HomeMy WebLinkAbout2006-12-12 Appointment
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NOTICE
THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING BOARD:
AIRPORT ZONING BOARD OF ADJUSTMENT
One vacancy. Unexpired + 5-yr Term
Ending December 31,2011
The powers and duties of the Airport Zoning Board of Adjustment are:
1. To hear and decide appeals where it is alleged there is an error in any order, requirement,
decision, or determination made by an administrative official in the enforcement of the Airport
Zoning Chapter.
2. To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which
such board is required to pass under the Airport Zoning Chapter.
3. To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning
Chapter as will not be contrary to the public interest, where owing to special conditions a literal
enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship,
and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Board meets at the call of the Chairperson.
Applications must be received by 5:00 p.m., Wednesday, December 6, 2006. The City Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application
forms are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be
directed to Randy Hartwig, Airport Commission Chair at 337-2101.
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in-
law, brother, sister, brother- in-law, sister- in-law, step-father, step-mother, step-
child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 0
Council Announcement Date: June 13, 2006; August 1, 2006; September 5, 2006;
September 19, 2006; November 14, 2006
Application Deadline: Wednesday, 5:00p.m., December 6, 2006
Council Appointment Date: December 12, 2006
AIRPORT ZONING BOARD OF ADJUSTMENT
One Vacancy - Unexpired + 5-yr Term
Ending December 31, 2011
Carl Williams resigned
No applications as of Wednesday, 5:00p.m., December 6,2006
00 Denotes applicant completed the Confidential page of the application.
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NOTICE
THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING BOARD:
AIRPORT ZONING COMMISSION
One vacancy - Six-yr Term
January 1, 2006 - December 31, 2011
Duties of the Airport Zoning Commission are:
1. To recommend amendments to the current Iowa City Airport Zoning regulations, including the
repeal thereof.
2. To recommend the adoption of new Airport Zoning regulations.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Board meets as required.
Applications must be received by 5:00 p.m., Wednesday, December 6, 2006. The City of Iowa
City encourages diversity in the appointment of citizens to boards and commissions. Persons
interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street.
Application forms are available from the Clerk's office upon request or on the City website at
www.icgov.org.
Questions about the Iowa City Airport Zoning Commission should be directed to Randy Hartwig,
Airport Commission Chair at 337-2101.
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in-
law, brother, sister, brother- in-law, sister- in-law, step-father, step-mother, step-
child, aunt, or uncle. (Resolution 85-354)
Males: 4
Females: 0
Council Announcement Date: September 20, 2005; November 1, 2005; December 13,
2005; January 23, 2006; February 28, 2006; March 21,
2006; April 18, 2006; June 13, 2006; August 1, 2006;
September 5,2006; September 19, 2006; November 14,
2006
Application Deadline: Wednesday, 5:00p.m., December 6, 2006
Council Appointment Date: December 12, 2006
AIRPORT ZONING COMMISSION
One Vacancy - Six-year Term
January 1, 2006 - December 31, 2011
Term expires for Mark Anderson
No applications as of Wednesday, 5:00p.m., December 6,2006
[RJ Denotes applicant completed the Confidential page of the application.
12-12.06
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I
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
BOARD OF ADJUSTMENT
One vacancy - Five-Year Term
January 1, 2007 - January 1, 2012
Duties: In appropriate cases and subject to appropriate conditions and safeguards, the Board
may make special exceptions to the terms of the Zoning Chapter in harmony with the general purpose and
intent of the ordinance and in accordance with general or specific rules contained therein. The Board may
grant variances to the Zoning Chapter only in the case of "unnecessary hardship." The hardship must be
substantial, serious, real, and of compelling force, as distinguished from reasons of convenience,
maximization of profit or caprice. The Board may also hear and decide appeals where it is alleged there is
an error in any order, requirement, decision, or determination made by a City official in the enforcement of
the Zoning Chapter.
Iowa City appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Board meets the second Wednesday of each month at 5:00 p.m.
Applications must be received by 5:00 p.m., Wednesday, December 6, 2006. The City of Iowa
City encourages diversity in the appointment of citizens to boards and commissions. Persons interested
in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application
forms are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Board of Adjustment Commission should be directed to Bob Miklo,
Senior Planner at 356-5240.
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Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in-law,
father- in-law, brother, sister, brother- in-law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 2
Females: 2
Council Announcement Date: September 19,2006; November 14, 2006
Application Deadline: Wednesday, 5:00 p.m., December 6,2006
Council Appointment Date: December 12, 2006
BOARD OF ADJUSTMENT
One vacancy - Five Year Term
January 1, 2007 - January 1, 2012
Term expires for Karen Leigh
Edgar Thomton III 00
631 Scott Park Dr
Elizabeth Kennedy 00
249 Haywood Dr
Frank Sutton Gersh 00
1041 Woodlawn Ave
Caroline Sheerin 00
807 Deerborn St
James Walden 00
312 Kimball Rd
00 Denotes applicant completed the Confidential page of the application.
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of
interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Retum the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME Board of Adustment
Youth Advisory Commission, Age on the date of filing:D Age 15 to 17 (or)
TERM: 5 Years
Signature of parent/guardian if Age 15 to 17:
D~e 18~21
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."AME Edgar T. Thornton III
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HOME ADDRESS 631 Scott Park Drive, Iowa City, Iowa
Is your home address (listed above) within the corporate limits of Iowa City?
How long have you been a resident of Iowa City? Three Years
OCCUPATION Director, Environmental Health & Safety ProQ EMPLOYER Kirkwood Community College
PHONE NUMBER: HOME 319-338-5579 BUSINESS 319-398-1029
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
My professional background includes nearly 20 years of government service in both federal and state level
government where my career has focused on public administration, environmental policy, and government
regulatory issues. Most recently (6-2002 to 9-2006) I served as the Deputy Team Leader of a 12 person urban
planning office for the U.S. Agency for International Development (USAID) working with cities in the developing
world with infrastructure, local govt operations and planning issues. In the past, I served as Deputy Cabinet
Secretary of the New Mexico Environment Department, as well as working as senior manager at the U.S.
Departments of Energy and Interior and the U.S. Enivormental Protection Agency. I each of these positions, I
worked closely with local governments in the United States on various types of planning activities.
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 1 of7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
This advisory board is empowered to hear appeals regarding Zoning issues.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
As I stated earlier, my past and current professional experience in government operations, permitting and regulatory
matters, urban planning and environmental issues will enable me to bring a high degree of understanding about the
topics discussed by the board as well as a keen knowledge of how to work with the general public.
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POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial interests and your dutieS to an emplOyer:
. particular, if you are applying to be a member of a board or commission which makeS recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
if you are uncertain whether a potential conflict of interest exists or haVe questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [Z] Yes D No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYes [Z] No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
,
'i
General Application
June 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
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:f~w!:~
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........ .. J
CiTY OF IOWA CiTY
Name of City
Board/Commission Board of Adustment
^ ./
Date / / I~ i 'I),C.
,
Name Edgar T. Thornton III
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
A;s,II.J:-:-
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C?
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. -;;;: 11
"...... -z. .
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NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature ~~ /: 71-. - ~.
Signature of parent/guardian if Age 15 to 17:
Address 631 Scott Park Drive, Iowa City, Iowa
~
-"
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 3 of 7
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
I! 1
-...,= -~...
