explore the somatic impacts of racial, gender, and class socialization. In form and content, their work poses a philosophical inquiry into the distinction between Self and Other, with the body as a social microcosm of distinct yet discursive dynamics to observe and question. Everything is both permeable and fractile. Dedeaux-Norris completed their BA at University of California at Los Angeles and their MFA at Yale University. Their work has been presented internationally at the Contemporary Arts Museum Houston, Mission Creek Festival, Nasher Museum of Art, Performa, Prospect New Orleans, Rotterdam Film Festival, The Studio Museum in Harlem, Sundance Film Festival, and The Walker Art Center - among other institutions. Dedeaux- Norris has participated in residencies at Grant Wood Colony, MacDowell, Skowhegan, and Yaddo. They are a 2019-2020 Pollock -Krasner Foundation grantee, a 2022 Iowa Artist Fellow, and a tenured Associate Professor at University of Iowa. What is your present knowledge of each advisory board you are interested in? I am newly acquainting myself with the HRC and feel that within my art practice and teaching pedagogy that I embody and already practice the ideologies and concerns of the commission. Having lived in Cedar Rapids/Iowa City for the past 6 years, I believe I've gotten great lived experience in understanding the needs and gaps of needed programming and advocacy. I'm also an eager learner. Potential Conflicts of Interest 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. 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. T.J. Dedeaux-Norris Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 43 Country of Origin Guam, USA Sexual Orientation Religion Do you have a disability T.J. Dedeaux-Norris Ethnicity Black American Race multi raced (black/white/native/creole) Gender Identity Fluid she/they pronouns *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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree T.J. Dedeaux-Norris Submit Date: Jun 25, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Air-in Last Name (Phonetic spelling) Fenn-l (like the letter l) Cha-met-ski Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 21 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Male Aaron J Fennell-chametzky 810 Roosevelt St Iowa City IA 52240 Mobile: (319) 471-2683 fcaaron02@gmail.com Paraeducator Aaron J Fennell-chametzky Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: Experience volunteering for presidential campaigns, attending rallies such as a gathering against the overturning of Roe v. Wade and as an ally at a march on Transgender Day of Visibility, going to a number of my college’s Office of Intercultural Life events, being a Student Senate member in high school, and being close to done with my degree- majoring in history, minoring in Gender, Sexuality, and Women’s Studies, and getting a certification to teach secondary social studies- all of which I feel relate to this position. What is your present knowledge of each advisory board you are interested in? All I know about it is what is listed on the card I was given: the duties of “Make recommendations on the racial equity and social justice grants” and “Plan programs and activities to eliminate unlawful discrimination,” as well as the requirements and term length. Potential Conflicts of Interest 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. 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. Aaron J Fennell-chametzky Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: Pedal Power MYEP Iowa City Community School District 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 serve on another Iowa City board or commission? Yes No (Optional) 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 Bisexual Religion None Aaron J Fennell-chametzky Do you have a disability A very mild one- high functioning autism. I don’t anticipate it would impact my ability to fill a role like this one Ethnicity Race White Gender Identity Cisgender 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Aaron J Fennell-chametzky Submit Date: Jan 09, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 7 months Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Denise Hagerla 174 Shrader Rd Iowa City IA 52245-4920 7732181287 didihag@yahoo.com Clinical Social Worker Denise Hagerla Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I've spent much of my 20+ years as a social worker serving marginalized populations and providing education and support to other professionals working with the LGBTQIA+ community. I am always seeking opportunity to create, live, and work in community that strives to uphold the values of diversity, equity, and inclusion. This is a big impetus for my recent move to Iowa City. What is your present knowledge of each advisory board you are interested in? I've been watching the educational initiatives of the Human Rights Commission over the past several months and have been impressed with the level of community engagement and the breadth and scope of ways in which this committee reaches out to community for education and impact. I also have watched several hours of the committee meetings to witness the content and purpose of these meetings. Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. Denise Hagerla List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 United States Sexual Orientation Lesbian/Queer Religion UUS Do you have a disability No Ethnicity Denise Hagerla Race White Gender Identity Gender non-conforming *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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Denise Hagerla Submit Date: Jan 09, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 7 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Male Boards & Commissions Ryan Hall 18 Kenneth Dr Iowa City IA 52240 3158706939 rhall@newpi.coop Information Technology and Data Analysis Ryan Hall Which Boards would you like to apply for? Historic Preservation Commission Board Member Information: Submitted Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Question applies to Historic Preservation Commission Board Member Information Historic Preservation Commission Category * None Selected Interests & Experiences Experience and/or activities which you feel qualify you for this position: > Political Science Honors graduate of the University of Iowa with a focus in bias, protest, and political revolution. Published academically on related topics. > Grew up in a poor single parent household and became a first generation college student. Understands the struggles of navigating our educational system without any prior experience or guidance. > Familiar with boards and their functions through my work with the board at New Pioneer Food Co-op > Very passionate about Iowa City's history and it's relationship with underserved communities. > Appreciative of the inclusivity that Iowa City offers while understanding that our work has just begun What is your present knowledge of each advisory board you are interested in? > Familiar with the functions of the committees and their relationship with Iowa City as a whole > Understands the limits of the boards as well as their importance > Good sense of board relationships and how to constructively and inclusively navigate topics and build solutions Potential Conflicts of Interest 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. 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. Ryan Hall Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 United States Sexual Orientation Heterosexual Religion None Ryan Hall Do you have a disability No Ethnicity Race White Gender Identity Cisgender *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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Ryan Hall Submit Date: Jan 09, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Ha-lee Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 1 month Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Male Michael Halley 310 Finkbine Lane 2 Iowa City IA 52246 641-233-0445 mhalley25@gmail.com Account Manager Ideal Energy Michael Halley Boards & Commissions Which Boards would you like to apply for? Climate Action Commission Board Member Information: Submitted Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: Served 12-years on Fairfield, Iowa city council and completed the Iowa League of Cities Certified Elected Municipal Official program, so I'm very familiar with city government. More recently I served as an unofficial advisor to the City of Fairfield Diversity, Equity, and Inclusion Committee, though I was not an official member. I've advocated for human rights during my time as an elected official and would like to expand that work here in Iowa City. What is your present knowledge of each advisory board you are interested in? I read information provided on the city's website, read the most recent meeting minutes, and watched the most recent meeting on Channel 4. 1 have a general understanding of the commission's responsibilities and activities. Potential Conflicts of Interest 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. 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. Michael Halley Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 47 Country of Origin United State Sexual Orientation Heterosexual Religion Do you have a disability No Michael Halley Ethnicity European-American 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Michael Halley Submit Date: Mar 14, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 2 years, 9 months Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Male Boards & Commissions Connor Hartig 108 S. Linn Street Apt 25 Iowa City IA 52240 Home: (563) 845-1232 connorhartig1232@gmail.com Service Manager at Chipotle Mexican Grill Connor Hartig Which Boards would you like to apply for? Ad Hoc Truth and Reconciliation Commission Board Member Information: Submitted Civil Service Commission Board Member Information: Submitted Climate Action Commission Board Member Information: Submitted Community Police Review Board (CPRB) Member Information: Submitted Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Ad Hoc Truth and Reconcilliation Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: Political Science B.A., Philosophy in Philosophy, Human Rights Certification, Pre -Law (expected May 2024) Leadership and Non -Discrimination Training (2022/23 through Chipotle) Academics and Professionalism Committee Member of Phi -Alpha Delta (Pre -Law Fraternity) (2021-present) Dubuque Caucus Precinct Captain & County Democrats Committee Member (2020) What is your present knowledge of each advisory board you are interested in? The knowledge I have pertaining to each advisory board is limited to the content provided on the Advisory Board/Commission site, as I just recently heard about the opportunity from the instructor of my "Governance and Human Rights" course. Although I do not have a thorough understanding of the work that each commission has done, I am eager and willing to put in the work to establish that knowledge. Potential Conflicts of Interest 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. 