HomeMy WebLinkAbout2007-08-21 Appointment
08-21-07
25a
NOTICE
THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING COMMISSION:
HUMAN RIGHTS COMMISSION
One Vacancy - Unexpired Term
Ending 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 eligible 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, August 15, 2007. 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 Human Rights Commission should be directed to Stefanie Bowers,
Human Rights Coordinator at 356-5022.
Board or commission: H'Wttan l$.gP;1::;",
ATTENDANCE RECORD
YEAR 2007
TERM
NAME EXP. 1/23 2/27 3/27 4/24 5/22 6/26 7/24 8/28 9/25 10/23 11/27 12/25
Bev Witwer 1/1/08 X OlE X NM X X X
Sara Baird 1/1/08 X X X NM X X X
Scott King 1/1/08 OlE X X NM X OlE X
Martha 1/1/09 X OlE X NM X X X
Lubaroff
Kate Karacay 1/1/09 X X X NM OlE OlE X
Florence 1/1/09 -- --- -- --- .n X X
Ejiwale
Joy Kross 1/1/10 X X X NM X X OlE
(Meeting Date)
KEY:
x = Present
o = Absent
OlE = AbsentlExcused
NM = No meeting
--- = Not a Member
NMNQ - No meeting, no quorum
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)
Council Announcement Date: July 10, 2007
Application Deadline: Wednesday, 5:00 p.m., August 15, 2007
Council Appointment Date: August 21, 2007
HUMAN RIGHTS COMMISSION
One Vacancy - Unexpired Term
Ending January 1, 2010
Sherry Hunter resigned
Kristi Lohmeier [8]
20 Evans St, Apt 2B
Joan Black [8]
419 S. 7th Avenue
Brian Braun [R] .
222-1/2 E Washington St #1
Eric Kusiak [R]
2629 Hickory Trail
Males: 2
Females: 6
[8] Denotes applicant completed the Confidential page of the application.
City of Iowa City
Advisory Board/Commission/Committee
,"",pplication Form
1 ~ !
--- = -~...
~~w!:'"?
,,~..galm~
_..&lL "l
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees 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/Committee Name Human Rights Commission
NAME Kristi Lohmeier
HOME ADDRESS 20 Evans Street Apt. 2B Iowa City Iowa
Is your home address (listed above) within the corporate limits of Iowa City? [{] Yes
How long have you been a resident of Iowa City? 3 months
Term ending Jan. 09
ZIP 52240
DNo
("~CUPATION Outreach Coordinator
EMPLOYER Iowa Policy Project
PHONE NUMBER: HOME (309) 716-7757
BUSINESS (319) 338-0773
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I have a masters degree in social work with an emphasis on social justice and community organizing. I have also taken
courses at the graduate level in women and gender studies. Both of these knowledge basis have given me a great theoretical
basis for understanding what discrimination is and how best to eradicate it. I also have a practical knowledge through my own
personal identities of how damaging and hurtful discrimination can be. Finally, I have worked for many years in educating
people on what discrimination, prejudice, and the multitude of 'ism's' that plague our society are and the history behind them,
which I feel gives me a better understanding not only of my own personal relationship with discriminatiPn:but also floW best to
~ I . ~,.C
educate others on what we can do together to address them. .~c-: -:-_c,
-.j
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
r~~
.J-"':- (__~
I know that the commission is appointed, has 9 members, has been around since 1963, focuses on education and does a lot of
community programming and community involvement.
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
December 2006
Page 1 of 8
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING) ?
I am new to Iowa City, having moved here for my current job, but believe very strongly in the power of local community politics
to make a difference. When neighbors talk to neighbors there is more trust and room for growth and change. I feel my passion
for this idea will make me a great addition to the commission. I want to make a difference, I am young and have the energy and
desire to empower people to grow and change. What I have learned in my experiences in doing work such as this is that it
takes a lot of time, patience and continuity in order to facilitate this type of change. I am new to the area yes, but I am settling in
Iowa, I love it here and want to do what I can to make it a better place.
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
" t apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.
L..ller 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.
" ., "
I cannot imagine there being a conflict with my employer because (a) we are a nonpartisan organizatiorrf1~d (b) V{e focus
primarily on economic and environmental justice generally and not social justice specifically. If anythingt feel my current job
will be an asset to the way I view discrimination by looking at entire systems that make discrimination possibie. .. ; ';
_.J
'-
f',)
l...:'" c)
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? []]YES DNO~' w
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES [{] 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
December 2006
Page 2 of 8
BOARD, COMMISSION, & COMMITTEES
BUSINESS LISTING
I! 1
_f1-= -~
!~W~'t
~~ ~='m~
........ .I.L.
