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HomeMy WebLinkAbout2017-03-21 Appointment_Trrf_TT 12a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: CIVIL SERVICE COMMISSION One Vacancy— Four-year Term April 3, 2017 — April 5, 2021 • Duties: Approve all entrance and promotional examinations used by the City of Iowa City for civil service positions. • Holds appeal hearings involving the suspension, demotion, or discharge of employees holding civil service rights. Ascertains to the best of its ability the facts of the case to determine matters involving the rights of civil service employees and may affirm, modify, or reverse any case on its merits per Chapter 400 of the Code of Iowa. Iowa City appointed members of boards and commissions must be 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions The Commission meets when deemed necessary. • Applications must be received by 5:00 p.m., Tuesday, March 14, 2017. 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 Civil Service Commission should be directed to Karen Jennings, Human Resources Administrator at 356-5025. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Board/Commission Application Cover Board/Commission: Civil Service Commission One vacancy to fill a four year term 04/03/2017 - 4/5/2021 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 1/17/2017 Application Deadline: 3/14/2017 Council Appointment Date: 3/21/2017 Date of Non -Gender Appointment: 4/17/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: None Current Gender Balance: Female: l Male:1 Gender Name and Address Female Bushman, Emily 100 Petersen Hall Female Jensen, Melissa 830 Elliott Ct Advisory Board/Commission Application Form "u�4il M % This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF UTERAn U NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 3/8/2017 First Name Emily Last Name Bushman Home Address* 100 Petersen Hall City IOWA CTY State IA Zip Code 52242 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 6304530038 Email Address* errtily-bushman@uiow .edu Boards & Commissions Select a Board or Commission you are interested in:* Civil Service Commission Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 8 Months 3. Occupation:* Student 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* I am an honors student at the University of Iowa studying business. I am a member of the bora Women's volleyball team and actively participate in the American Marketing Association group on campus as well. I volunteer with the Program Fuel up to May 60 with which I help teach children how to live a healthy lifestyle. Growing up, my family moved often which exposed me to many new people and experiences. I experienced diversity in every aspect of my life and have many friends that come from diverse backgrounds. I really value diversity and w+sh to see our community grow in acceptance of equality, this is something that I am passionate about and wish to be more involved with. I self identify as a feminist while also fighting against racial, gender, ethnic, or any kind of discrimination. 6. What Is your present knowledge of each advisory board you are interested in? * I have just learned about these advisory boards from a presentation in law class that peaked my interest and prompted my to apply for a position to get involved and take action. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerelly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to sere on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 19 10. Country of Origin us 11. Sexual Orientation Heterosexual 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity Caucasion *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down A I i Advisory Board/Commission Application Form ry `1 1i�_j y t F0-0 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/16/2017 First Name Melissa Last Name Jensen Home Address* 830 Elliott Ct City IOWA CITY State IA Zip Code* 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3195305490 Email Address* melissa.jensen@kirkwood.edu Boards & Commissions Select a Board or Commission you are interested in:* Civil Service Commission Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 18 years 3. Occupation:* Senior Director, Emergency Services & Campus Security 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* Former chair of the Community Police Review Board. I served on the board for 1-1/2 terms. Law enforcement & fire service background. Public Admin degree. I have been a supervisor at a variety of levels for over 25 years. Have been an investigator for a number of years and in my current role, am also a member of the threat assessment team and deputy title N coordinator. I'm a big believer in being involved in my community. Resume is also available if you would like more information. Thank -you! 6. What is your present knowledge of each advisory board you are interested in?* Knowledge of employment laws and regulations, and City operations. Previous reference & discussions with Paul Fbffey, former Civil Service board member. Former member of CPRB, a number of these years as chair. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. City Council Resolution # 15-300 established a policythat the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-ir-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-ir-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* Klo Demoqraphic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 58 10. Country of Origin us 11. Sexual Orientation 12. Religion United Church of Chr 13. Do you have a disability? No 14. Ethnicity wh 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 64rocT�r Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Board/Commission: Civil Service Commission ATTENDANCE RECORD YEAR 2016 (Meeting Date) NAME TERM EXPIRES 3121116 515116 6123116 7/13/16 7129116 1212116 Lyra Dickerson 413118 X X X X X X Paul Hoffey 414116 X — --- --- --- — Jesse Case 413117 X . O/E OlE X X X Rick Wyss 414120 -- X X X O/E X KEY: X = Present O = Absent O/E = Absent/Excused NM = No Meeting Not a Member 12b NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: CLIMATE ACTION STEERING COMMITTEE Up to five at -large vacancies Expected term One Year — Beginning spring 2017 Duties of the Commission include: • Actively participating in the development of a consensus -based Climate Action and Adaptation Plan for the Iowa City community which will identify priority actions to be taken to reach the City's greenhouse gas emissions reduction goals • Working on behalf of the community to identify programs and projects to reduce emissions that are practical and achievable Educating and promoting these issues to the public and other interest groups to solicit their input and get feedback on them • Those interested in the position must be at least 18 years old. Iowa City residency is preferred, but not required. Applicants may hold a position on other City boards or commissions. • The City is in the process of hiring a consultant to assist in the facilitation of creating the plan, and once hired, more details like a start date, meeting times and responsibilities will be available. • Applications are due, Tuesday, March 14, 2017 by 5 p.m. Forms and can either be completed and submitted online, or printed and delivered to the City Clerk's Office at City Hall, 410 E. Washington Street, Iowa City. More information about the Climate Action Steering Committee can be found at icgov.org/climatecommittee or by contacting Iowa City Sustainability Coordinator Brenda Nations at 887-6161. Board/Commission Application Cover Board/Commission: Climate Action Steering Committee Five At Large vacancies 1 year term beginning Spring 2017 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 2/7/2017 Application Deadline: 3/14/2017 Council Appointment Date: 3/21/2017 Date of Non -Gender Appointment: After date above Council may appoint without regard to gender Gender Balance Requirement: None Current Gender Balance: Female: Male: Gender Name and Address Male Kollman, Jim 210 Colchester Dr. Male Charles TStaner. Brown St. Female Norbeck, Martha 906S.7 th Av Male Ford, Justin 407 Magowan Ave. Female Lutz, Michelle 820 Iowa Ave. Unit A Female Hazen, Erin 2181 Saint Bridges Rd NE, Solon IA Female Hoving, Kara 824 E. Jefferson St. Male Weitzel, Tim 523 Grant St. Female Kubby, Karen 1425 Ridge St. Female Marshall, Katharine M 1777 Louis Place Female Ongie, Sheila (Samuelson) 614 S. Governor St. Male Weger, Nathaniel 625 S. Clinton St. Apt 2 Male Stephan, Jan 3201 Muscatine Ave. #3 Female Opitz, Amanda 426 N. Gilbert St. Male Falk, Jeffrey 7 Princeton Ct. Female Guerra, Clarity 1124 Franklin St. Female Amundson, Rose 1027 Keokuk St. Male Mostafavi, Kaveh 3541 Galway Court Male Jones, Eric 8213`d Ave Male Axelson, Eric 928 Canton St. Worlds, Solomon Furious 611 S. Clinton St., Apt 1 Male Eicke, Chant 904 Juniper Dr. Female De Wald, Eden 725 Bowery St. Female Hansen, Anne 908 Roosevelt St. Male Noyce, Christian 824 Dover St. Male Donham, Joel 2327 Cameron Way. Male Hall, Ryan 200 S. Summit St. Female Miller, Cheryl 1120 Sheridan Ave. Male Milster, Ferman 12 Notting Hill Ln Female Rupe, Blake 1106 Marcy St. Male Fraser, John H. 2040 Little Creek Lane Male Edwards, Todd 837 Walnut St. Male Tate, Eric 1234 Santa Fe Dr. Female Soglin, Becky 65 Rita Lyn Ct Female Ehlinger, Grace 216 E. Market St., Apt 2 Male Female Male Female Female Female Biger, Matthieu 519 N. Johnson St. Russett, Anne 14 Forest Glen Samuelson, Riley 606 Westgate St. Apt. 30 Sherlock, Stacey Hockett 2513 Potomac Dr. Fixmer-Oraiz, Vanessa 437 S. Governor St. Fattal, Ranan 229 S. Dubuque St. Submission #4 � City of Iowa City Submission #4 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 01/31/2017 - 9:55pm 173.28.221.5 Date of Application Tue, 01/31/2017 Name Jim Kollman Home Address 210 Colchester Drive Contact phone number 7122690137 Email Address jkollman@me.