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. Connor Hartig Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 20 Country of Origin United States Sexual Orientation Gay Religion Agnostic Connor Hartig 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Connor Hartig Submit Date: Jan 09, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Thorn Hawthorne 327 Highland Drive Iowa City IA 52246 8179805820 hello@thornhawthorne.com Communications Specialist Thorn Hawthorne Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: As a communications specialist working in the next town over, I serve alongside city council and every board and commission. I've become extremely familiar with everything about the process and would really love to be able to do the same work in Iowa City since I live here. I'm transgender, disabled, and a descendant of refugees, so I'm also particularly well versed in related social justice and human rights issues. What is your present knowledge of each advisory board you are interested in? I've been interested in and watching public meetings since I moved to Iowa City Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. Thorn Hawthorne List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 26 Country of Origin America Sexual Orientation Queer Religion Do you have a disability Yes Ethnicity Not Latino Thorn Hawthorne Race Middle Eastern / White Gender Identity Transgender / Agender *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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Thorn Hawthorne Submit Date: Mar 22, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 3 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Jessica Hobart 4377 East Court St Iowa City IA 52245 Mobile: (309) 948-0606 hobartjessica@sau.edu Social Worker Jessica Hobart Which Boards would you like to apply for? Community Police Review Board (CPRB) Member Information: Submitted Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) CPRB Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am getting ready to complete Johnson County Community Police Academy and have a master's in criminal justice in addition to my master's in social work. Additionally, I have worked on many policies in enhancing care for individuals within a hospital system. I also have experience in public relations and marketing events to community members. What is your present knowledge of each advisory board you are interested in? Have reviewed past meetings for each board and have looked through the webpages for both boards. I have also discussed CPRB with local Iowa City Police Officers. Potential Conflicts of Interest 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. 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. Jessica Hobart Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: none 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 serve on another Iowa City board or commission? Yes No (Optional) 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 28 Country of Origin US Sexual Orientation Heterosexual Religion n/a Jessica Hobart 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Jessica Hobart Submit Date: May 29, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) 3194003877 Last Name (Phonetic spelling) Keycha' Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 30 Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Anne O Kiche 2958 Keel Boat Loop Iowa City IA 52240 Home: (319) 400-3877 Home: (319) 400-3877 aokiche@gmail.com Educator Anne O Kiche Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Human Rights Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: A strong advocate for marginalized communities. Chair of African community network, Director of DEI at AAUW. Strong advocate RVAP among other responsibilities. What is your present knowledge of each advisory board you are interested in? Advocates for human and civil rights. Mediate discrimination complains Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. Anne O Kiche List your answers here: None 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 serve on another Iowa City board or commission? Yes No (Optional) 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 58 Country of Origin Kenya Sexual Orientation Heterosexual Religion SDA Do you have a disability No Ethnicity Black Anne O Kiche 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Anne O Kiche Submit Date: Jun 21, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Jayms Last Name (Phonetic spelling) Pahr-kehr Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 18 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Male James L Parker 1908 B Street Iowa City IA 52245 Mobile: (319) 331-9419 jparkeria@gmail.com Registered nurse James L Parker Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: -10+ years as an RN working ob-gyn/ent/urology post surgical, med/surg float pool, emergency department, psychiatric/mental health division -fluent in french, beginner fluency in Spanish -2.5 years living abroad