CITY OF IOWA CITY
Name of City
Board/Commission/Committee Human Rights Commission
Name Kristi Lohmeier
Date 05/04/2007
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.
BUSINESS NAME BUSINESS ADDRESS
nla nla
L) Co',
.--t
". .~"" ( _~..d
- ..--
", ~ n.
-_._-~ - .. --
. I
.... - -
.- -r'~ i
-,.-..
,j '-, -' ,
" -.
.- .~.. ..
. -
.J-;' ,=--,
LV
NOTE: A new form must be completed if the above information changes or an ownership interest
is acquired in an .~di\iOnal busi~ess.
Signature ~~ ~~~- ,
Address 20 Evans Street Apt. 28 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.
Human Rights Commission Application
December 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 Level) 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." (Ord. 94-3647, 11-8-94)
OPTIONAL: ._~ --.J
PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSII)ER~WH:eN
CHOOSING AN APPLICANT.
~. ~.i~~"
. I
. ,
I
--'
0Age
ISPiritual
-,'J
j1~ijeIi g i ~~
~> Ci
(,.,)
~ Disability
femalel Gender
In/a
$30,0001 Income (see table)
IWhite
I Race, color
or ethnic group
I National origin
flUidl Sexual Orientation
IUSA
[2] Other (Please explain below)
I feel another demographic that describes my experiences is that of a young, single, professional female who is settled
in her location and profession and not looking to leave Iowa for greener pastures (so to speak!).
Human Rights Commission Application
December 2006
Page 4 of 8
Kristi M. Lohmeier
20 Evans Street 2B
Iowa City Iowa 52240
309.716.7757
kmI4peace(W,vahoo.com
OBJECTIVE:
To obtain a position on the Iowa City Human Rights Commission.
EDUCATION:
University of Louisville, Kent School of Social Work, Louisville, KY
Aug 2001- May 2004 GPA: 3.9/4.0
Masters of Science in Social Work
University of Kentucky, Lexington, KY
August 1996-August 2000
Bachelor of Science in Family Studies GP A: 3.3/4.0
Major: Individual and Family Development
WORK AND VOLUNTEER EXPERIENCE:
Iowa Policy Project
Outreach Coordinator
Iowa City, Iowa
January 2007 - present
The work of Outreach Coordinator concentrates on outreach and networking,
predominantly around state fiscal and economic policy. The focus is wori<:!ng witg:
a variety of constituent groups, legislators and Iowans to ensure IPP wo~g:;is --.J
relevant and widely distributed. '
Communities United to Strengthen America
Community Canvasser
Davenport Iowa , _
September 2006 - November 2006 ::;:: / I:?
In my most recent position, I acted as a community canvasser for Communitie~Bnited tuj
Strengthen America. My responsibilities include going out in to the community and W
informing predominantly middle and working class citizens about issues related to
candidates they would be making decisions about in the November 2006 elections. I was
also able to provide input in a variety of community related projects and voter registration
activities in preparation for the elections.
University of Louisville - Office for the Vice Provost of Diversity
Liaison
August 2004- August 2005
As the first person to hold this position, I acted as the liaison between the lesbian, gay,
bisexual and transgender students, staff and faculty at U of L and various administrators,
professors, students and staff. In this role, I was able to affect policy relating to these
various communities to improve their situation on campus. The focus of this change was
through education, awareness and community building. I also worked closely with many
student leaders to mentor them to change the climate of safety and community at U of L.
.......-._.1
. ,
Louisville Central Community Center
Researcher/facilitator
August 2003 - May 2004
As a practicum student, working with a grassroots community group around the issue of
economic development. Responsible for planning and structuring meeting agendas,
researching critical parties involved with economic development in Louisville,
collaborate in the formation of the coalition group, and work with the group to improve
their situation in the metropolitan political and economic environment.
Louisville Youth Group
Mentor/Counselor/Grant writer/ Researcher
August 2002 - May 2003
As a practicum student, working with a youth support group composed of
people ages 14-20 who identified as lesbian, gay, bisexual or transgender. Responsible
for supporting the core group of youth leaders who ran the meetings, choose the topics,
and organized a variety of activities to build community within the group. Also
interacted with administrators, teachers and parents on behalf of young people who were
struggling in school in the form of speaking at school board meetings, speaking with the
superintendent on these issues, and meeting with parents to ensure their children received
the same education as other children in the school district. Finally, the group participated
in many activities in the Louisville community, attending fundraisers and providing a
variety of educational services to many different agencies throughout the social service
arena.