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? Six months Occupation: Retired high school science teacher Gender Male What is your present knowledge of this steering committee? I am aware of the goals and mission of the committee. I am also well aware of the importance and urgency of forming this committee. Page 1 of 2 Please summarize your employment history and education experiences which you feel qualify you for this position. I have a degree in science education and numerous graduate hours in the sciences and education. I taught high school science courses for 29 years in Denison, IA, including over 20 years teaching environmental science. https://www.icgov.org/node/14986/submission/1831 3/13/2017 Submission #4 1 City of Iowa City Page 2 of 2 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). As an educator, and science department chair, my role was to inform students and the community of environmental challenges we faced and to facelitate the development of strategies to address those challenges. I wrote curriculum for secondary science courses and delivered the curriculums to a very diverse clientele. I was also involved in the Science Bound Program through Iowa State University to develop interest in STEM careers and encourage pursuit of STEM degrees among students of traditionally under represented How do you see yourself representing this work to others in.the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? As a relative newcomer (returnee) to the community, I don't have established contacts within the community. I would, however, feel comfortable in addressing groups of any size, and I look forward to the opportunity to become an active and productive member of a community I have always loved. Age 61 Country of Origin USA Sexual Orientation Heterosexual Religion Catholic Do you have a disability YES Race, Color or Ethnic Group Caucasion Signature of applicant Jim Kollman https://www.icgov.org/node/14986/subniission/I831 3/13/2017 Submission #5 1 City of Iowa City Submission #5 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 02/01/2017 - 9:02am 173.28.94.65 Date of Application Wed, 02/01/2017 Name Charles Stanier Home Address 529 Brown St. Contact phone number 319-330-2403 Email Address charles-stanier@uiowa.edu Is your home address within the corporate limits of Iowa City? yes How long have you lived in Iowa City? 12 years Occupation: Associate Professor, Engineering, Univ of Iowa Gender Male Page 1 of 3 What is your present knowledge of this steering committee? I have discussed the committee briefly with Jim Throgmorton. I have some knowledge of the City's past efforts at greenhouse gas management and accounting from hearing presentations of Brenda Nations, from speaking with Brenda Nations, from speaking with Jim Throgmorton, and from reading reports from the City on sustainability and carbon footprint. Please summarize your employment history and education experiences which you feel qualify you for this position. Bachelor's and Ph.D. in Chemical Engineering, specializing in environmental and air pollution issues Master's degree in Environmental Engineering https://www.icgov.org/node/14986/submission/1836 3/13/2017 Submission #5 1 City of Iowa City Page 2 of 3 5 years work experience at International Paper, as an environmental engineer Held Professional Engineering License (Environmental Engineering) while with International Paper (license no longer current, but knowledge on many aspects of environmental engineering still highly current). Twelve years experience as a professor/researcher in engineering see http://user.engineering.uiowa.edu/—cs_proj/index.htm Research grants, publications, and teaching on greenhouse gas emissions, monitoring, and modeling Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). USDA Agricultural Air Quality Task Force, 2016 -present. This is a federal advisory board advising the USDA on all emissions from agricultural to air, including greenhouse gases. Coalition for Agricultural Greenhouse Gases. Invited speaker 2016, where I presented a proposal for a nationwide awards program for climate smart agricultural. Executive committee, Center for Global and Regional Environmental Research (2013 - present) How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I could assist with outreach and "representing" the work through writings (i.e. letters to editor, blog posts) and by incorporating the Iowa City greenhouse gas efforts in my normal outreach throughout the city, state, and nation. I would see my role on the steering committee as a technical expert, making sure the strategy reflects established and developing engineering and scientific understanding, as well as assisting with the difficult issues of accounting for the emissions in a transparent and sensible way, identifying effective strategies to meet goals, and considering issues such as cost, implementation, public acceptance, and minimization of record keeping burdens. Age 44 Country of Origin United States Sexual Orientation heterosexual Religion protestant Do you have a disability https://www.icgov.org/node/14986/submission/1836 3/13/2017 Submission #5 1 City of Iowa City Race, Color or Ethnic Group white / caucasian / European Signature of applicant Charles Stanier charles-stanier@uiowa.edu Page 3 of 3 https://www.icgov.org/node/14986/submission/I836 3/13/2017 Submission #6 1 City of Iowa City Submission #6 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 02/01/2017 - 9:30am 97.127.136.161 Date of Application Thu, 02/02/2017 Name Martha Norbeck Home Address 906 S. 7th Ave. Contact phone number 3196214168 Email Address martha_norbeck@hotmaii.com Is your home address within the corporate limits of Iowa City? 906 S. 7th Ave. How long have you lived in Iowa City? Iowa City Occupation: Architect Gender Female Page 1 of 3 What is your present knowledge of this steering committee? Read memos in council packets and followed Council proceedings pertaining to the Climate Action Plan. Please summarize your employment history and education experiences which you feel qualify you for this position. I am an environmentalist who became an architect to practice environmentalism. As founder and president of C -Wise Design and Consulting LLC, we've overseen the incorporation of sustainable building practices into more than 2 million square feet of LEED certified commercial and residential buildings. C -Wise specializes in LEED/green building Consulting. Other relevant experience includes: • Fulbright Scholarship for research of Swedish Ecovillages https://www.icgov.org/node/14986/submission/1841 3/13/2017 Submission #6 1 City of Iowa City Page 2 of 3 • Permaculture Design Certificate • Training in Biomimicry, and as a Naturalist with Audobon Naturalist Society Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). • Council Member and Member of Go Green Commission - Fairfield, Iowa (2 years) • USGBC Iowa Chapter — Founding board member and current board member and secretary. (since 2004) • Environmental Advocates Secretary/Board Member and advocacy for Think Bicycles. (since 2012) How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? Through my company, we work with architects, engineers and building owners in the region on energy efficiency and other sustainability initiatives. I speak often on this topic and would happily expand those discussions. I work within the cycling community to promote cycling, and commuting by bike in particular and will leverage work in progress with the bike plan and the cycling community to help increase people powered transportation. Our local foods community is robust and already doing great work. Hopefully the committee will include a representative from