in France as a young adult -active in the Boy Scouts of America throughout my youth and returned to it as an adult; obtained rank of Eagle in 1992 and completed Wood Badge Leadership course in 2007. -BS in Management with an IT concentration; BS in Nursing; MS in Nursing student with anticipated graduation in December 2023; plan to obtain a PMHNP license in Iowa after graduation. - currently serving as a young men advisor (ages 13-15) at church -Addiction recovery program facilitator with weekly meetings -moved around in my childhood and adolescence to various states providing racial, cultural and socioeconomic experiences -10 years in the over-the-road transportation industry -3 years as a jailer and 911 dispatcher in Smith County Texas What is your present knowledge of each advisory board you are interested in? Next to nothing. Potential Conflicts of Interest 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. 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. James L Parker Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: UnityPoint Health 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 serve on another Iowa City board or commission? Yes No (Optional) 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 49 Country of Origin United States Sexual Orientation Male Religion The Church of Jesus Christ of Latter Day Saints James L Parker Do you have a disability No Ethnicity Non-hispanic 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree James L Parker Submit Date: Jan 09, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 11 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Grace Kreger 20 S. Lucas Street, Apartment D Iowa City IA 52240 5157107634 gkreger@gmail.com Program Director Assistant, Reach for Your Potential, Inc. Grace Kreger Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have ten years combined professional experience serving individuals with disabilities and low-income, at -risk youth (MYEP - Direct Support Professional/Program Facilitator, RFYP - Program Director Assistant, NCJC - Youth Counselor). I have extensive professional and volunteer experience working on political campaigns, most recently serving as an elected delegate in 2018 and 2020. 1 have additional formal volunteer experience with Iowa City Hospice, Iowa Youth Writing Project, and Girls on the Run. As an undergraduate student at the University of Iowa, I studied nonfiction creative writing with a focus on gender studies, social justice, trauma, and empowerment. I am passionate about advocating for and defending the rights of others. What is your present knowledge of each advisory board you are interested in? The HRC educates the public on discrimination and civil rights via public forums, activities, and programs. The HRC also provides suggestions to City Council regarding legislation concerning discrimination. The HRC meets once a month, and members serve for three years. This is an unpaid, volunteer position. Potential Conflicts of Interest 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. 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. Grace Kreger Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 31 Country of Origin United States of America Sexual Orientation Bisexual Religion Unitarian Grace Kreger Do you have a disability No 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Grace Kreger Submit Date: Mar 21, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? 15 years Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Male Boards & Commissions Mark Pries 1128 Denbigh Drive IOWA CITY IA 52246 Home: (319) 321-5263 pries.mark@gmail.com Lutheran Pastor, retired Mark Pries Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: 5 years as a Human Rights Commissioner in the City of Dubuque, Iowa (1978-1983); continual training in Human Rights work as a theologian, pastor, and citizen; completing a first term with the IC Human Rights Commission during which time I have received training in implicit bias, critical race theory, E.Q. (emotional intelligence) toward understanding the necessity for D.E.I. (diversity, equity and inclusion) to enrich and hold secure life of every resident. The IC HRC has just begun a 3 year strategic plan "Breaking Bread" in which I had a contributing role and am prepared to invest all the more in the realization of this plan. I am an old (73), white, heterosexual, married, male with a passion for the human rights of every person - a willing and eager voice with time and energy to to serve. What is your present knowledge of each advisory board you are interested in? I'm completing a first term on the IC Human Rights Commission. My attendance record is near perfect as we navigated our way thru the COVID-19 pandemic. I have led the training sessions for citizens to learn how to apply for Iowa City's annual Human Rights grants and then contributed to the ranking and awarding of these grants; I have served on the Human Rights Award committee this and last year. my relationships with Stefanie Bowers, Equity and Human Rights Director, and commissioners is positive and supportive. Potential Conflicts of Interest 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. 