Kent School of Social Work
Graduate Assistantship
October 2001 - May 2002/January 2003 - June 2003
Was awarded a full tuition assistantship with the Kent School of Social Work. Duties
included administrative activities such as filing, creating databases, entering and filing
data, and preparing reports. Performed research, assisted current students, and recruited
prospective students.
National Conference for Community & Justice, Bluegrass Region
Advisor/Mentor
Nov 1999 - June 2005
Facilitated workshops on cultural diversity, violence prevention and conflict resolution
with a group of diverse adolescents at a summer leadership camp and throughout the
year. Counseled and mentored adolescents. Assisted in reprogramming the camp to gear
towards leadership and self-reflection. Acted as the personnel director of 22 staff
persons. Duties: orientating and debriefing staff on activities pertaining to camp, acting
as a liaison between staff and executive directors, and supporting staff during camp.
r,)
c-)
Page 1 of2
Marian Karr
From: Kristi Lohmeier [kmI4peace@yahoo.com]
Sent: Friday, May 04,20072:08 PM
To: Marian Karr
Subject: RE: Interest in serving on the Human Rights Commission
Thank you for getting back with me! I do have the application filled out and printed, and will be
dropping it by this afternoon!
Thank you again for the communication!
Kristi
Marian Karr <Marian-Karl@iowa-city.org>wrote:
Thank you for your email expressing interest in serving on the Human Rights Commission. However, we
do need you to complete and sign the application form. I have attached the application for your
convenience. Please complete, sign, and return to my office. You may return by mail, fax (356-5497), or
drop by my office any business day between 8AM and 5PM. I will retain the materials you have
previously sent and include with your application to the City Council. Again, thank you for your interest
and I look forward to receiving your application by the May 30 deadline.
.Hn4imt X Ytau
City Clerk
City of Iowa City
Population 62,380
(phone) 319-356-5041
(fax) 319-356-5497
From: Kristi Lohmeier [mailto:kmI4peace@yahoo.com]
Sent: Friday, May 04, 2007 10:49 AM
To: *City Council
Subject: Interest in serving on the Human Rights Commission
Hello!
My name is Kristi Lohmeier and I am interested in a position on the Human Rights
Commission. It was advised during the course of my application process to make contact with
all of you, so I wanted to introduce myself initially and follow up at a later date, closer to when
decisions will begin to be made.
Some of the questions I answered on the application include:
What experiences and/or activities which you feel qualify you for this position:
I have a masters degree in social work with an emphasis on social justice and community
organizing. I have also taken courses at the graduate level in women and gender studies. Both
of these knowledge basis have given me a great theoretical basis for understanding what
discrimination is and how best to eradicate it. I also have a practical knowledge through my
own personal identities of how damaging and hurtful discrimination can be.
5/4/2007
Page 2 of2
What contributions do you feel you can make to this advisory board:
I am new to Iowa City, having moved here for my current job, but believe very strongly in the
power of local community politics to make a difference. When neighbors talk to neighbors there
is more trust and room for growth and change. I feel my passion for this idea will make me a
great addition to the commission. I want to make a difference, I am young and have the energy
and desire to empower people to grow and change!
I also wanted to attach my resume, just to give you an idea of other experiences I have had that I
feel qualify me for a place on the commission. I realize that I am new to the area, and don't yet
know all the ins and outs of what is going on in Iowa City. I am however very enthusiastic and
would love to get involved with this commission, primarily because of what seems to be an
exciting focus on education. I believe empowerment comes from education, and when it comes
to issues of discrimination based on our difference, the only way we can move forward is to
educate ourselves and our neighbors about these differences.
I would be more than happy to entertain any questions, and look forward to the next step in this
process.
Sincerely,
Kristi Lohmeier
Expecting? Get great news right away with email Auto-Check.
Try the Yahoo! Mail Beta.
Looking for earth-friendly autos?
Browse Top Cars by "Green Rating" at Yahoo! Autos' Green Center.
5/4/2007
City of Iowa City
Advisory Board/Commission/Committee
Application Form
&! 1
--= -~
~~W!:tt
~ ..-.~
........~
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees 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 81., 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/Committee Name Human Rights Commission
NAME Joan M. Black
HOME ADDRESS 419 S. 7th Ave Iowa City, IA.
Is your home address (listed above) within the corporate limits of Iowa City? [2] Yes
How long have you been a resident of Iowa City? approximately 17 years
Term ends Jan. 1,2009
ZIP 52~
C ~
:~N~
\ .. _u :~l:'
, '
... j
OCCUPATION attorney
EMPLOYER self-employe~/-: ~-)
rin.