this sector of our economy, if not, hearing their voice in another capacity will be important and I would be happy to connect my friends and leaders in this sector. Backyard Abundance, along with several other local groups, are actively promoting habitat restoration work. Biodiversity and perennial plantings improve biological resiliency to climate change, increase the moisture retention capacity of the soil, and soil building sequesters carbon. Positive support and expansion of their work will be valuable and I would be happy to connect my friends and leaders in this sector. Age 45 Country of Origin IA Sexual Orientation bisexual Religion protestant Do you have a disability NO Race, Color or Ethnic Group caucasian https://www.icgov.org/node/14986/submission/1841 3/13/2017 Submission 46 1 City of Iowa City Page 3 of 3 Signature of applicant Martha Norbeck https://www.icgov.org/node/14986/submission/I841 3/13/2017 Submission #7 1 City of Iowa City Submission #7 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 02/01/2017 - 1:34pm 72.50.244.146 Date of Application Wed, 02/01/2017 Name Justin Ford Home Address 407 magowan ave, Contact phone number 7739831486 Email Address justincford@gmail.com Is your home address within the corporate limits of Iowa City? 407 magowan ave How long have you lived in Iowa City? iowa city Occupation: Environmental Specialist Gender Male Page I of 2 What is your present knowledge of this steering committee? I know only what I have read. it is my understanding that this is a steering committee that will work on the climate change and adaptation plan and be a liaison with the greater Iowa City community. Please summarize your employment history and education experiences which you feel qualify you for this position. I have A Masters degree n Environmental and Occupational Health. In my time in graduate school, I spent a significant amount of time taking environmental policy related courses. Since joining industry, I have been an environmental specialist helping companies comply with regulation and participate in sustainability initiatives. https://www.icgov.org/node/14986/submission/1846 3/13/2017 Submission #7 1 City of Iowa City Page 2 of 2 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? Age 27 Country of Origin IA Sexual Orientation Religion Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Justin Ford https://www.icgov.org/node/14986/submission/I846 3/13/2017 Submission #8 I City of Iowa City Submission #8 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 02/01/2017 - 5:21 pm 173.21.221.92 Date of Application Wed. 02/01/2017 Name Michelle Lutz Home Address 820 Iowa Ave Unit A Contact phone number 3192133614 Email Address michelle-lutz@uiowa.edu Is your home address within the corporate limits of Iowa City? 820 Iowa Ave Unit A How long have you lived in Iowa City? Iowa City Occupation: Student, the University of Iowa, Anticipated graduation May 2017 Gender Female Page 1 of 3 What is your present knowledge of this steering committee? As an individual interested in sustainability I am familiar with the steering committee here in Iowa City. The steering committee is a group of individuals who is a part of the Iowa City's greenhouse gas reduction plan. The goal of the committee is to identify and carry out ways to reduce greenhouse gas emissions. In passing I have briefly met with Brenda Nations, Iowa City's Sustainability Coordinator, as a guest lecturer for Professor Eric Tate of the University of Iowa and as a speaker for events in the University's Office of Sustainability. Brenda, along with many others in the environmental science and policy fields, have enabled me and my interest in working with a committee of individuals who aspire to create change for a green and peaceful future both in Iowa City and the world. https://www.icgov.org/node/14986/submission/I 851 3/13/2017 Submission #8 1 City of Iowa City Page 2 of 3 While I have some basic knowledge of the steering committee goals, I am excited to learn more about each initiative for the City while focusing on these sustainability efforts. I am excited to educate, plan, organize and act on the issue of climate change here in Iowa City. Please summarize your employment history and education experiences which you feel qualify you for this position. Defensive Specialist Volleyball Coach, Tiffin, Clear Creek Amana High School (June 2013 — Present) • Provided head coaches detailed practice plans for both upper and lower level practices • Lead and delegated team practices with over —40 athletes in the gym each day • Implemented strategies and techniques that assisted each player with new skill development for their individual ability • Collaborated on improvement and "End of the Year" goals with each coaching staff member to ensure maximum growth for the CCA Volleyball Program Career Leadership Academy, Iowa City, The University of Iowa (Aug. 2014 — May 2016) • Developed a wide range of leadership skills through working in groups, organizing projects and public speaking • Strengthened communication, teamwork, interpersonal and presentation abilities • Participated in networking and leadership development events at HotelVetro and the Sheraton in Iowa City • Attended employer panels regarding important life skills for post -graduation careers and success Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). NextGen Climate, Iowa City, Fellow (October 2015 — August 2016) • Completed —500 calls per week informing community members about our mission of achieving 50 percent clean energy by 2030 and expanding our grassroots organization • Coordinated and planned events with NextGen team members for the community to learn new ways to get involved in the political process • Attended local events for presidential candidates and other politicians throughout Iowa during the 2016 election • Assisted skills training for new volunteers to take on more responsibilities and new roles within the NextGen community How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? Before I became and environmental policy major I was admitted to the School of Social Work here at the University of Iowa. I was first interested in social work because I wanted to be a voice for marginalized communities and found myself particularly interested in environmental racism and environmental justice. I made the decision to leave the program https://www.icgov.org/node/14986/subniission/I851 3/13/2017 Submission #8 1 City of Iowa City Page 3 of 3 specifically because I was informed of the environmental policy major and wanted to challenge my skills and knowledge of environmental and energy policy. My experience in the School of Social Work in addition to my experience as an environmental policy major has allowed me to network with and learn from individuals within these professions. Some of these individuals work to assist geriatric patients, assist those living in poverty, or are community activists working to educate people on political candidates at local, state and national levels and their positions on climate change. My supervisor at NextGen Climate, Patrick Burton, helped connect me to the Iowa City community and informed me, along with the other fellows, ways to get involved in the political process. These initiatives included clip -boarding, tabling and calling state representatives to voice concerns on their positions for issues like the Clean Power Plan or the Supreme Court confirmation hearing. In addition to political activism, I have participated in individual efforts in which I believe firmly align with those of the steering committees initiatives. These individual efforts include issues of non -automotive transportation in Iowa City. I am an avid biker along with many of my friends and neighbors. Unfortunately, Iowa City is not as "biker friendly" as it is "oar friendly". With a lot of work and advocacy on the issue, my friends in student government successfully installed bike -maintenance stops all around campus for bikers to maintain their tire pressure along with other bicycle needs. Allowing for more GHG friendly modes of transportation is one of the many necessary steps to help mitigate the effects of global climate change at the local level here in Iowa City. Age 21 Country of Origin Iowa Sexual Orientation Heterosexual Religion Agnostic Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Michelle Lutz https://www.icgov.org/node/14986/submission/1851 3/13/2017 Submission #91 City of Iowa City Submission #9 Submission information Form: Climate Action Steerinq Committee Application Form Submitted by Anonymous (not verified) Wed, 02/01/2017 - 5:45pm 128.255.5.39 Date of Application Name Erin Hazen Home Address 2181 Saint Bridgets Road NE, Solon IA 52333 Contact phone number 319 400 3266 Email Address erin-hazen@uiowa.edu