~~W~~
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.....~
CITY OF IOWA CITY
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of
interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
. ADVISORY BOARD/COMMISSION NAME TERM: j YYS
Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or) 0 Age 1!!,to 21
- =
Signature of parenVguardian if Age 15 to 17: ~ ~~ ~
I
\JAME-Elr;?-o,beh,-- }(p tJCJeDY '-~;L :_~
HOME ADDRESS ().. r ~~~ 7~ L-.9'S"
Is your home address (listed above) .thin the corporate limits of Iowa City? ~ y;;[;No
How long have you been a resident of Iowa City? '3)' y< 'OM ~""" t,'l~ '1 .I,J ~:s -\v-b.Q.,
OCCUPATION ~;\ LlJL'(' Uv \litl ~L1 EMPLOYER _ 70, _.:.... ~ ~ vn I1A'\ rho
PHONE NUMBER: HOME 31'1Sq4-oG.Oc:, BUSINESS -;:a../>'I"-..f._
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
ro~re-n~ ~. tWo,W ~ ~ r>"' OJ;~ S"lM-P 1J~_
c~ ~ pli C(&J . ~s "'- QreJ::Mrt/tAl hsJic ~ J .::r~~
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elM' '''-jrvJ:seJfn fJ~,r" ~I~j,,,-~~~
. . " . / .' 4J -Jrrr
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Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 1 of7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
* \JOt!. 1 t!.JrJ5~ re.vi~/ <2.-01'\;\) v~~rl itl+i~ [n'flv.
~~()yro~ WteAP ,H ir~ L' aJ2 i s (J:~X S-~ ~ --
v D VM.\
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
:1. CttM. <<7~ ~. persf~d-i lff- cr& (A- y~ pelsoYZ Who
I,vtb tft '!?e(oW fu Nlr' ~ (,VlC()YV\Q vb ~ tv\.QA. OJ14
bOOc'{tJ ~. Vl>> vtfrt~.~~ ~ ~ i2~
tViULJ... I'm ~ 1D'1 J ~ _ b~ 1'- 41(,-g~~ seU fn
Vr ~o.- ~ ~e) i~ r/~ 111 fzfCL 0'0 0+ ~ttmv 1\
td-U ~ bo^-(~ NI-{/cD 0'iktN
<
rV\.
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial interests and your duties to an employer.
In particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 ofthe Code oflowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030. _;?;
t:;;;;:1
..-- .,..-"
~:~
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IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes [i1J.to;;; ',j
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSI6iij? [}res ~No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
o
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CJ
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Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 2 of?
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING.
I! 1
-...,.:. -~...
:t~W~'"
-.;::,... ...1IlI1'
....~
CITY OF IOWA CITY
Name of City .. ct~ A~' ~
Board/Commission Soo. v '. d
NameYli7Ab~ tL.K~NtJW'1
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
Date P./ 'f / {J h
( (
List all businesses in which you or your spouseldomestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
None
.
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.... co -n
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NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature ~~______
Signature ofparentlguardi if Age 15 to 17:
Address a y
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 3 of7
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
1 ~ 1
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~.. -::'~
....,........
CITY OF IOWA CITY
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of
interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the .
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME 6'0AIZ--j) D.f }\.\)jJ )\Jv1 f~ TERM: Jjl j07 -, II (/L
Youth Advisory Commission, Age on the date offiling:D Age 15to 17 (or) rn~ 18~ 21
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Signature of parent/guardian if Age 15 to 17:
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Is your home address (listed above) within the corporate limits of Iowa City? I2i Yes D. No
How long have you been a resident of Iowa City? ?) ~ 12-5-
OCCUPATION \\ '{ L Ii JL.Ofrt '>/ EMPLOYER 6f.f>'H I HII-rLiJ~r1 ~. ,,-;r-
. 3~ "7 .: '. nl.! L-l.,fg
PHONE NUMBER: HOME '.' 1- 7Li S ~ BUSINESS 3;; 0-11 Ie, 0
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
\ i-'-i'>JS S:~i.v~O DN \)-t E... H ()\Of2..lL {1~~f!;.iZ...vk1\ ~,"'-./
(:;:>JV' }Vi.\~)\ON l;i\2.. "\\1R-.t.. lCAF'>). 1\1f. (.0N\ivl t>.! I 0;'-" ) \...tlcf-
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H f\lLO;, H \ P 0 N m C- q~T of' H'oiVI ED w,">l ~ ~ iP IN<C ,::>.E.i\tcx.fr..LIN ~
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HOME ADDRESS 10 Y I . WJ-''>l)LA-w rJ
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Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 1 of7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
c.9 I"~ H/\"\jS- ~ ~-f\I--:> '\}<2 ,tv1f'rf'&f-.,f\-L '0N\')-IC c \ )'Y ~JE~IT~
f\-N)) TrI ~ NOll (S \ N m c f.~tQ. ff) r: kU'Jo vV .$() Mf.,01'J e
0N \)-'\e.:. g,0t'\i?D (l- .Hf\\i~ ''"\A1-iCr':;)IOThtU' (It.f.~::'c\J '
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
\,_ \ff Lj \\-/A \ 1\> A )5L)::,'N<2S.j 0f\JrJ2 KA/VD-'f?(\I1P.---{<...
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?_ \V ~ C (\'{ -\0 vv-Ad2= \TA:- uS S-TI ~ VL A-<. -F- .
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial interests and your duties to an employer.
In particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attomey's office.
You should also know that Section 362.5 ofthe Code oflowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030. . 0 ~
..-
j;
"-0
CD rJ fl l..T)
~- )
=~:'l c--:'
,- ,----
~";t~
r-q
n
I
0'
-'n
2:::
:"-l-j
l~'-l
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [J Yes ": "'i--lo ;;,
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~Yes BfNo
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
I! !
-....= -1Qo...
~~~!:~
~... .......'"
~t.L
CITY OF IOWA CITY
Name of City '.
Board/Commission IS '-, .1\Y-''0
rv::;?-A1N k "-,
Name ~' '>
J' !:l..-7-, \ ,,--fl.~" ,...,.-
~ I' V-I"'> \ ,-,r..-f'-J I
6 S+-i, Ii.
Date~~
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions" a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isatlached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
t,lZPI-l 1\.1.1\(4.1>" r-J ;r- }VS:J(...\ A~> 102.1 l20C He~Tf.? tW.
10"'-'1\ c\'S'i iA C 7.2-. L(\
. .
.
~
-,
~- 5':'"
:J> _~ r-ri -11
C")
0"
'. -'" ---
:! ';:...:. Tl
..:-'....., .-
r\:i~ ,
-,"- >.J
. ~';'/" .,
<:
.>' N
NOTE: A new form st be completed if the above information changes or an ownership interestis
acquired in an ad tional business. / ~
Applicant Signature -V- ~ t <;- (jt:/v- 6k
Signature of parenVguardian if Age 15 to 17:
Address (01.{ \ \r-bOi)L ~r-1 iN,) \o"..;A c I"\( ) (A '::,' 2.-2l{';' -
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application,
.
General Application
June 2006
Page 3 of7
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
\PPLlCATION FORM
I ~ I
-....= -~...
f~W~~
-..;:.... ......"
........_ "l
CITY OF IOWA CITY
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of
interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME ~a.r~ D~ ,A-ol jU.S+mt.lI\.... TERM: '2.OOl:f
Youth Advisory Commission, Age on the date of filing: D Age 15 to 17 (or)
Signature of parenUguardian if Age 15 to 17:
~ge 18~ 21
~~'Q ~
::. r-. il
'-. ~'
---;1.. ......