.....HONE NUMBER: HOME (319) 339-7499
BUSINESS (319) 360-01~ ~._
<~' ..
):;
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
Prior to law school I was a social worker in the Iowa City community for 14 years. During that time I had the opportunity to
work with children and families from many different backgrounds whether it be racially, economically, religious affiliation,
sexuality, age, or mental and/or physical challenges. As a law student and new attorney, I continue to see clients with diverse
life experiences that face challenges specific to those differences. Additionally, as a lesbian, I have had the experience of a life
lived outside of the mainstream. As a single parent, having adopted my foster sons, I have a great deal of experience in
dealing with societal institutions that are sometimes slow to broaden their definition of family. In short, I believe the
combination of my educational background and my personal and professional life experience makes me qualified to serve of
the human rights commission advisory board.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I know that the advisory board participates in both recognizing community members for their efforts in ending discrimination
and in providing outreach and education regarding discrimination.
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
December 2006
Page 1 of 8
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING) ?
After 14 years in social work in Iowa City I chose to attend law school at Drake University. For the past three years I have done
little except study, drive and spend time with my children. I am now beginning a law practice in Iowa City. I feel that I have
much to offer as stated above, and have a desire to contribute to my community in a way I have been unable to do in recent
years. Although my job title has changed, my heart remains true to my social worker roots. I believe the Human Rights
Commission Advisory Board is a good "fit" for my personal skills and interests.
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
'1at apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.
...Jther 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.
r--.J
0 c=
--J
..~~ C)
~ - .
~ .> -.-- -Tl
-<
'''-~-'''''i c.)
. "
-"- , C)
---1
--- , : t
- -0
r-t :-.~
/'-, :: '_.j
'-..-i
~" / " N
."~
?
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [2]YES DNO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES W NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
I" 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
December 2006
Page 2 of 8
BOARD, COMMISSION, & COMMITTEES
BUSINESS LISTING
1 ~ l
--= -50
f~W!:'t
~ "aD'~
-, ...IlL.
CITY OF IOWA CITY
Name of City
Board/Commission/Committee Human Rights Commission
Date 05/30/2007
Name
Joan M. Black
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.
BUSINESS NAME BUSINESS ADDRESS
Black & Hinshaw, P.L.C. 1321/2 E. Washington St. Iowa City, IA. 52240
r<'
r; C~-:l'
=
~ -;',~
~~:. .~ , -~-~~. ...-
-' I
,~.. .... n 0) .--
..---..-
=:(-~ --cY ~--~-
-; , i
I ---:'"
-- -....... .~
i"-~:-. __
-,' /' ' "T;;T
~~
::::-:- -
-- -
A new form must be completed if the above information changes or an ownership interest
is acquired in an additional business.
Signature k~. ~
Address 419 ~h Ave Iowa Cit~, IA.
NOTE:
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
December 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 Level) 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)
OPTIONAL:
PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN
CHOOSING AN APPLICANT.
0Age
Religion
femalel Gender
Disability
35,000/yr.llncome (see table)
IWhite
Race, color
or ethnic group
lesbian I Sexual Orientation
National origin
D Other {Please explain below}
Human Rights Commission Application
December 2006
Page 4 of 8
City of Iowa City
Advisory Board/Commission/Committee
P ,plication Form
& ~ i
~~~~'t
~ ~IIII'~
~~
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees 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/Committee Name HtAl"'l'''' E~ ",,-h
NAME \3.-'4v'\ ~",-y"\
HOME ADDRESS 'Z:I:Z. 1/7... E"'. CJ:uh ~ 5"J-. ~ I
Gr"1l""1issi OV\
Term 7I:V1 - 'lot 0
Is your home address (listed above) within the corporate limits of Iowa City?
- Yi:
How long have you been a resident of Iowa City? L mc.~<)
OCr.UPATION Eu:>;ne'i ~~,.r
Ph0NE NUMBER: HOME 31' v'n G:>540
ZIP J"2Z40
Yes --D~
Q -..