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. Mark Pries Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) 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 73 Country of Origin United States of America Sexual Orientation Heterosexual Religion Christian Mark Pries 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Mark Pries Submit Date: May 25, 2023 First Name Middle Initial Last Name Home Address Suite or Apt City State Postal Code Primary Phone Alternate Phone Email Address Occupation Advisory Board/Commission Application Form 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 considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application (Date will be captured on form submission) First Name (Phonetic spelling) Last Name (Phonetic spelling) Is your home address (listed above) within the corporate limits of Iowa City? Yes No How long have you been a resident of Iowa City? Almost 8 years. Gender (*This question is mandatory for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" may be provided in the Demographics section of the application below.) * Female Boards & Commissions Viana Qadoura 1023 Tipperary Rd Iowa City IA 52246 Mobile: (319) 671-2195 mariamgirlsclub@gmail.com Volunteer job at Al-Iman Center Viana Qadoura Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Viana Qadoura Experience and/or activities which you feel qualify you for this position: I have been advocating and fighting for the rights of minority students, especially Muslims, since 2005 when my children started attending schools in a small, conservative, Christian town in Iowa. Resources were denied and my efforts weren't welcomed by those in office due to my religion and to the headscarf I wore. Both the school’s board members and the community around us wasn’t tolerant nor helpful in aiding and supporting minorities which forced me to acquire tools that I could use to do so myself. I began with letters to the editors at the local newspaper, started purchasing and donating to the District bias-free books that represented Muslims as who they are and not what they were defined by others as, and I held multiple meetings with the Superintendent and school principles on many occasions to address the bigotry of the educators, the need to diversify the staff within the district, and the injustice that included some threats towards me and my family. I fought to include my identity on behalf of my children in the public schools by volunteering and doing various things which includes but is not limited to: reading stories, sharing Palestinian/Arab culture during school sponsored events, celebrating our holidays with others, and giving lectures to High School students addressing microaggression, biases, and shedding light on Muslim’s true reality which was a total contradiction to what they had been taught so far. Moving forward to 2015, I came to Iowa City and saw that regardless of the diverse atmosphere of the city and the large Muslim community here, our youth - especially the Muslim girls - are still struggling, parents are helpless, and the voices of those who are seeking justice, tolerance, and respect are neither loud enough nor brave enough to be heard and responded to. I couldn’t help but start the cycle again, and I put myself out there even more adamantly to better and save our youth and community. In 2018 I initiated the Mariam Girls’ Club (MGC) for Muslim young ladies with the aim being to to connect, unite, and empower them. The Club is a haven for our girls which allows and gives them the room to speak freely, to share their trouble, to connect with each other, and to feel the essence of belonging and giving. This club is set to empower young girls and to show them that they can maintain a dual identity while living in the United States. Fostering the feelings of camaraderie and support is a major aspect that we work on. MGC is here to tell our girls that we hear them, we love them, we will always be here for them, and we will grow with them. Besides MGC, I have devoted the last few years to serving the needs of the students at Al-Iman Weekend School at the Iowa City Mosque. While teaching and carrying out many responsibilities, I simultaneously advanced and prepared an Islamic Studies curriculum that suits the children’s age groups, and I initiated the Al-Iman Library which provides the children with what they need and with what is clearly missing from public schools and libraries: books that represent them within the pages. Through the years, I have been donating books to various agencies, and I have been at the forefront in supporting our children in all grade levels throughout the district. I have also been organizing and hosting fun social events for the Al-Iman School since 2018 and have since become the school’s official extracurricular activities organizer. As of January 23, I was appointed as the Head of the Social Events Committee at Al- Iman Center and have since organized by far one of the largest Holiday Prayer Congregation and celebrations for our Muslim community in Iowa City and the neighboring areas. The privilege of being born and raised in the beloved Holy Land - where our basic human rights were and still are denied by the atrocity of the occupation - obligates me to advocate for the voiceless, and it demands me to lay the groundwork to support others. So much work has yet to be done, and I refuse to be a bystander or to watch the daunting principles of assimilation and submission take over our humanity while plunging this nation into chaos. I am hoping that my work continues to shed