_r r-
,"- I: ,... - e^ ^ ' 'r" -0 :'11
NAME \"",O.('Du nt ~V\.c ,;.. 0 =J :Y. ('J
5/'-. - '<0,.
,10ME ADDRESS ~, 'DE:A-~~ ~", IO~ 0" Y I I A- itP ~
Is your home address (listed above) within the corporate limits of Iowa City? ~es aNO
How long have you been a resident of Iowa City? 51 I'ltC 'JU.\'6 '0_
OCCUPATION \Y\~~f O~ ~p..l "'/(:+\~ EMPLOYER tJ '" ~
PHONE NUMBER: HOME.C!A) 'SS-Lt-,\c.t'1 ../ BUSINESS (31~' ~"S- ql~L
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
"'t. W()"~d. ~ r ..II.... ~""r~ c:a.S Q.A """(S~Q.I"L'" ~f'po~
CO~~\~, ~~ C4",-\ cF c...\Mc..-{)o, T~ -\-i.o~ JDb, ~~~
oc. ~ c.o.Sc.c; "J: ~c:>('~e..d (J'tII. tt\V()lv~.:;.l ~Ol'\.i('l~ C'SCk.c.'(
't C;pe."'-"" Mo...,^,,~, ~I'\." h.o~'S wo(~i "q wi~ A.lk,..~
D..~ ci~ Y"~I GloU\.+S r'~ ~"" ot"-f-or+- +0 .....~d(".c. 'U)1"\1"'",
t~c:c.u.c.S, ~ C)..-. (l..V\o\\\,....... wi-\-h VUi~t\'~~ ~DN\ """','t~)' ""..,~
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 1 of7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
-r o.M o..u.JCV~ #\a..o\- -+'M. Boe..V'O( i~ UH,\"\"YI~ ,,~
CDrt'\yY\"",^~ ~ volv..~+--t..~ I ~OI... +-~ -t-k~ &c:l......,( l's
rtS~Ol'\4\y.( ~r (SC;W ^~ vw; Q.."',(..~. .
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
\+A..VI~ ~t>'~+ ~~~ ~()l.A./S WC)t"; ~~ wi0\-4-.
lDMVlfI.""-\"\,.l\~ 'diD"",,?';, c.c",^M"",~i ~ '~"lrS, ~ell.f..l(Jp'
-v' ~ ~~ C\ ~ V"e.~~o.l~~+<;, :r o..~ V(..l'~ ~ 'Ol.r
WI't"lt\ ""Z.DM ~ (C; ~~e.C;. l oj c:..o OA../ pre..&A ~ +tv-
..t..w'oH """ ~ CJl-.I'\.t'l €Lt ~II\.Goi<<.l . \l'\ 1I.e";'~ ~
~'a p.t.O('<.J.. ~~ ~ ~~t-e.. ~ ~\ ~ ~
~~'Dc.\..~ ~ou..lol \:..Q ~ a.S~'" "' ~ Bozvrot.
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests,induding financial interests and your duties to an employer.
In particular, if you are applying to be a member of a board or commission which makes recommendations tothe
ity Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" indudes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030. 0 ~
j:; '- ,
,--.., -<
'-. .->
=~(~,
..~/ I
-- '"n'
=
rr~!
c-:o
I
'"
11
,.-.-
,
-0
Tl
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~Yes :No 7:" '.J
00 YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? o:>r'es ~
(It has been Council policy not to permit an indMdual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 2 of?
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
I ~ I
~~=-=IIt...
~~q!ll'"!.
...:::... "III'~
.......- ~
CITY OF IOWA CITY
Name of City r.t - - - I' A"
Board/Commission U()lJ.""d. l)t <<ju.S+ \'rttJ1.+
Name ~~ol;"t ~~4!.r;"
Date~
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please Indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
t\lO~
'::-0
'-d c-,
:s. ,--,. ""
C;:" "--1
-- --.! -
'-) . -'-!
--<::~ .~ ;-,-,
0"; '+, ::.i: r~\
r :::.':!.
~ -
..
- -
.s:-
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature ~v1..{.
Signature of parent/guardian if Age 15 to 17:
Address~6A,e &tfU\1 Sr. low,4 (lTI' lo"-'A ~.z.2."'O
"
J~
,
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 3 of 7
- -~-~._~-,--_._..~"----~----,------_._---'--------------'-~'-
r'!'
~!i: ',,!
'J\.t.t., (-\i-i'\/ ~'1\^11
I ,'., ". ,.'" " ' ...' ~ ,{ \
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of
interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
I! I
-....= -4
!~ai;!:*t
~.. .......,:.!P.i, ~
'ilIII1::m..~
...... ..
CITY OF IOWA CITY
CITY OF IOWA CITY FII F-j
ADVISORY BOARD/COMMISSION . I.. L
APPLICATION FORM ZOGfl DEe -6 PH 4: 56
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME
BOCdd et AJj~,;t.....",,,,,-t-
TERM:
Youth Advisory Commission, Age on the date offiling:O Age 15 to 17 (or) 0 Age 18 to 21
Signature of parenUguardian if Age 15 to 17:
u-Jq.-v"l a. s
We.. \ J~V1
NAME
.,.
-:AI 2. K ,~ l., ~~ H R d I <l (, +-.., ZIP
HOME ADDRESS C/ ..J.
Is your home address (listed above) within the corporate limits of Iowa City? [1] Yes
How long have you been a resident of Iowa City? I 7 7 € e; or s
OCCUPATION T a a. c L, ",01" EMPLOYER
PHONE NUMBER: HOME "3 1'1 3;-1.\ '-I" '-f I BUSINESS
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
S-2Zt..f~
ONO
I"" c::+ S,\".9.91",
'1
l'VI4'" '1
c~ +" .
'1 €.".,r S
a"'.J [.., '" s
"",1...0 lit A 5
,."" ;...-+".,....s-+
l,v<Z.J '''' Lp"",,,,
\Y1 fhe; 1r'"vJ-h.
C. +-1 +"".-
0+ P"'''-v
\ C.t IN'>
C\ (".o...-"\'1.ttowV\4t,-v
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
k",OoN
0..11
b.<< $; < a ( 11
e)l r--\ A:.....zlr
w""4.+ tt..c lo.""...-J "\","",5, Tl-1.e 1..P6...J'S
t? """,,/2.. 14'1. 4. ~u'f/"rev\.+ t...N'I-cE'...V'1- k>>~".-...
f-iAll'1~ +:.~ 1'1
vJ E... S
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)? .
A~' {j t e 4 , h .It<t (..\ -\ : ~ '" '" " '" ,,1 h.r...... ~ <' oN v> JZ or.. (
I
1,1<1.I? "'......- C~+1
. t .. j~ r&
C 1 , z. ~V\ $
..
1>"OvJ ,.....
u. Cc P'4Vl + .
'" vo./'"1 tl.....+ -t4ks th..e
+.~'" I +).,"'+ 1 Ce......
....eels ..f ...11
""
0 ~,
C..:;;;;:'
<::;: "'"
<.0 0
)-~ =:: Pl il
C'
") I
--1 C 0'
../ r . m
. '.
n , -0
::::J ~ :-,
r. '-.,J
'J 7-~
-< .;::-
)> Ul
u,
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial interests and your duties to an emp.loyer.
In particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 ofthe Code oflowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356.5030.