;::::: n (-
5> :::::- '= II
EMPLOYER H€O.'I) ~~? ~ :==
_,,; (",3 :
BUSINESS '31el ''5':lI'Cl ~"5?: ;-11
o ."U -,~_.J
</~ -
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITIO~ ~
-r", ~ ru.J. ")t?~~\ 'feeV') r ~~_ be€Y'l Q.r'\ a.c,five. <;v><1. l&c!ij iVt-e.y'\\~""'cJ.t nU.I"lt'~~ (oft\ell co.f\'l'jM\
o..~d. Jowl J5kk o'J=i .~~-h'c......\ . Q~oLed"J -G-r ~i-hw. ch'"'1.e.. ".....~ s"'pf'-,d- omcj 'fYl1n<-y,'J-f ~~fr. A.J.. ,
C.,J~e, T &(..kd m .~ "'L":' p~rl~.J. <.it . -I-t-e- ~~'l+- body - j?~~eccc\;.!J I Q'~l>I~ ",.}he... ~j~s, -/'he. ve.J:..r""f"
o*- ~ 'i~-l.tR>A+- 1,,-,,^,~"''''''Mj.. ~d7/.../iC.""'';'' f'IUv1 tie )y"eclk" vepv-es-e,"\k-h:<>^ '*' oft-CC~\ "S }-....<k..,-h o.-<i ~.J..devl'k c.f..:
ne~ \'(>),d.evu.. \nc.lh. AddrhClo'Al\1 T 6J:J Cl r'l- ct ~ r~ilc!..ev1h Ck,.d.u "Ld.i".J,'.J-y J01 ~ ~(,.e it> ad\.Ccu-k. -k."..* .
oAlIht'^ o+- "J~f'\~< ;aeVlh~f Q<od e^p..e~iCJoA ,\ ,4v -l\~ cAkj.('f . t1",'dil("if'\o""'o,~'o-, rile-j. Lik~{u;H:_, O^ ~ ~~ k )~IT
Icb~ied (M6. ~c''-'l'\k~,,~ C\+1\~ cej>,kl.. 0Ji-m 1v-e 5....k.Sch,,"h --Y;;:,k ~Le..I(()o1~,I;J Jei~/<.-b<, *', 'JlAfP"d"heVt'(e..~.
'5",.k s"h","\'s b./\ (~ o'le...., (i'v, \ l"f' ~ Code. A Su-<h ..D~ '~P"~{<:,,\.e.J C<>ff'd\. o,.f- .10'-'-"'~ ~'d.e.. f'.Je.t..-x.-Aq (oll')~ (c'C,I'hG-.-
,~ Q..r 5<.hwl~ S'" 7'-~hiy"+- oll/cvo<.€. My Io.d. 'I--eor <.:'-+ St.\,c,ul .r (,Na' ",Is", "'- c<.V'€ 'l"'\eM~"'-- ,A.. /hire! L.A..-e. R~.....-c-c. ~
Q. R\'Y\II1.~l ~SG<H,-e. j....""p Co..>he...-e.. {.,e.. p"'u;~~-h"'t. Ccw."",wll+i Vj ~... ')C;.k IWW""\, l.J(.'.eh\i~ls o...c. .!C....,j,Il.s}-b""lt /I },'("IY'j'
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
-:J; "Jel,-hc.... -J..!he. ed'-tCN-hC'-\ c..cl ('Jol-4tu-.\.-, P....yiCi'V'S SpcVll-J ~f JH:.. H1?C. jike {;./,.", ~sh'v"ls i sYY"'jY-,ri'i.All1S, Cli1d.
, ~v.f\~t<t~les I H1?G pJ(V,J :~ q-,'l>'l:-<Ct\, H~ f'1"~ -4c.--..x~d $o;:(.~ C"'~ ':"(,,~1 Av-:,.c1~ Fc;;ve+ ;~ a*~e''': ')k~~
JVlc1~de ~ pli"f<~d.. . ~-=!{ Hc.<Jl,Y) "ij-.....,pc>,'-""^:. ~~A-'rL.4 r\.')yw~ (C~.j..tb<..Jio--<..\ c.(..d~,' D,t'v€.~111 pay o--.d 1t-€ pe~o.",c'
(01 ~,.\MhchS '1,1 (f,:,,~,,~5r'Gh ,...,e>",S-l~. f~"\GV",,1 (C"-t')'J~,,,",\ 1r1<.k..lU €,-cv, "",e,,,,,I,e.'O"5 I 5"l<A.iJ;<,.e '''' t1~<" +0 )'u!:x:C'\'l'l"" ~>t'\
o...~tK?" <J'< 0^i'Ci> J.. (01)''''';)';'''''- -...,\w<,d. eve\.\~ o,..~ ctll'-ft-t. <_4kc.- t...X,,'/-t: i.,v..:,l...,€ in y,?,-#i <"1) .....- Ct~,,'1V''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.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING)?
s G.v-et:eVl'\-' 'y,,-~"c,~k e.....<i /(.v\1-:le.OOIi....j a.c.-h'vht-Cv,d edvo<.<"<k c!- c::/.-rr"^d~,"';"'is.}-- rek,k~ ;5J~j IV;
JPi.-1<t, T k~ \ T \-1<:..vt:.. k"V\.,-,Ie~~ c+ ~ 5-hu-J~leJ <>-,-c. veJ.",,<'~j c.v",ik~te. +0 ~O-I'te.. pevffve ch(.1e.