light on the importance of co-existing without being forced to relinquish our spiritual and ethical principles or to fear repercussions and worry about being silenced. What is your present knowledge of each advisory board you are interested in? The Human Rights Commission’s recommendation to the City Council regarding the Racial Equity and Social Justice Grant funding and the Youth Human Rights Awards are two things that I was introduced to and became familiar with. I might not know much about the details of the work that this Commission has accomplished or initiated, but from what I do know, I am confident that this is a great group of people with like-minded principles that will tirelessly advocate for human and civil rights. Individual voices might not otherwise make it to the City on their own, but with the Human Rights Commission’s advice and collaboration we can eliminate and prevent discrimination city-wide. Viana Qadoura Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? Yes No (Optional) Demographic Information Viana Qadoura 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 Palestine Sexual Orientation Heterosexual Religion Islam Do you have a disability No Ethnicity Middle Eastern Race White Middle Eastern 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) Viana Qadoura 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. I Agree Viana Qadoura r Advisory Board/Commission Application FormrYppr° i y This application is a public document and as such can be reproduced and distributed for the 25 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: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. Date of Application 8/29/2022 First Name* Holly Last Name* Stevenson First Name ( Phonetic spelling ) Optional 3198008421 Last Name ( Phonetic spelling ) Optional Home Address* 4430 E 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* 3198008421 Email Address* hastevenson@optimaelifeservices.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? Occupation: * Director of Diversity, Equity and Inclusion 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 Demographics sectionof the application below. Male Female Experience and/or activities which you feel qualify you for this position: * I currently serve as the Director of Diversity, Equity and Inclusion for Optimae LifeServices. We serve over 40 of Iowa counties and I am based out of Iowa City. I have my PhD in Philosophy, focusing on social injustice, from The University of Iowa and I also have my MAs in Philosophy and Gender, Women and Sexuality Studies. I am published on issues pertaining to marginalization and intersectionality and I also offer a unique perspective being from the UX and also having an invisible disability. What is your present knowledge of each advisory board you are interested in?* At present, I am aware that this board is doing invaluable work to both spread awareness and education to all members of the community regarding their rights but also to promote social justice progress to make Iowa City a city that is advancing DEI initiatives and making them a priority. 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 Optional) 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 United Kingdom Sexual Orientation Straight Religion N/A Do you have a disability? Yes 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. How long have you been a resident of Iowa City? 1 year Occupation: Executive Director, Immigrant Entrepreneurs Summit 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 Demographics sectionof the application below. Male Female Experience and/or activities which you feel qualify you for this position: * I am the Executive Director for a nonprofit organization that works with immigrant and minority business owners to help educate and advocate for business success. We hold business summits in Eastern Iowa as well as in other parts of the Midwest to bring people together to support and encourage the immigrant entrepreneurial experience. Additionally, I serve as Branch Manager and Marketing Manager at Community CPA, a regional CPA firm that is an immigrant and woman -owned business, and which serves a large immigrant and minority client base. What is your present knowledge of each advisory board you are interested in?* I am interested in the Human Rights Commission. Currently, I know some of the members who were formerly part of the commission, and I know that it advocates for civil rights in Iowa City, as well as make recommendations for the 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. Attachments:Resignation CPRB - Vander Vegte.msg.pdf Item Number: 12.a. July 11, 2023 Community Police Review Board - One vacancy to fill an unexpired term, upon appointment - June 30, 2026. (Stuart Vander Vegte resigned) Correspondence included in Council packet. Applications must be received by 5:00 P.M., Tuesday, August 29, 2023. From:Stuart Vander Vegte To:Tammy Neumann Subject:Resignation from ICPB Date:Monday, June 26, 2023 7:59:13 PM ** This email originated outside of the City of Iowa City email system. Please take extra care opening any links or attachments. ** To the Iowa City Police Board, With sadness, I must resign from my duties on the board. I will be moving to Centerville, IA July 3rd and will no longer be a citizen of this fine town. It was a pleasure working with you all. Sincerely, Stuart Vander Vegte