I Io,ave ..,'" f'",tc!'''+''''[ cc",+I~..-h ...f- ~..+e<esT tl.4T 1<:",..,-" 0+.
.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes D No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYes es:J No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
I ~ 1
-,..= -~
!~~!:'t
-..;;;.... ......,~
..... ____ l
CITY OF IOWA CITY
Name of City
Board/Commission
Be<<.d
g+ Ad).....-I'" ...~..-r
Date
I 7- / 0 '5'"/ c (.,.
Name
J (, "'" c S W <. \ J...........
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
\1 ,:1", e...
,....,
Q =
en
~'::.-:. f;i --~
(.-" ~....I
.
I ...-
~
-::!\>~ v :T1
fY\ 3! ti
--:=:: --r-: --""
.....::;./'-. ~
..".
)> ~
NOTE: A new form must be completed if the above information changes or an ownership interestis
.".Im' ,. '" .dd"o~1 g
Applicant Signature ~~
Signature of parent/guardian if A e 15 to 17:
Address '3 \ 2- K\o'1'1 to """ \{ 12 J: {p,,-,"-, '"
c~
s- "2. ,. '-\ S-
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 30f7
c::J
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
BOARD OF APPEALS
One Vacancy - Five-Year Term
January 1, 2007 - December 31, 2011
It is the duty of members of the Board of Appeals to hold appeal hearings on matters concerning the
Uniform Building Code, Uniform Plumbing Code, National Electric Code, Uniform Mechanical Code,
Uniform Fire Code, the Dangerous Building Code, and the Iowa City Housing Code. Members must be
qualified by experience and training to pass upon matters pertaining to building construction.
Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa
City. The Board meets the first Monday of each month at 4:30 p.m. or at the call of the Building Official.
Applications must be received by 5:00 p.m., Wednesday, December 6, 2006. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions regarding the Board of Appeals should be directed to Tim Hennes, Sr Building Inspector at
356-5122.
Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in-law,
father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 6
Females: 0
Council Announcement Date: September 19. 2006; November 14. 2006
Application Deadline: Wednesday. 5:00 p.m., December 6, 2006
Council Appointment Date: December 12. 2006
BOARD OF APPEALS
One vacancy - Five Year Term
January 1, 2007 - December 31, 2011
Term expires for Stephen Buckman
No applications as of Wednesday. 5:00p.m., December 6,2006
o Denotes applicant completed the Confidential page of the application.
CJ;J
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
HUMAN RIGHTS COMMISSION
Two Vacancies - Three-Year Terms
January 1, 2007 - January 1, 2010
The duties of the members of the Human Rights Commission are to receive and to determine the
merits of human rights complaints alleging unfair or discriminatory practices in the area of employment,
credit, public accommodation, education, and housing. The Commission shall provide conciliation and the
enforcement necessary to further the anti-discriminatory goals of the Human Rights Ordinance and to
protect citizens from unfounded charges of discriminatory practices.
The Iowa City Human Rights Commission has an obligation to investigate and study the existence,
character, cause, and extent of discrimination in Iowa City in order to eliminate discrimination by
education, conciliation, and/or enforcement. It is also the duty of the Human Rights Commission to draft
revisions to the Human Rights Ordinance if necessary to eliminate prejudice, intolerance, bigotry, and
discrimination.
Iowa City-appointed members of boards and commissions must be eligibie electors of the City of Iowa
City. The Human Rights Commission meets once a month at 7:00 p.m.
Applications must be received by 5:00 p.m., Wednesday, December 6, 2006. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hali, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Human Rights Commission should be directed to Stefanie Bowers,
Human Rights Coordinator at 356-5022.
Board or Commission: Hnman Rights
ATTENDANCE RECORD
YEAR 2006
{Meetin ' Date
TERM .
NAME EXP. 1/24 2128 3/28 4125 5123 6/27 7/25 8/22 9/26 10/24 11/28 12119
Lisa Beckmann 1/1/07 X X X X NMN X X X X NM OlE
Q
Paul Retish 1/1/07 OlE X X OlE NMN X X X X NM X
Q
GeoffWilming 1/1/07 X X X X NMN OlE OlE X OlE NM X
Q
Sara Baird 1/1/08 X X X X NMN X X X X NM X
Q
Bev Witwer 1/1/08 X X X X NMN X X X X NM X
Q
Scott King 1/1108 X X X X NMN OlE X X X NM X
Q
Martha 1/1/09 X X X X NMN OlE OlE OlE X NM X
Lubaroff Q
Sehee Foss 1/1/09 X X X OlE NMN OlE OlE X OlE NM X
Q
Kate Karacay 1/1/09 X X X OlE NMN X X X OlE NM X
Q
KEY:
x = Present
o = Absent
OlE = AbsentlExcnsed
NM = No meeting
--- = Not a Member
NMNQ - No meeting, no quorum
3
Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in- law,
father- in- law, brother, sister, brother- in-law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 1
Females: 6
Council Announcement Date: September 19,2006; November 14,2006
Application Deadline: Wednesday, 5:00 p.m., December 6,2006
Council Appointment Date: December 12, 2006
HUMAN RIGHTS COMMISSION
Two Vacancies - Three Year Terms
January 1, 2007 - January 1, 2010
Term expires for Paul Retish, Geoff Wilming
Sherry Hunter ~
1060 Scott Park Dr #207
Eric Berger ~
25 N Westminster
~ Denotes applicant completed the Confidential page of the application.
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSIO~i
\PPLlCATION FORM r '-
20(].)I:),: i 3 Pi~ I: [) 4
Individuals serving on Boards/Commissions play an importarl:ih,le in,'!lfu'~lfl9 the Council on matters of interest
to our community and its future. Applicants must reside iniQ9~\qty.r( i~YN,A.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDFl.
Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
I! 1
~&~-;~
~~.
....111.
CITY OF IOWA CITY
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE
PUBLIC, WITH THE EXCEPTION OF THE lAST PAGE MARKED 'CONFIDENTIAl,' THIS APPLICATION Will BE
CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICAllY CONSIDERED FOR ANY VACANCY DURING THAT
TIME.
ADVISORY BOARD/COMMISSION NAME iltI/YWAY_J.'JJ4~ &".;4/1#},
NAME ~J.i."'~,L: -:::~r fA.. 1)
HOME ADDRESS /~ ..!$-.... L<5 I'~ A""'" dlJdy
TERM
g~.
Is your home address (listed above) within the corporate limits of Iowa City?
How long have you been a resident of Iowa City? / ~nnti;
~Yes
ZIP ..G~_.y $'
DNo
-'=-
OCCUPATION
lONE NUMBER: HOME 464/- 4'/?~ Y&~d2..
EMPLOYER
BUSINESS
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: -.". -
"-
.... -
8. /J. tf~dlU?~-d./ ~J:...&b ~-t.- - N
.~h.d/ ~A.) )<iR~~ ~0J2R1f' t?A-4.f1?~
L{Y<--t) ~Mn-<? ~~ ~~ ,
dd-<~~-()'4Z;/ ~/ yf)--L~--") ~y,a.c-i<L~~.d----, ,--ta7 J:~-' t:"
J.L~~ J .~--e'L<!:~ O-~<cdJ ~-<'L.#f-<,~/ AJZ~~~
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
W ~7; ~t:-Oc-</J 1;/ p<<Z;-GJ4/ ~ .--I2-eLL-te'./ tV
...,LAbdb--d..-/ ~~~ y~ ~~~~ ~h
~~ ~ ~'&"r?: '
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all the questions, Council may not consider your application.