~i+n;..... <lVV- C~""f"'\""ihe\ I os <->dt O~ -tl-e.. leade.,hip CVI~ \'Vl,,-h\JaJi~ -k- E'('\c.c..r~~.e, Su.ch ch,^,')e, Jh~
fcu-i-~: ie<~') T ,~ bee.n ~ ad.;vt. Y"'€."",be.-;", -h-e- (t~"'''''-,;I :~i~'-'--'Bh..... I 6';<;e~..."".\ I fruy I Lf"hl~'\,IIr;.,"'J
W'\C, 41lied Coik'f CCM.Jetf'(~ ( hB'(.-t-T A4LC-) t ((s ~/I <1\ fu CNln.k.. lor.vll1e. o.'\~ Cevi\.e.r 'R~J,k A-~<.Jo.~"ft (Oct, 1io.--
Cc"'k'~l-es, b,,'~ ~<"h'''') (aM""...-1;-h~~ c<-'\ c:."J,.i k 'lvi<J:I(Jf:- /Sjl}eifY'S ct-Gpp-vejft'er-'\ cvd Je"deYtH~.~"'" ~~+;+-~
')~,)vt's. r;,...., 5;,.(~\A I ve... bw'JY>\- "'5IjhI-0AC. \~'<i€~hlp 1tJ'Mo.,! (0'1"'(\ ~ ('(""''''''<MIff-' ff ...w~(\.J-.j
J:; k{J\ fof+"c<-I.IC:lly close.1-o "'l..V"'\"" y-if'-t. i~sv<s 61 vol\Al\-k~;J 1""(,O"'#.\j a.+fu~edl<;' \)iole~e
"I0~~."l~",^ 'fV"'JYGU"'" C>"\d. h~l""'l<'<<JcI~...\<,,^ Clinic t:M'Y ~~.,.. I Y"'<A*S. ~ c;\, s-evY\es~-kJ s*,JI-(.\\'~<k!
'f~JV'O-"'" ,..... H:.::fu((Co -h-i, jeav- ('eVl~~+i~ i....~~.~vW- \:sei;Jo<;.\/H.....fl..e (..,,<k')""""d.~G1 (CYVI""''''^'+t. r ,:\c"f\ed.. c>,
""'.~ S,e,'\U\",e. c-.d ~1V"'J""h::.j..,~ Qf~'"."'l-.. -\v ~lIT pv<>sau...J.i"""" <>^~ ')~~~l~S I v; a. Ho;..ull.... ..,kk- I o-'c ~ S'~ fte..t:
1"n1 ("J........j~""+- \YIC d~",mcl.o1.'n. 'j'IAhc<,j ~Chv,lw.. /\., --he s*,-k5. "1. ~l V"',/ €ifeV,eVlCe I ,^c~t C"~ -en+1.-tMs,....Y""\ c..J111
o.M -tv ~ <-->,-"h. cf ~ HVY\'\"",1Z1)"'''' lCVlol.....i<I;(,.'-'o. OV\<! ~'<i. /.J- j.... ,.,....lei") ~'C:+-f '" },el/(v plcl.c.e k",,/l ,,~iis (il1c'fv'l}.
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
th?+. apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.
C ;r 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.
o
7~C)
't-~-
c:::>
(.:;.::}
-.I
f__
c"-
r-"
11
',-, .)
w
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~YES DNO j>
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES
~
:-r1
1'-1
'_..J
("--"\
~../
<:"~
;>
o
,.....
-
[3"NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
,Jlisrepresentations 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.
Jul-13-07 09:11
UlllJi~UUI r~l lU:~~ r.~l Jl~J~Ovq~t lU"j ~lll ~~~
P.Ol
Ijg UULr UU,
BOARD. COMMISSION, & COMMITTEES
BUSINESS LISTING
I! i
&:~~tt
~ ~_I~
_.., W
CITY OF IOWA CITY
Name of City
BoardlCommiesionlCommittee Hu.""'--1ltJw, C~~IJ;9^ Oate-.JJ"'l../61
Name~ira..>'\ 'B...<UW\
Section 362_ 5 of the Code of Iowa generally prohibits, with certain important exceptions, ill member
of a city Board or Commission from having en interest in a city contract. A copy of Section 362.5
is attached (see pijge 7).