Is your home address within the corporate limits of Iowa City? No How long have you lived in Iowa City? n/a Occupation: Renewable Energy Gender Female Page 1 of 3 What is your present knowledge of this steering committee? I was very pleased to learn of the planned formation of this committee late last year. It's a powerful and important commitment from the City of Iowa City to rise to the challenge set forth by the Paris Agreement. I'm especially glad that a professional consultant will be engaged, to help ensure that the Committee's work will be focused, effective, and durable. My personal and professional experience dovetails very well with the duties of Committee members. I have direct experience with the technologies that Iowa City may choose to deploy, in order to reach the City's greenhouse gas emissions reduction goals. My real-world energy industry experience will help inform the Committee as we evaluate what projects and initiatives are practical and achievable. https://www.icgov.org/node/14986/submission/I856 3/13/2017 Submission #9 1 City of Iowa City Page 2 of 3 Please summarize your employment history and education experiences which you feel qualify you for this position. I am a renewable energy professional with in-depth knowledge of the major green technologies, and hands-on experience in all phases of energy project development and execution. I have a comprehensive understanding of power generation, electric grid interconnection, manufacturing, complex multi-year construction projects, logistics, supply chain, and project financing. I am currently employed by the University of Iowa as the Renewable Energy Business Development Manager. My role is to broaden the deployment of renewable energy on campus, and my major focus is to phase out the use of coal at the main Power Plant by expanding and commercializing the biomass fuel program. Prior to my job at the University of Iowa, I worked for more than 9 years in the utility -scale wind and solar power industry. My project development portfolio at Acciona Energy included over 900 megawatts of renewable energy generation. Prior to entering the renewable energy industry, I worked for nearly 15 years in Materials Management at several eastern Iowa manufacturers. I have broad knowledge of local industrial processes, materials consumed, and sources of emissions and solid waste. I believe I would be a strong asset to the Committee in terms of informing stakeholders about the proposed projects and initiatives and getting buy -in. In the windpower industry, a key part of my responsibilities was to recruit landowners and win permitting approval for large windfarms, which are not always universally welcomed. I am skilled at making constructive relationships with both proponents and detractors; identifying community benefits and concerns; and explaining complex projects and their benefits and tradeoffs in a straightforward manner. I am experienced and comfortable speaking to large assemblies at conventions, to students in classroom settings, at community meetings (both friendly and contentious). I have received on -camera media training in the past. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Member, American Wind Energy Association 2007 - Member, Solar Energy Industries Association 2010 - Member, Southern Alliance for Clean Energy 2015-2016 International District Energy Association 2016 - How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? In my professional role, I regularly speak about renewable energy topics with diverse constituencies within the university, at conventions and at other educational institutions, and in the eastern Iowa community at large. Even after transitioning from the manufacturing arena into renewable energy, I maintained https://www.icgov.org/node/14986/submission/l856 3/13/2017 Submission #91 City of Iowa City Page 3 of 3 close contacts with Iowa City -area manufacturers and their suppliers and customers. I understand manufacturing realities and processes, and I believe I will be able to translate the work and goals of the Climate Action Steering Committee into actionable projects and commitments from area manufacturers. I would be very interested to participate in this aspect of the Committee's work, as I continue to have keen interest in manufacturing. Champions of major projects tend to be passionate about promoting the many benefits, and that enthusiasm is essential to make all the "heavy lifting" of big projects feel worthwhile. But it is important to also recognize that any project of significance will carry costs and require compromises; we must never take community acceptance for granted. Wider acceptance is earned by soliciting and understanding stakeholder concerns, adapting plans where possible, and communicating early, often, and always respectfully. With my direct work experience in this area, I am hopeful that I could contribute to the success of the Committee and to the execution of the City of Iowa City's Climate Action goals. Age 49 Country of Origin USA Sexual Orientation Heterosexual Religion n/a Do you have a disability NO Race, Color or Ethnic Group Caucasion Signature of applicant Erin Hazen (electronic) https://www.icgov.org/node/14986/submission/I856 3/13/2017 Submission 410 1 City of Iowa City Submission #10 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 02/01/2017 - 6:02pm 129.255.227.19 Date of Application Wed, 02/01/2017 Name Kara Hoving Home Address 824 E Jefferson St, Iowa City, IA 52245 Contact phone number 815-342-2922 Email Address kara-hoving@uiowa.edu Is your home address within the corporate limits of Iowa City? yes How long have you lived in Iowa City? 3 years Occupation: University of Iowa student Gender Female Page 1 of 2 What is your present knowledge of this steering committee? I learned about this committee through my US Energy Policy in Global Context professor, Tyler Priest. I know that the purpose of the committee is to develop a Climate Action and Adaptation plan, identifying strategies to continue reducing the city's greenhouse gas emissions, informed by interactions with community members. Please summarize your employment history and education experiences which you feel qualify you for this position. I am a junior studying Environmental Science with a Certificate in Sustainability at the University of Iowa. I have taken considerable coursework on climate and sustainability, including Intro to Sustainability, Sustainable Development and Green Building Concepts, https://www.icgov.org/node/14986/submission/I861 3/13/2017 Submission #10 1 City of Iowa City Page 2 of 2 and Urban Ecology, and I am eager to put the concepts I learned in these classes into practice in the service of the Iowa City community. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I have been a member of the University of Iowa Environmental Coalition for the past three years, and have served as its co -president since spring of 2016. Through this organization, I have participated in and organized numerous environmental activism endeavors and educational events. I was also a fellow for the Climate Narrative Project in spring of 2016, exploring different topics in climate justice under the supervision of Jeff Biggers and creating a poetry project about the intersection between women's issues and climate justice. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? As a university student and as co -president of the UI Environmental Coalition, I have many contacts within the university's Office of Sustainability, Student Government, and other environmental organizations on campus. I have also had the pleasure of working with other community groups, such as the 100 Grannies. The university community and student body make up a large portion of the Iowa City community, and I would love to serve as a connection through which the diverse voices and novel ideas of the students can be heard in the construction of the city's climate action plan. I also feel it is important that members of the university community remain informed about the city's sustainability decisions, and believe that they have much to learn from the thriving community that exists beyond the campus. I would be happy to promote the city's climate action plan to the students and to the community at large. Age 20 Country of Origin United States Sexual Orientation Religion Do you have a disability NO Race, Color or Ethnic Group Signature of applicant Kara R Hoving https://www.icgov.org/node/14986/submission/I861 3/13/2017 Submission #111 City of Iowa City Submission #11 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Thu, 02/02/2017 - 8:59am 63.152.98.246 Date of Application Thu, 02/02/2017 Name Tim Weitzel Home Address 523 Grant St Contact phone number 3196218429 Email Address weitzel.tim@gmail.com Is your