Human Rights Commission Application
June 2006
Page 1 of8
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING)?
..2'0 ~~~<'_/ -4LeA--e../ ...../-4?~~L-c->L-e~ !f ~/
LpA(")q(tfX4/.? ~i~7~.k--e~ a-*dJ dn-<<~xr:
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~-1t'*!.n.L--<.eA<1" ~_U.-dA~->Y--e:/ ~ _7/>JY ~./-7U4/M.~1-.
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal interests,
including financial interests and your duties to an employer.
In particular, if you are applying to be a member of a board or commission which makes recommendations to
the City Council about the allocation of City funds, please list any present affiliations you have with agencies
that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.
I'1ther types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that 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. A copy of
Section 362.5 is attached (see page 7).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the
Code of Iowa, please contact the City Attorney's office at 356-5030.
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IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? DYES MNO 5;2512 ---.J
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DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~S [gJ NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all the questions, Council may not consider your application.
Human Rights Commission Application
June 2006
Page 2 of 8
BOARD, COMMISSION, & COMMITTEES
BUSINESS LISTING
I ~ ..6.....
~
CITY Of IOWA CITY
Name of City ^ // /7 '
Board/Commission . <a" ~Ad ,,(::~_.L.-cvk'.b
Name ~/;At: L M-/--K~AJ
Section 362.5 of the C de of Iowa generally prohibits, with certain important exceptions, a member
of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5
is attached (see page 7).
~,
Date
/~ - t)-t"J<b
List all businesses in which you or your spouse/domestic partner have an ownership interest (for
example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there
are none.
BUSINESS NAME BUSINESS ADDRESS
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/ \ / ./ ,
/ \ / ...-
/ \ /
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/ '(
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NOTE:
A new form must be completed if the above information changes or an ownership interest
is acquired in an additional business, 0-- ~
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Misrepresentations on this application will constitute just cause for removal of a~ppoint!te.
If you fail to answer all the questions, Council may not consider your application);: ;;,
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Human Rights Commission Application
June 2006
Page 3 of 8
TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY
Effective March 8, 2006
Household 30% Median Income 50% Median 60% Median 80% Median Income Median
Size (Poverty Levell Income Income (low income) Income
1 $15,250 $25,400 $30,480 $40,650 $50,800
2 17,450 29,000 34,800 46,500 58,000
3 19,600 32,650 39,180 52,300 65,300
4 21,800 36,300 43,560 58,100 72,600
5 23,550 39,200 47,040 62,750 78,400
6 25,300 42,100 50,520 67,400 84,200
7 27,050 45,000 54,000 72,050 90,000
8 28,800 47,900 57,480 76,700 95,800
ATTACHMENT TO APPLICATION FOR THE
HUMAN RIGHTS COMMISSION
It is the mission of the Iowa City Human Rights Commission to protect residents of the city from
discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city
strives to ensure that the Human Rights Commission is representative of the community.
Therefore, "appointments shall take into consideration men and women of various racial,
religious, cultural, social and economic groups in the city.' lOrd. 94-3647, 11.8.94)
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OPTIONAL: ;Eo ::'
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PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDt6WHEN'
CHOOSING AN APPLICANT. =i c; Z;
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~ Age (1 J1./t.t~.nJ 1;:ae!fgiOr'i7"
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I M~1Jl I Sexual Orientation
o Other (Please explain below)
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,
I Race, color
or ethmc group
I National origin
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Jman Rights Commission Application
June 2006
page 4 of 8
Sherry L. Hunter
1-641-919-7542
huntercom8088@yahoo.com
Obiective
Being a part of the challenges and growth of Iowa City by serving on the Human Rights Commission
Oualifications
Published Author - newspaper articles, short stories, press releases, poems and my first novel was
published April 2006
. Communications - written and verbal Accomplished public speaker - Competent Speaker
Certification Toastmasters International
. Sales - Exceeded company goals both in newspaper and telecom positions
. Marketing! Advertising - Prospecting, cold calling, built lucrative client base -annual sales of
$900,000.00, advertising design and layouts
. Public speaking and presentations - Wrote and conducted professional seminars
. Public relations - Wrote press releases
. Goal oriented - Exceeded monthly sales goals
. Self-motivated - In outside sales I used my down time to call on prospective clients and cold calls
. Organizational skills - Years of experience as office manager, administrator and ran my own
telecom business as an Independent Agent
. Excellent people skills - Outgoing, motivator and team player
. Computer Literate - Word, Windows 95, 98, XP, Excel, Adobe, Outlook Express, Fax and several
in-house software programs with database
Exoerience
:z005 - :z006 - Vision Technology - Retention Sales/Quality Assurance - Responsible for speaking with
customers, explaining benefits of products and sales. QA-responsible for listening to recordings, post
fmdings to spreadsheet and mail merge.
:z003 -:zOOS Receiving a residual income from Primus Telecommunications allowing me to finish my
novel. PublisbAmerica, LLLP has acquired the rights to publish.
1997-:Z003 Primns Telecommunications Fairfield, IA Independent Agent
Responsible for telecom sales, marketing, advertising, building client base both residential and business-
domestic and international, customer service and administrative duties. Built a client base from zero to
$900,000.00 in annual billing.
1995-1997 Mt Pleasant News Mt Pleasant, IA Account Manager
Responsible for newspaper advertising sales, building and maintaining customer base, layout and design of
ads, meeting critical deadlines, customer service and administrative duties. Increased sales by 15%
1993-1995 Douglas County Sentinel DouglasviUe, GA Account Manager
Responsible for newspaper advertising sales, building and maintaining customer base, layout and ~ign of 0;.-;
ads, meeting critical deadlines, customer service and administrative duties. Exceeded monthly bu~t~oals ~
and increase sales by 10%. )';: ~ ~
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Education
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1989-1991 Iowa Wesleyan College B. A. Communications
Dean's List and Blue Key National Honor Society
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CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest
to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF).
Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE
PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE
CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT
TIME.
ADVISORY BOARD/COMMISSION NAME --I:1lA.fV\t1[ f\ \' 1'j~t.J . TERM )'c{Il.) ~JX/f
NAME Eri(~ Ee~~~f'
HOME ADDRESS , s N-! W' e--..st fh ~ n si f/ r , -rotv~'~
Is your home address (listed above) within the corporate limits of Iowa City? Yes
How long have you been a resident of Iowa City? _I ~ ~ e.C1 f'.J
OCCUPATION~l'O -.? f'4 111 r, fA!'. EMPLOYER
PHONE NUMBER: HOME ]. I ~ .1...SLl "SS T l BUSINESS
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EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ....~ p
A-n ll\te-rc..st l(\ hGt~C{8) (,iS~ J. lS.s~eJ'~5( :;;: .J
f'\ e. r: be." A-l>l~e-s t i j... ni.e..tnc:d- lOna. \, .}> ~
ACL\Ve it) t~e. C-L10\pql/)i1 fo~ D.ctV'fvtf'. .
o r.~0 V\ \' t t ~ q 1'11111 to f' Dart' qr I Vl ::Lower C I t1,
iX&" q ?f'CS c ryL c;--t l'Ur) 0 n DCtd''f1.(' cd fl11 c..hC/[fc~,
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WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
:I bc\('cV~ -t~ t €JcJ
O~ HC4Y1 C{CI) r\'5~ t ~ lS )Gttf
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all the questions, Council may not consider your application.