List all businesses in which you or your spousefdomestlc partner have an ownership interest (for
9xsmple, sole proprietor, partner, 5% or more of corporation's stockholdlngs). Please indicate if there
.rA none.
.,.-..,...-.. ... -..-. ", .,..----
BUSINESS NAME BUSINESS ADDRESS
lVor'te
----
.--.-...
- """'
.......... \.---! , -
-->
~-- "4' .......... ----..-,. -.-:::;.. "-'-"
--
j> -- i=
~_._" h-,
......-.. 0 I I
- ~
" , r "
- - .-- .-
-- ...~ -"", II
- __'C<' ,
Q-;~ --'::"
- >
...-...-.- .::>
);: ..
.~._.... -" " '.' ~".._' ..-.- r-.
rOo
NOTE:
A new form must be comoleted If the above Information changes or an ownership IntereSl
Is ~ in an additional bu9l....,..
Sign~lU1e
Addre.ss ZZl. 'h r;: ~),;r -tt- 1 ,:Lx-..... c. 'If
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 applicQtiQn.
TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY
Effective March 8, 2006
tiousehold 30% Median Income 50% Median 60% Median 80% Median Income Median
Size (Poverty Level) 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)
OPTIONAL:
PLEASE PROVIDE ADDITIONALINFORMA TION FOR THE COUNCIL TO CONSIDER WHEN
CHOOSING AN APPLICANT.
~Age
cd.t\eis+
I Religion
Ylc,;o"\-e,.
I Disability
Y\'1ale
I Gender
1'30'1. ~JiOl\ lh(c"'~ Income (see table)
&:"''OpGY\ CCl'-lC4);c..oI\.
I Race, color
or ethniC group
I Na~nal origin
C) ~
~=: C-:. ~
)> =--: '.- --1l
:............-\
~Q,'i I Sexual Orientation
uS
~ther (Please explain below)
<"'0
J e~,dR. v' -exp V€SSlo.": fV) ql e.
_. it ,
~f:
~~ :-;~:
)>
-
...
-...,,..
~..__'c.
, '
it;
-.........,
C)
Human Rights Commission Application
Page I of I
Marian Karr
From: Brian Braun [braun.brian@gmail.com]
Sent: Thursday, July 12, 2007 9:05 AM
To: Council
Subject: HRC Appointment
Council Members,
My name is Brian Braun, and I'm applying for the vacant position on the Human Rights Commission.
Shortly you will receive my application and have the opportunity to view my qualifications and interest
in becoming a member of this advisory commission.
I feel strongly about making our community welcoming and safe for all its citizens, and I believe that
my personal investment in our city will contribute to the HRC's efforts to do such work. For the past
three years I have been actively involved in local and state organizing and leadership, working to
encourage positive social change, including the Iowa Safe School's Task Force, Iowa Pride Network,
Domestic Violence Intervention Program, and Emma Goldman Clinic, to name a few.
As a member of our community who has been involved in organizing in Iowa City and devoted to social
justice, please consider my application and unique qualifications in age, perspective and experience.
Thank you.
Brian Braun
7/12/2007
City of Iowa City
Advisory Board/Commission/Committee
Application Form
,~ 1
--= -~
t~W!:. !t
~... ~IIII.~
~~
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees 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/Committee Name Human Rights Commission
NAME Eric Nicholas Kusiak
HOME ADDRESS 2629 Hickory Trail
Term to Jan 2nd 2010
Is your home address (listed above) within the corporate limits of Iowa City? [ZlYes
How long have you been a resident of Iowa City? 17 years
@> 5224~.;
:m-;; / -. :::;;
......\ No'"
.;. _,_ ,..-.-'0-
-- . ....