Human Rights Commission Application
February 2005
Page 1 of 8
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR.
APPL YINGl?
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--L ViCtue C{ l{~t--tCP1e- l/l14't';f- 10
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i Vy.{ e-( eJ i-ei\ 1\ --t he- p ('0 1'1 I) f { '01 tif
fCv(" r \ \. 1-,''< d;J f'd'<ad. 'ff <;, ,
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal interests,
including financial interests and your duties to an employer.
In particular, if you are applying to be a member of a board or commission which makes recommendations to
the City Council about the allocation of City funds, please list any present affiliations you have with agencies
that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.
Other types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that 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. A copy of
Section 362.5 is attached (see page 7).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the
Code of 10'!Y', please contact the City Attorney's office at 356-5030.
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IF YOU ARA-JOT SmCTED, DO YOU WANT TO BE NOTIFIED? \:SJ'ffs DNO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES ~O
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all the questions, Council may not consider your application.
Human Rights Commission Application
February 2005
Page 2 of 8
BOARD, COMMISSION, & COMMITTEES
BUSINESS LISTING
It.
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..... ......
On OF IOWA On
Name of City ~ ' ~t. P If JoG
Board/Commission , 4 fVl.0~ ~ Z \ Date '- , ~ f
Name F ~ ---IS_ r _
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. A copy of Section 362.5
is attached (see page 7).
List all businesses in which you or your spouse/domestic partner have an ownership interest (for
example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there
are none. ;1j()hr i -
BUSINESS NAME BUSINESS ADDRESS
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Signature
ve information changes or an ownership interest
NOTE:
Address
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Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all the questions, Council may not consider your application.
Human Rights Commission Application
February 2005
Page 3 of 8
TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY
Effective February 11. 2005
Household 30% Median Income 50% Median 60% Median 80% Median Income Median
Size {Poverty Levell Income Income (low income) Income
1 $15,250 $25.400 $30.500 $40,600 $50.800
2 17,400 29.000 34,800 46,400 58,000
3 19,600 32,650 39.200 52,200 65,300
4 ...:t" 21,800 36,300 43,600 58,000 72,600
5 u ~3,500 39,200 47,000 . 62,650 78,400
r6 .- r" C25,250 42,1 00 50,500 67,300 84,200
ill 0- 'i.!" 27,000 45,000 54,000 71,900 90,000
-8 cO ,_) :28,750 47,900 57,500 76,550 95.800
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ATTACHMENT TO APPLICATION FOR THE
HUMAN RIGHTS COMMISSION
It is the mission of the Iowa City Human Rights Commission to protect residents of the city from
discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city
strives to ensure that the Human Rights Commission is representative of the community.
Therefore, "appointments shall take into consideration men and women of various racial,
religious, cultural, social and economic groups in the city." (Ord. 94-3647, 11-8-94)
OPTIONAL:
PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN
CHOOSING AN APPLICANT.
~Age
/'f1C1k~
L1J 111) t -
I Religion
I Disability
I i1 I Gender
~o~tf.:~b~
~O I Sexual Orientation
./~/!J.,((t-L
I Race, color
or ethnic group
~6- 1.UV crl'CZihNational origin
D Other (Please explain below)
Human Rights Commission Application
Febtuary 2005
page 4 of 8
CITLJ
NOTICE
THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING COMMISSION:
PARKS AND RECREATION COMMISSION
Two Vacancies - Four-Year Terms
January 1, 2007 - January 1, 2011
The duties of the members of the Parks and Recreation Commission are to recommend and review
policies, rules, regulations, ordinances, and budgets reiating to parks, playgrounds, recreation centers,
and cultural functions of the City and make such reports to the City Council as the Commission deems in
the public interest; to exercise broad responsibility for the development of parks, recreation centers,
playgrounds, and cultural facilities to serve the City--inciuding the creation and appointment of advisory
groups to make studies.
Iowa City-appointed members of boards and commissions must be eligible eiectors of the City of Iowa
City. The Parks and Recreation Commission meets the second Wednesday of each month at 5:00 p.m.
Applications must be received by 5:00 p.m., Wednesday, December 6, 2006. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Parks and Recreation Commission should be directed to Terry
Trueblood, Parks & Recreation Director at 356-511 O.
Parks and Recreation Commission
November 9, 2005
Page 7 of 7
P ARKS AND RECREA nON COMMISSION
ATTENDANCE RECORD
YEAR 2005
TERM
NAME EXPIRES 1111 2/8 3/8 4/12 5/10 6/7 7/19 8/9 9/13 10111 1118 12/13
Craig
Gustaveson 111107 X X X X X DIE DIE X X NM X
Judith
Klink 1/1/07 DIE X X DIE X X X X X NM X
Margaret
Loomer 111108 X X X X X X X DIE X NM X
Ryan
O'Leary 1/1/1 0 X X X X X X X X X NM X
Matt
Pacha 1/1/09 X X X DIE DIE X X DIE X NM X
Jerry
Raaz 1/1/08 X X X X X X X X X NM X
Phil
Reisetter 111109 DIE X DIE X X X DIE X X NM X
John 1/1/07
Watson X DIE X X X X X X X NM X
John
Westefeld 1/1110 X X X X X X DIE DIE DIE NM DIE
KEY:
X=
0=
DIE =
NM=
LQ=
Present
Absent
Absent/Excused
No meeting
No meeting due to lack of quorum
Not a Member
Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in- law,
father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 6
Females: 1
Council Announcement Date: September 19, 2006; November 14, 2006
Application Deadline: Wednesday, 5:00 p.m., December 6,2006
Council Appointment Date: December 12, 2006
PARKS AND RECREATION COMMISSION
Two Vacancies - Four Year Terms
January 1, 2007 - January 1, 2011
Term expires for Craig Gustaveson, Judith Klink
Craig Gustaveson
2603 E Court St
1RI
(Currently serving 2nd term)
David Bourgeois 1RI
1477 Buckingham PI
Clay Claussen 1RI
2145 Palmer Circle
1RI Denotes applicant completed the Confidential page of the application.
CITY OF IOWA CITY
tDVISORY BOARD/COMMISSION
APPLICATION FORM
I ~ j
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~~W!:~
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of
interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME~e-t:- J ~( (Q WI /'11 J 551Ft TERM: H-07- It II-II
Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or) D Age 18 to 21
Signature of parent/guardian if Age 15 to 17:
NAMEf~~ hu"iTItJE50rl
HOME ADDRESS ~bo 3 E (oc<aT
ZIP 5dd~/
Is your home address (listed above) within the corporate limits of Iowa City? [lj Yes D No
How long have you been a resident of Iowa City? '6:S 'f-S . .
OCCUPATION ~, - AI.I">"f'",- ~.,_~ CJl!"fhe;,; EMPLOYER &T'rJ Bklzl:- tZ/l1'4
PHONE NUMBER: HOME 3',)-'is'3g:.y BUSINESS 337-</97/
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
d.. 4c, vnS I\IL'?- <1 ~(.
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Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
-t-\A~ ":X (' Il <- Co ~ Ct'i:> -\ d-. -r' Q..
5c'{u<cJ Z- -C'u.-L\ -\.e."",S
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
.~
COr>.-\,,,'-U'd l0-\-.cr~S-+ 1 ~ -'(Qfl>(';:> 1> d-ej('lcJ?,/~ n..ec.D
a...1K-(\v.RS ~iL \2.-e.c I?- <C~-\ 10\'\ C;
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial interests and your duties to an employer.
)In particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. . Affiliation" includes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362. 5 of the Code oflowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Se.c~on 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030. Q 2:~
-~:; ( ~
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IF YOU ARE NOT SELECTED, DO YOU WANT TO 8E NOTIFIED? [K] Yes []I No ':'? -
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSIO?r? ~es B No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 2 of?
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
I! I
-....= -liQ'...
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-..::.... .....,
...... ..
CITY OF IOWA CITY
Name of City 2 \/ ~
Board/Commission f::W::'L ct e'C
NameC\<A\S c:::.~-\ei.v-eSc;l\
(0IYVY\65/M
Date ;I~ I \~ 0 G"
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate ifthere are none.
BUSINESS NAME BUSINESS ADDRESS
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NOTE: A new form must be completed if the above information changes or an ownership interestis
. acquired in an~d' nal bUSi~S. 11
Applicant Signatu ~ ~
Signature of paren rdianiiAge 15 to 17:
Address d-~O~ E C+ S1-. ~c. C:::;cl.~..\l )
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
.
General Application
June 2006
Page 3 of7
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
I! 1
~~~~'t
-.;:::.... ~..~~
...... ..
CITY OF IOWA CITY
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of
interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS Y AND AUTO~.T1CALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME. )! ~ /'
ADVISORY BOARD/COMMISSION NAME (jz .c ~ 'Pt?tf. CA TERM: t..j '/ /C
Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or) D Age 18 to 21
Signature of parent/guardian if Age 15 to 17:
'l^ME ~vld h: ~t3dur'1et
HOME ADDRESS /411 (5C1.C f::Pv11
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ZIP 02. 2'-/0
DYes D No
Is your home address (listed above) within the corporate limits of Iowa City?
How long have y~eeJ1 a Fesi~t of Iowa City? 10Ct e$""-
OCCUPATION <f:.~ tfe & EMPLOYER
PHONE NUMBER: HOME"35'7' (it?17 BUSINESS ~
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
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~:5 ~At-U'1 .C 'ftttiCi7zd.i?u '0--1\ 4 ~Q.-tiZoI1 t1,cC,
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Misrepresentations on this application will constitute just cause for removal of an a~~~te~ yo~-tail
to answer all the questions, Council may not consider your application. )> 0)
-.J
General Application
June 2006
Page 1 of7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
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fo (/ '-I t1 {{<,
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO T IS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?,
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POTENTIAL CONFLICTS OF INTEREST " '.. 0' -;'1
Please identify any potential conflicts between membership on the advisory board' '@nd ~r ~ryonal
interests,including financial interests and your duties to an employer, 0 =,,: N
.,.:;." .-
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)1 particular, if you are applying to be a member of a board or commission which makes recommeneations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City, "Affiliation' includes being a board member or employee of the agency,Other
types of affiliations must be examined on a case by case basis by the City Attorney's office,
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You should also know that Section 362,5 oftheCode of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract A copy of Section 362,5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030.
I
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? gJ Yes D No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYes rn No
(It has been Council poliCY not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
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CITY OF IOWA CITY
Date Is;~j<o
Name of City
Board/Commission
~ (? t:i \oJ t<ea:'fCl~(M) ~ '
Name
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions. a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
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Applicant Signatur
Signature of parent/guardian if Age 15 to 17:
Address
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 3 of7
From: ClayClaussen@aol.com [mailto:ClayClaussen@aol.com]
Sent: Wednesday, December 06, 2006 2:58 PM
To: *City Council
Subject: Application for Parks and Recreation Committee from Clay Claussen
This correspondence will become a public record.
Dear Iowa City council member.
I would appreciate your consideration and support in my application for appointment to one of the current
openings for the Parks and Recreation Committee. As the former Director of the Rockwell Employees
Recreation Center, I helped create and operate one of the largest and most well-recognized on-site
wellness/health promotion/filness/recreation/rehab programs in the entire country. I am now a Realtor and am
committed to helping our community remain one of the most desirable places to live. I have been a long-time
resident of Iowa City, left to pursue job opportunities, and have returned permanently with my wife, Vicki, to
help our four children raise our grandchildren.
Please feel free to contact me to discuss my qualifications and any issues of concern.
At your service,
Clay
Clay Claussen, REALTOR, CBR
REIMAX Real Estate Centre
1121 Shirken Drive
PO Box 189
Iowa City, IA 52244
Cell: 319.331.9911
Office FAX: 319.337.4431
Homel Home FAX: 319.351.HAWK(4295)
Licensed to sell real estate in the State of Iowa
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12/6/2006
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Real Estate Centre
Clay Claussen, CBR
REALTOR
1121 Shirkcn Drive PO Box 189
lovl<t City. lol'l;::! 52244
Direct (319) 331.9911
Fax: (319) 33/-4<131
clilyclausscn:(i'iJolcom
IOlfla-cily-i<l-tlOmcs.e-agenl biz
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CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of
interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk. 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC. WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME ~vk~ J- l2..e.c..y.u:-+':O,,", TERM: 1/1/01- .) I }J l
Youth Advisory Commission. Age on the date offiling:D Age 15 to 17 (or) D Age 18 to 21
Signature of parent/guardian if Age 15 to 17:
NAME c.. \\ C \o.......s ,S,<-'-'
HOME ADDRESS 2..ILfS- P...{~ Qy",(~ ,/0";4. G....-*(-IlJ' ZIP S2-2-I.{O
Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes D No
How long have you been a resident of Iowa City? ov<...".. 2S- ,U'v ~
OCCUPATION (2.eA-I+ov EMP(OYER lZt=/mM 7<.u1 .f.r-Mc.~
PHONE NUMBER: HOME 'L~ / '1 -.3 s-l-lf 2.11 S- BUSINESS ..31'1 -.1 J' - 'i '11/
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
o l1~v 2,.D 1 (.Air J ;... * +- ./-k$-n IIV~ I J....-e..,I.:?i.fyy...".... o-./.. oj ",..;
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Misrepresentations on this application will constitute just cause for removal of an app~~. If~U fi!rit"
to answer all the questions, Council may not consider your application. 3>':'
General Application
June 2006
Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
/-l- o'J e........ JV'.IUV7 b.~ -l-L~ ()vov-<,.L,.,. ;"'c)""* ........P..-.J~
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
I t............ bvJ J.............,I~, c-y-+,...J.-\,........ t.-O,,-~k e..~ '- J"--::\
J--e..J-<."-<. -h .t--- e.. (jOJ.~.~ i.....--PfA-LV\'-(... ,'...... (J'vov/.Q..<j ~<""'h'k..
{PM/?' ~ k~v~o", {JV"~:r"~ oJ- ~*~~/.,- "--
~:s-""'J.
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial interests and your duties to an employer.
In particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attomey's office.
You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Se~on 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030. 5;;2 ~
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IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes ~o
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? D Yes I0' No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
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..... - --
CITY OF IOWA CITY
Name of City I? -:1 J .
Board/Commission (J c.. v /?J J.- /Ce.c-v L...:?'"t.:l "'-
Date /2. - ~ - D!.c
Name
C.\
C-\ 0.. <..A J k "'-
Section 362.5 of the C de of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
BUSINESS NAME , BUSINESS ADDRESS
eCG (JIvo L.--. ('RL~(j.,~ ...l. 170~-l7o~ H Jr-. /C><..JII- / .'-h.,
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NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature ~ Clef. -;>-..