~_:)
-_:r'
.....--' c- c.n --
EMPLOYER Johnson CO(]rity,-{\ttorn~ts qfficy
:-__\ __' ; _._ -~ I
-' -_."-
BUSINESS -.~:: /', _
.i:>
G'l
--.J
OCCUPATION Victim/Witness Assistant Clerk (unpaid volunteer)
PHONE NUMBER: HOME (319) 594-9361
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I have adamantly and passionately been involved in confronting the sociopolitical effects of discrimination professionally and
privately and wish to be involved in more experiences that have a larger "hands on" effect in my community. Professionally, I
currently work with Janet Lyness and Sandra Bucher in the Johnson County Attorney's Office in the Victim and Witness
Assistance Program and have been exposed to many case files and crimes where the catalyst has been a deep rooted form of
racism, sexism and many other types of discrimination. Privately I have been working several years on a documentary film
about the Westboro Baptist Church, the famous anti-homosexual religious group under the leadership of Fred Phelps; entitled
"God Hates Fags" (the words displayed on their most infamous picket sign). In my research of the group (which included but
has not been limited to following them to several protests including staying with them in Topeka for a weekend) my film is an
attempt to open what I feel is a crucial dialogue between the church and the individuals they make suffer because of their
l1)essages. An incomplete version of the documentary was featured at the Hardacre Film Festival in 2005 and Truman State
University in 2007. Another version is also available here in Iowa City at Rentertainment.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I understand that the HRC disseminates information and educates the community on discrimination and human rights
violations. With the proper enforcement, HRC protects citizens from discrimination in the public/private sector. I am also aware
of the annual Human Rights Awards Breakfast where individuals, organizations and businesses are given recognition for their
progressive human rights commitments. I am also aware of the programs held each year that foster discussion on HR issues.
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
December 2006
Page 1 of 8
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING) ?
Currently I study political science and philosophy (with a focus on liberty, limits of government and ethics) and currently am a
pre-law student. As a student at the University of Iowa, I have a perspective of the community which would make a unique
contribution the commission would not ordinarily have. My intimate relationship with the student body will considerably assist
the commission in understanding the priorities and values of the student body who make up such a large percentage of our
community's population. Because their impact in Iowa City is so large, it is important that they are not only reached but have a
general interest in the activities and events sponsored by the HRC. Because of my unique cinema knowledge (and access to
such film resources), I also will contribute greatly to the Film Series. My knowledge of the cases and crimes that occur in our
community because of my work in the Victim/Witness Assistant Program has exposed me not only to the prevalence of
discrimination and human rights violations, but types of discrimination that are typically not seen as discrimination. When
studying case files I have found that many domestic abuse cases manifest themselves because of a deep seated sexist
ideology that I feel has not been addressed nearly enough. Furthermore, I feel heart broken and saddened when I study the
cases of women who have been abused not once, but several times by the same perpetrator. Although that is only one
example, I have a unique knowledge and access to the knowledge of the demographics regarding crime in our community, and
the racist, sexist and other discriminatory implications that can arise because of it. I feel characteristics like the city's geography
contribute vastly to discrimination. Urban planning and develope can go a long way in terms of exposing different people with
each other. Although education in diversity and HR is crucial, diverse experience is important as well. The city should be .
pushed to have this in mind when developing and expanding our community.
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. II 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 Iowa, please contact the City Attorney's office at 356-5030.
Q
;~~-: C)
,.....L.....~' .
--~
~....d
r' ._'\ ..__ .'
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? I7lYES DNO ~~~ :::~
~ ?
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES
er;
1-" I 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
December 2006
Page 2 of 8
BOARD, COMMISSION, & COMMITTEES
BUSINESS LISTING
1 ~ 1
-~= -~M-
t~W~'"'-
"~_&mt~
....... ~
CITY OF IOWA CITY
Name of City
Board/Commission/Committee Human Rights Commission
Name Eric Nicholas Kusiak
Date OfJ/f~ 107
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.
BUSINESS NAME BUSINESS ADDRESS
-::c:c: .c.
~(" ~--,~
"... ~
> .'" ...,i <
, ;
...., .-,..,....
. , \,..".;1
. \
.. '. -
, _.,
_. -'
\~ ,.,/-., ~
~: ::c- --
~
P "..J'l
,-J
NOTE: A new form must be completed if the above information changes or an ownership interest
is acquired in an additional business.
Signature ~-::?"'~ ~_..
Address 2629 Hickory Trail
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
December 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 Level) 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 ci~y from
discrimination as defined in the Human Rights Ordinance. In order to further tl\ls goal,~:ihe city
strives to ensure that the Human Rights Commission is representative of :1:~e~corTimunitv.-;
Therefore, "appointments shall take into consideration men and women ofvarjouS~~racic~Jc:~
religious, cultural, social and economic groups in the city." lOrd. 94-3647, 11-8-94') (;1
/"~....
OPTIONAL: ~ Ul
PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSidER WHEN
CHOOSING AN APPLICANT.
0Age
IBUddhist
Religion
MI Gender
Inone
I Disability
Ilncome (see table)
Iw
Race, color
or ethnic group
Straightl Sexual Orientation
Icanada
National origin
D Other (Please explain below)
Human Rights Commission Application
December 2006
Page 4 of 8