Signature of parenVguardian if Age 1 b to 17:
Address 2,.''/'1 (1<-1"-'.. ~~, /o<-..J< ~, /4 .j2-l'fb
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2006
Page 3 of7
Clayton "Clay" Claussen
2145 Palmer Circle
Iowa City, IA 52240
Cell: 319.331.9911
Home: 319.351.HAWK
Objective
To be appointed to the Iowa City Parks & Recreation Commission. With over
twenty years of experience in recreation I can bring a seasoned vision to Iowa
City's recreational endeavors. Currently, as a realtor with RElMAX Real Estate
Centre, I understand the real property value of recreational facilities and services
to our community as well as the social and educational opportunities they can
provide our citizens.
Professional Recreation Experience
Management Consultant, Iowa & Texas, 1986-2003: Provided a variety of
planning, operations and management services to high visibility corporations.
.. Amana: Major appliance manufacturing plant in Iowa with 2,000 employees.
. Assisted in a feasibility study for an on-site employee fitness facility.
. Provided budget projections, facility design and operations input.
.. Benefits Design Incorporated: Austin, Texas benefits company providing
outsourced HR services to companies in 37 states and 14 foreign countries.
. Helped determine the feasibility of establishing a fitness center for
clients in a new office building.
. Provided a matrix of projected profits or losses for various sized
facilities.
. Utilized my budget projections in their final site selection and did
establish an on-site wellness operation.
.. Core Fitness: New 20,000 sq. ft. fitness center to open in Iowa City in 2003.
. Created the business plan presentation for financing. Solicited cost
estimates for all equipment, furnishings and systems.
. Established an operating budget for the first year with projections for
years two and three.
. Assisted the architectural firm in developing a functional layout design.
Configured the exercise areas including studio types and sizes,
equipment selection and placement. Configured the locker rooms for
maximum utilization and proposed custom features: women's private
dressing area, massage area with access from men's and wCl5en's til
locker rooms and heat and humidity control zones. =-?: n ~
. Marketed to adjacent businesses to establish credibility via m~> -~ ~~]
corporate wellness background. (~i ~-~. 6-,
. Created and trademarked the name. Established a website fQi! t
marketing and establishing a potential member data base. 0 ~~ ;:g
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. Dell Jewish Community Center: An exclusive twenty acre education and
recreation center overlooking Austin, Texas.
. Audited their problematic fitness center and made operational
suggestions.
. Recommended a restructured staffing model and personal trainer
compensation plan (which were both adopted).
. Per my direction, created staff training and operations manuals, a new
member utilization tracking system, a cleaning and maintenance
schedule and a new member orientation program.
. ErtI Toy Company: A manufacturing plant with over 500 blue collar
employees in Dyersville, Iowa that operates a recreation center as a joint
venture with a local civic group.
. Conducted a systematic analysis of the operation.
. Presented findings to the Community Development Council.
. The Council hired a new manager, implemented staffing changes and
increased marketing efforts.
. John Deere: The renowned farm implement manufacturing plant in
Waterloo, Iowa.
. Hosted a committee studying the feasibility of an on-site employee
fitness facility.
. Provided operations insight that included budget formulation, staffing,
program scope, site requirements, equipment needs and a myriad of
specific recommendations.
. Provided follow-up support. Eventually a plan was implemented with
their local YMCA providing equipment and staffing.
. Quaker Oats: A large food processing plant with over 2,000 primarily blue
collar employees in Cedar Rapids, Iowa.
. Supported an employee committee studying the feasibility of
establishing an on-site employee frtness center.
. Performed a site assessment and recommended a new building
outside the manufacturing complex for dependent, non-secure access.
. Provided budget projections.
. A facility is still under consideration.
. Trilogy Software: A progressive software design company with nearly 1,000
professional employees in Austin, Texas.
. Prepared key portions of an employee interest survey which _ ':"
overwhelmingly supported creating an on-site fitnesslleisure ~ter. ~
. Project on hold pending the company restructuring for a publ~ri~
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Director, Rockwell Employees Recreation Center, Cedar Rapids, Iowa,
1986-1999: Directed the successful start-up and ongoing operation of a 60,000
sq. ft. corporate recreation center, one of the largest in the United States.
Subsidized initially, the Center now operates in the black due to innovative
strategies and creative management.
. Established a joint venture physical therapy clinic.
. Reduced lost work time 25% by providing services on-site.
. Produced a profit center to offset high-cost, low-income
services.
. Created an Extended Family Plan Membership.
. Expanded eligibility beyond traditional employee ranks to a
cross-section of the community.
. Opened a new, lucrative revenue source.
. Presented a high-profile community resource for health promotion,
charity events, summer camps, sports leagues and tournaments.
. Honored by the Iowa Governor's Council on Physical Fitness and
Sports as the best corporate program in the state.
Manager, Iowa City Racquet & Health Club, Iowa City, Iowa, 1981-1985:
Turned a failing 40,000 sq. ft racquet club (now North Dodge Athletic Club) into a
profitable multi-purpose fitness operation.
. Expanded programming to include weight training, aerobics and health
promotion services.
. Changed memberships from annual to monthly. Reduced seasonal
revenue fluctuations and increased membership retention.
. Provided time share services to the University of Iowa Recreation
Program and Department of Athletics.
Education
Health Promotion Director Program, The Cooper Institute, Dallas, TX 1999.
Premier Fast Trac I Entrepreneurial Training Program, Cedar Rapids, IA 1999.
Bachelor of Arts, Political Science, University of Iowa, Iowa City, IA.
Affiliations/Activities
Association for Worksite Health Promotion, former Professional Member
International Health & Racquet Sports Association, former Associate Member
Austin Well City Initiative, Founding Member
Health Promotion Director Credentialing Group, Advisory Member
University of Iowa Alumni Association, Life Member
I-Club, Member
Iowa City Girls Softball, former Board Member
Regina Education Center, former School Board Member
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NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
SENIOR CENTER COMMISSION
One Vacancy - Three-Year Term
January 1,2007 - December 31,2009
The duties of members of the Senior Center Commission are to:
1. Serve in an advisory role to the City Council with regard to needs of the Senior Center.
2. Make recommendations with regard to policies and programs at the Senior Center.
3. Join staff and other interested persons in seeking adequate financial resources for operation of the
Senior Center.
4. Encourage full participation by senior citizens in the programs of the Senior Center.
5. Ensure that the Senior Center is effectively integrated into the community and cooperates with
organizations with common goals in meeting the needs of senior citizens.
6. Serves in an advocacy role with regard to the needs of senior citizens in Iowa City.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa
City. The Senior Center Commission meets the third Tuesday of each month at 3:00 p.m.
Applications must be received by 5:00 p.m., Wednesday, December 6, 2006. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Cierk at City Hall, 410 E. Washington Street. Application forms
are avaiiable from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Senior Center Commission should be directed to Linda Kopping, Senior
Center Coordinator at 356-5225.
---------.--..----.....--
Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in- law,
father- in-law, brother, sister, brother- in- law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 3
Council Announcement Date: September 19, 2006; November 14, 2006
Application Deadline: Wednesday, 5:00 p.m., December 6,2006
Council Appointment Date: December 12, 2006
SENIOR CENTER COMMISSION
One vacancy - Three Year Terms
January 1, 2007 - December 31, 2009
Term expires for Josephine Hensch
No applications as of Wednesday, 5:00p.m., December 6,2006
00 Denotes applicant completed the Confidential page of the application.