home address within the corporate limits of Iowa City? yes How long have you lived in Iowa City? 16 years Occupation: Historic Preservation Gender Male Page 1 of 3 What is your present knowledge of this steering committee? The steering committee was created by an act of the City Council in furthering its goals to identify ways to reduce the City's impact on the climate that are practical and achievable and is part of the climate action plan process. There will be five at -large members chosen as well as others identified as experts in the subject area. The committee will work primarily with a consultant to achieve the goals of the committee. I understand that members must be 18, and need not be a resident of Iowa City and that a diverse group is being sought to be fully representative of the community at large. Please summarize your employment history and education experiences which you feel qualify you for this position. https://www.icgov.org/node/14986/submission/I871 3/13/2017 Submission #111 City of Iowa City Page 2 of 3 My specific experiences relevant to this committee including working on local groups for climate action, such as Fair! of Johnson County as well as being the Longfellow neighborhood newsletter editor for a number of years where climate action events and activities were promoted when possible, such as Backyard Abundance and energy conservation for older homes. While on the Historic Preservation Commission we routinely approved building improvements that would aid in energy conservation, especially new windows and doors, as well as working to preserve our existing housing stock, an activity that the National Trust for Historic Preservation has identified as a leading sustainability activity due to conservation of the embodied industry already in place in buildings. In the four years FTE that I worked in the Community Development Division of Iowa Economic Development Authority for disaster recovery, we were required to take into account the Green Streets policy of the Authority, which included energy conservation, but would have allowed alternative energy sources where appropriate had applicants chosen to adopt these measures. In personal experience at home, we have been working to improve energy efficiency and conservation in our choice of fixtures and appliances as well as adopting several storm water retention features in on our property. Along with energy conservation, buildings preservation, seeking out ways to sensitively adopt renewable energy generation, keeping material out of the landfill, and to prevent storm water surges within the city limits are key ways that are practical and achievable to seek out climate action and environmental conservation measures. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Membership currently or in the past in Fair!, I -Renew, Citizens for Community Improvement, Nature Conservancy, Iowa Chapter of the Sierra Club, National Trust for Historic Preservation, Union of Concerned Scientists, Friends of Historic Preservation, Habitat for Humanity. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I think grassroots publicity is the best way to communicate the work of the committee through neighborhood associations and their social media contacts. I think working with the various environmental and affordable housing groups in town will reach a large number of people as well. Age 49 Country of Origin USA Sexual Orientation prefer not to answer Religion prefer not to answer https://www.icgov.org/node/14986/submission/l871 3/13/2017 Submission #111 City of Iowa City Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Timothy Weitzel Page 3 of 3 https://www.icgov.org/node/14986/subrnission/I871 3/13/2017 Submission #12 1 City of Iowa City Submission #12 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Thu, 02/02/2017 - 9:52am 63.152.107.180 Date of Application Thu. 02/02/2017 Name Karen Kubby Home Address 1425 Ridge St. Contact phone number 3193381566 Email Address kubby@pobox.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 42 years Occupation: artist/activist/administrator Gender Female Page 1 of 2 What is your present knowledge of this steering committee? The Climate Action Steering Committee will meet for one year and work with a paid consultant to devise an action plan for reducing green house gas emissions that are practical and achievable. This group will also engage in public feedback and education around the ideas put forth by the committee. Please summarize your employment history and education experiences which you feel qualify you for this position. Graduated from the UI with a degree in science education with an emphasis in environmental education. This degree places an emphasis on communication around environmental issues. https://www.icgov.org/node/14986/submission/i 876 3/13/2017 Submission #12 1 City of Iowa City Page 2 of 2 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Founding member of Environmental Advocates, 1987. Community Activist since 1979 with emphasis on practical radicalism --doable, effective programs to facilitate positive local change with the hopes of larger effects. City Council member from 1989 to 2000, giving me experience in what is achievable through local government. Member of the Press -Citizens Writers Group since 2017. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? My experiences in the public sector, the non-profit private sector, and the for-profit private sector gives me the privilege of knowing and understanding many perspectives. I believe it is vital that this committee look at what individuals, neighborhoods, small and large businesses, the development community, schools (especially children), and local governments can do to slow down green house gas emissions. I have contacts in many of these areas and would freely share these resources for this important task. Age 56 Country of Origin United States of America Sexual Orientation bisexual Religion Jewish Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant Karen Kubby https://www.icgov.org/node/14986/submission/1876 3/13/2017 Submission #13 1 City of Iowa City Submission #13 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Thu, 02/02/2017 - 11:24am 128.255.214.50 Date of Application Thu, 02/02/2017 Name Katharine M Marshall Home Address 1777 Louis Place, Iowa City Contact phone number 319-541-0471 Email Address marshall.katharine@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 10 years Occupation: Fundraiser at University of Iowa Foundation Gender Female Page 1 of 3 What is your present knowledge of this steering committee? It is my understanding that the City has set goals to reduce greenhouse gas emissions and that this committee will be responsible for developing a climate action plan for the City. With this comes identifying priorities, programs, and projects to reduce emissions. I also understand that this committee will seek input from interest groups and work to educate the public on these issues. While my experience and my career are limited, this is an issue I am deeply passionate about. I am a hardworking, dedicated, responsible young professional looking to give back to a community that I am proud to call home. It would be an honor to serve on this committee and I am grateful to have the opportunity to be considered. https://www.icgov.org/node/14986/submission/I 881 3/13/2017 Submission #13 1 City of Iowa City Page 2 of 3 Please summarize your employment history and education experiences which you feel qualify you for this position. I graduated from the University of Iowa in 2014 with a BA in International Development. I have always been passionate about sustainability, so in addition to my BA I also received a Certificate in Sustainability Studies. This multidisciplinary program gives students the knowledge and skills to develop sustainable systems. While working on this program I had the opportunity to study ecotourism and sustainable development in Kerala, India. After graduating, I held a yearlong position with the Vice President for Student Life, Tom Rocklin. In this role I developed and implemented a program to better engage alumni with the Division of Student Life. During my time with the Student Life I learned a great deal about the infrastructure of the University and I came to understand the wide variety of programs, resources, and opportunities available to students, faculty, and staff. I currently serve as Assistant Director of Development for the Holden Comprehensive Cancer Center at the University of Iowa Foundation. In this capacity I act as a philanthropic advisor and liaison to the Holden Cancer Center for supporters of the University of Iowa. This role has continued to strengthen my relationship with the University of Iowa Community and its constituents. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). While I was a student at the University of Iowa I was involved in a student organization called "Take Back the Tap" from its creation in 2012 until my graduation in 2014. This organization worked to reduce use of bottled water at the University of Iowa. We worked with University of Iowa Student Government to upgrade water fountains on campus and hosted events to raise awareness of the issue on campus. Unfortunately this organization is no longer active. Also while I was a student at the University of Iowa, I served as Sponsorship Director for the University of Iowa Dance Marathon. Part of this role involved providing all hospitality needs to 3,000+ attendees of the organizations 24 hour Dance Marathon. This included three full meals, snacks, and all beverages and required our organization to not only meet, but exceed the University of Iowa Sustainability expectations. During my tenure we dramatically reduced waste by replacing disposable paper cups with a reusable water bottle system. Last year I joined the Iowa City Noon Rotary Club. Rotary is the world's largest bipartisan, non -denominational service club in the world, striving to promote peace, fight disease, provide clean water, sanitation, and hygiene, support mothers and children, provide education, and grow local economies. Since joining Rotary a year ago, I have become involved in a variety of committees, including the New Member Involvement Committee, the Rotarian's Supporting Women Committee, and the "Fore the House" Ronald McDonald House Golf Outing Committee. Through this organization I have developed relationship with individuals in this community who have a remarkable capacity to impact this community. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could https://www.icgov.org/node/14986/submission/1881 3/13/2017 Submission #13 1 City of Iowa City Page 3 of 3 inspire others to begin some of the initiatives that the steering committee recommends? I am deeply engaged in, and committed to, the University of Iowa. I have excellent professional and personal relationships with senior leadership of the University of Iowa, University of Iowa Hospitals and Clinics, and the University of Iowa Foundation. I remain connected to the organizations I was involved in as a student and feel that I have a good understanding of how to communicate with and motivate young professionals. While I served as Sponsorship Director for the University of Iowa Dance Marathon I worked with a wide variety of local businesses in the Iowa City Community. I have maintained and grown these relationships with leaders of the Iowa City business community since graduation, and have appreciated their mentorship as I have transitioned from a student to a professional. Joining Rotary has introduced me to individuals who are deeply committed to the Iowa City community. The Iowa City Noon Rotary Club is the largest club in Iowa, and is an incredibly active service organization. I strive to continue to develop relationships with members who come from a variety of backgrounds in the community. This organization has helped to diversify my involvement in the Iowa City community. Age 23 Country of Origin United States Sexual Orientation Bisexual Religion Unitarian Universalist Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant Katharine M Marshall https://www.icgov.org/node/14986/submission/I881 3/13/2017 Submission #14 1 City of Iowa City Submission #14 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Sat, 02/04/2017 - 5:18pm 173.24.117.127 Date of Application Name Sheila (Samuelson) Ongie Home Address 614 S Governor Street Contact phone number 319-400-8285 Email Address sheila.samuelson@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 14 years Occupation: Sustainability Manager (National Co+op Grocers) Gender Female Page 1 of 3 What is your present knowledge of this steering committee? With the help of consultants, the committee will help identify actions, programs and projects to help Iowa City meet its GHG emission reduction goals. The committee may also help collect input and feedback from other members of the public. Please summarize your employment history and education experiences which you feel qualify you for this position. With a background in biological sciences (Ulowa; 2004) and an MBA in Sustainable Management (Presidio Graduate School; 2009) my work experience over the past dozen+ years has been in the area of creating positive "triple bottom line impacts." I have worked on projects in the nonprofit, education, local and state government, small business, and large corporation levels. Most of these projects have included an emphasis on calculating or mitigating climate impacts. A few examples include helping Greensburg, KS plan for a low- https://www.icgov.org/node/14986/submission/1886 3/13/2017 Submission #14 1 City of Iowa City Page 2 of 3 carbon future following the devastating tornado in 2007, serving as the first sustainability coordinator at an Iowa city in Dubuque in 2009, calculating ACT, Inc.'s first carbon footprint and reduction plan around 2012. In October 2016, 1 spoke at a national sustainability conference on "climate change and social justice" and in March 2017 will also speak to a national audience about climate issues on a panel for The Climate Collaborative. My current work is with National Co+op Grocers, an association of over 150 food co-ops with 200+ retail stores throughout the country. My role is designing and carrying out programs that help our members to measure and manage their triple bottom line impacts. This includes helping the stores understand their carbon footprints and how to strategically reduce their emissions. I am a regular guest lecturer in the Sustainable Marketing class at the University. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). In 2004-2005 1 was a board member of a local group called The James Gang, where my focus was launching a community sustainability festival called Earth Expo. This festival continued for several years after I moved to San Francisco. More recently, I served as a board member in 2010-2011 for Backyard Abundance, and am currently an incoming board member of Environmental Advocates, based in Iowa City. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? This will depend on the types of recommendations developed. I envision being most helpful with outreach to the business or university/college communities, and through my personal network that includes many different types of groups. Age 36 Country of Origin United States Sexual Orientation Straight Religion None Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant Sheila M Ongie https://www.icgov.org/node/14986/submission/1886 3/13/2017 Submission #15 1 City of Iowa City Submission #15 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 02/07/2017 - 12:09pm 129.255.227.46 Date of Application Tue, 02/07/2017 Name Nathaniel Weger Home Address 625 S Clinton St Apt 2 Iowa City, IA 52240 Contact phone number 319-560-7672 Email Address nateweger@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 2.5 years Occupation: Engineering student Gender Male Page I of 3 What is your present knowledge of this steering committee? I understand that this will be the first community -wide committee in Iowa City based on fighting climate change and reducing greenhouse gas emissions. I understand that there is a goal to reduce city emissions by 26-28% by 2025 and by 80% by 2050. 1 understand that the committee will be working with a consultant who will help in the development of the plan. I understand that it should be a diverse committee made of people with different skill sets and life experiences. I understand that the committee will be representing the community and should work on their behalf and ask for their input. Please summarize your employment history and education experiences which you feel qualify you for this position. https://www.icgov.org/node/14986/submission/1896 3/13/2017 Submission #15 1 City of Iowa City Page 2 of 3 I am a University of Iowa undergraduate student studying mechanical engineering. I will be graduating in May 2018, when I will begin my doctorate at a school that I have not decided on yet. I will be pursuing a career in clean energy sources. While at the University, I have taken a class on basic wind energy, where I learned about the surface level mechanics and aerodynamics of wind turbines. I am also doing research in biomass gasification, which is a process that takes in biomass and converts it to clean energy. From this, I am knowledgable about biomass, which is a large source of fuel for the University of Iowa. I have also learned more about what biomass is replacing and why it's important. I have a deep scientific understanding of the scientific processes related to biomass energy. Last summer, I completed an internship with Eaton Corporation as an Operations Engineering Intern. There, I worked in a plant to improve processes and reduce costs. From this, I have the ability to look at a large concept, see where improvements can be made, and make them. Although a city is on a much larger scale than a manufacturing plant, I believe much of what I learned and gained is transferrable. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I am a Senator on the University of Iowa Student Government. This is the first year I have been involved with them, and I am on the Sustainability and Governmental Relations committees. I am currently working on a water recycling project for the university that could reduce water costs, water usage, and energy usage. I am also on the Executive Board of the Ulowa American Wind Energy Association. With them, I have designed, built, and tested a small-scale wind turbine that is capable of powering a mobile device. We promote sustainability on campus. We hosted a trip to the new Cedar Rapids Indian Creek Nature Center, which is a completely self -sustainable building and area. We also regularly host trips to wind farms around the state. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? As a Ulowa student, I am well-connected throughout the university and much of the city. My most obvious connection to the community is with other students. I am involved in a lot of different groups, so I know a lot of people in many different parts of the university. I regularly talk with the people at the power plants and water plant, and have worked with them on various sustainability and energy conservation projects. I have also worked with Erin Hazen, the Renewable Energy Business Development Manager at the university, and she is a great person to work with on energy projects. I personally know many engineering professors who feel strongly that more should be done to reduce greenhouse gas emissions and are doing work in that area, and they would be great help as well. Overall, I will represent this work to others in the community through in-person discussion, as well as through social media. I will encourage suggestions and conversations in an attempt to get the community more involved in the process. https://www.icgov.org/node/14986/submission/l896 3/13/2017 Submission 415 1 City of Iowa City Page 3 of 3 Age 21 Country of Origin United States Sexual Orientation Heterosexual Religion N/A Do you have a disability NO Race, Color or Ethnic Group White/Caucasian Signature of applicant Nathaniel Weger https://www.icgov.org/node/14986/submission/l896 3/13/2017 Submission #17 1 City of Iowa City Submission #17 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 02/08/2017 - 1:56pm 97.127.137.3 Date of Application Wed. 02/08/2017 Name jan Stephan Home Address 3201 Muscatine Ave, #3 Contact phone number 3192700128 Email Address janetstephan8@msn.com Is your home address within the corporate limits of Iowa City? 3201 Muscatine Ave How long have you lived in Iowa City? iowa city Occupation: retired RN Gender Female Page 1 of 2 What is your present knowledge of this steering committee? I am only aware of what is online,but am very interested in any more info that can be provided. Please summarize your employment history and education experiences which you feel qualify you for this position. I am an RN with an MA in counseling. Currently retired. I have been active in the environmental community in Johnson Co. and the state. I was raised in Iowa and have lived in Iowa City since 2004. https://www.icgov.org/node/14986/submission/I911 3/13/2017 Submission #17 1 City of Iowa City Page 2 of 2 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I serve on the steering committee for 100 Grannies for a Liveable Future and have done so for 4 years. I have been active in all Grannie events with goals of advocacy education and agitation. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I have done public speaking regarding social issues and more recently regarding environmental issue. I have worked both at Mercy and UIHC and maintain connections at both places. I am a member of a local PEO group. I have been active with the Mississippi Stands No DAPL group as well as the keystone activists. Age 73 Country of Origin iA Sexual Orientation Religion Do you have a disability NO Race, Color or Ethnic Group cauc Signature of applicant jan Stephan https://www.icgov.org/node/14986/submission/1911 3/13/2017 Submission 418 I City of Iowa City Submission #18 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 02/08/2017 - 9:53pm 67.55.154.29 Date of Application Wed, 02/08/2017 Name Levi Lappin Home Address 212 Village Dr. #11 Contact phone number (641)295-0852 Email Address levi-lappin@uiowa.edu Is your home address within the corporate limits of Iowa City? No How long have you lived in Iowa City? 1 year, 1 month Occupation: Communications at Iowa Cancer Consortium Gender Male Page 1 of 2 What is your present knowledge of this steering committee? I know that this steering committee has just been implemented and it's goals include achievable targets that will reduce greenhouse emissions from the Iowa City area. Please summarize your employment history and education experiences which you feel qualify you for this position. While I have no professional experience in the field of greenhouse emissions and climate change, I sincerely posit that my critical thinking abilities and statistical experience can aid in making decisions regarding this subject. https://www.icgov.org/node/14986/submission/1921 3/13/2017 Submission #18 1 City of Iowa City Page 2 of 2 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Iowa Cancer Consortium - Communications -- Project management in LGBTQ Tobacco -Use campaign (surveying data, implementing actions steps, etc.) How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? Many of the people that I interact with daily have an extreme interest in this subject. Although most of them are not part of any formal group that does any sort of greenhouse emission control, I believe that to be their greatest asset, as it connects with the general public and could invite collaboration among different groups. Additionally, my work at the Iowa Cancer Consortium could be of high impact among this project due to the connection of chemicals and cancer. Age 23 Country of Origin United States Sexual Orientation Gay Religion Atheist Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant Levi Reid Lappin https://www.icgov.org/node/14986/submission/1921 3/13/2017 Submission #19 1 City of Iowa City Submission #19 Submission information Form: Climate Action Steering Committee Application Form Submitted by amanda-opitz@io... Fri, 02/10/2017 - 10:39am 198.151.137.42 Date of Application Fri, 02/10/2017 Name Amanda Opitz Home Address 426 N. Gilbert St. Contact phone number 406-431-7105 Email Address opitzphotography@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 1.5 years Occupation: Program Supervisor with Iowa City Parks and Recreation Gender Female Page 1 of 3 What is your present knowledge of this steering committee? I learned of this steering committee through a press release from the City of Iowa City requesting applications for members. Prior to this release I was unaware of the existence of this body. Please summarize your employment history and education experiences which you feel qualify you for this position. I attended Gonzaga University in Washington as an undergraduate from 2005-2007, and then transferred to complete a degree in Photojournalism from the University of Montana in 2010. After graduating, I served two years with AmeriCorpsVISTA (one year placement with Montana Public Radio, & one year placement with the Montana Campus Compact) and then took a job as Communications Coordinator for a women's crisis organization in Missoula. I https://www.icgov.org/node/14986/submission/1926 3/13/2017 Submission 419 1 City of Iowa City Page 2 of 3 worked there for several years, and then moved to Iowa City, IA about year and a half ago after my husband accepted a spot in the Creative Writing MFA program at the University of Iowa. Currently, I serve as Program Supervisor for Customer Engagement with the City of Iowa City Parks and Recreation Department. In this role, I supervise customer service employees at two municipal recreation centers, as well as coordinate external communications for the Department. One half of my job affords me the opportunity to interact with the public on a daily basis and then act as a conduit to City management to make sure the public's needs are heard. The other half of my job challenges me to create systems allowing for greater public access to information, and an easier route to engaging with public processes. My eventual landing in Parks and Recreation isn't just happenstance, rather a culmination of a lifetime of seeking adventure in the outdoors and choosing to pursue a career in the public good. This fortune has led me to a field that combines my passion for building healthy communities with my love of natural spaces. Though I am relatively new to Iowa City, I feel very committed to helping this community cut greenhouse emissions and improve sustainability, and I can offer up my skills as a communications professional and a Parks and Recreation employee to support this work. In my personal life, I have committed to reducing my own carbon footprint by walking or biking almost everywhere, and reducing the amount of non-recyclable/compostable waste that I produce. I would love to have the opportunity to continue to grow my understanding of conservation and impact our shared environment in a way that benefits all Iowa City residents. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). For a number of years before I moved from Montana to Iowa I volunteered regularly with the Clark Fork Coalition on river clean-up projects, and with our local Trout Unlimited Chapter on various watershed improvement projects. I have also been a member of the National Recreation and Parks Association as well as the Iowa Parks and Recreation Association wherein I have connections with professionals throughout the state. These bodies always welcome the sharing of information and tools. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I think that Iowa City Parks and Recreation is a very logical place to start when looking at impacting our climate. Our staff is already committed to minimizing pesticide use, conserving water (https://www.icgov.org/news/parks-and-recreation-staff-launch-million-gallon- challenge), maximizing the health of our urban forests, and connecting our community through a well-maintained trail system. Having a liaison from my Dept. on this committee seems like a great way to share information about our successes as well as bring back new ideas generated through the committee to hopefully lead to sound community solutions to issues related to climate change. Age 30 https://www.icgov.org/node/14986/submission/1926 3/13/2017 Submission #19 1 City of Iowa City Page 3 of 3 Country of Origin USA Sexual Orientation Heterosexual Religion NA Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant Amanda Opitz https://www.icgov.org/node/14986/submission/1926 3/13/2017 Submission #20 1 City of Iowa City Submission #20 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Sun, 02/12/2017 - 11:22am 63.152.122.237 Date of Application Sun, 02/12/2017 Name Jeffrey Falk Home Address 7 Princeton Ct Contact phone number 319-800-9869 Email Address joanjeff@centurylink.net Is your home address within the corporate limits of Iowa City? yes How long have you lived in Iowa City? two years in March Occupation: retired statistician Gender Male Page 1 of 3 What is your present knowledge of this steering committee? I have read what has been posted on the Sustainability department's website including the 2015 report, the 2016 update, the greenhouse gas report, and the sustainability assessment. I have also skimmed what is available on the web for the Compact of Mayors. I was also present at a recent city council meeting where the steering committee was briefly discussed. Please summarize your employment history and education experiences which you feel qualify you for this position. BS in math; graduate work in philosophy and a MS in statistics. Taught high school math for one year and lower level college math for three years. I was a self-employed carpenter/furniture maker for a number of years. I worked for a number of years as a statistician for the Red Wing Shoe Company, Red Wing, Mn, and in the quality improvement https://www.icgov.org/node/14986/submission/1931 3/13/2017 Submission #20 1 City of Iowa City Page 2 of 3 department at Gundersen Medical Center in LaCrosse, Wi. I volunteered with Community Education and the Food Shelf in Winona, Mn. I currently volunteer at the Kirkwood Learning Center. I have been interested in environmental issues for a long time and have studied climate warming/change for over a decade. I audited a MOOC course on climate change denial, attended a recent senior college course on climate warming, participated in the senior center science discussion group sessions on Kolbert's The Sixth Extinction and current session on sustainability. I have also read books on climate change by Michael Mann (the "hocket stick" person) and David Archer. I make it my business to keep up to date reading the RealClimate website and the reports produced by the ACEEE (American Council for an Energy Efficient Economy). I was part of a Buffalo County, Wi, group opposed to frack sand mining making air quality my particular emphasis so I became familiar with government regulations, health concerns, and monitoring as well as how to discuss technical topics with non -technically oriented people. My experience teaching helped in this regard. When we moved to Iowa I met and was employed for a while assisting Professor Tom Peters at Ulowa on analysis and presentation of an air quality monitoring project around sand facilities in Western Wisconsin. I currently use a number of data loggers monitoring temperatures inside and outside our house as well as furnace run times to analyze our energy use and document movements towards greater efficiency. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Please refer to the previous question and response. I am not an organization joiner. I volunteer with many groupings and sporadically participate but consider my volunteering to be more than doing a service. I try to get to know people I, under usual circumstances, would probably never meet. I also consider myself technically proficient enough to be secure meeting challenges and highly motivated to understand other people's concerns and communicate in a non -demeaning manner my concerns. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? "Inspiration" is a difficult term. I dislike "motivational" discourse. I'd prefer to use the word "challenge". In particular, non-violent challenge implies a deep confrontation with values in play. How's that for gibberish? Being new to Iowa City and a non -joiner I would hope to be able to assist others with communication. In addition, I believe there is much more that can be done within commercial and industrial facilities. These are the major sources of ghg's. I believe with appropriate data and analysis and perhaps "shaming" , inspiration can occur. Age 72 Country of Origin Chicago, Illinois, USA Sexual Orientation heterosexual? https://www.icgov.org/node/14986/submission/1931 3/13/2017 Submission #20 1 City of Iowa City Page 3 of 3 Religion jewish ethnicity Do you have a disability NO Race, Color or Ethnic Group human race, caucasian color,jewish chicagoan ethnicity Signature of applicant Jeff Falk https://www.icgov.org/node/14986/submission/1931 3/13/2017 Submission #211 City of Iowa City Submission #21 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Sun, 02/12/2017 - 4:52pm 50.81.229.223 Date of Application Sun, 02/12/2017 Name Clarity Guerra Home Address 1124 Franklin St. Contact phone number 323-793-2611 Email Address clarity.guerra@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 5 years Occupation: Communications, University of Iowa Gender Female Page 1 of 3 What is your present knowledge of this steering committee? The Climate Action Steering Committee was recently authorized by the Iowa City City Council to discuss ways to reduce greenhouse gas emissions in the community. The council wants the steering committee to oversee the development of a Climate Action and Adaptation Plan. Please summarize your employment history and education experiences which you feel qualify you for this position. I think my B.A. in environmental science and current career in communications makes me a good fit for being on the Climate Action Steering Committee. Additionally, climate change is a personal passion of mine and as a composter, CSA -holder, commuter cyclist, and happy Iowa City resident, would be honored to serve and share my time for this effort. https://www.icgov.org/node/14986/submission/I936 3/13/2017 Submission #211 City of Iowa City Page 2 of 3 I was an Environmental Science major in college and my concentration was in climate change. I learned the science behind climate change, and with my classmates, looked at large data sets both to understand current trends as well as learn how human intervention could best be implemented to neutralize the trends. We researched solutions that citizens and cities could implement that would be cost-effective, lasting impact to reducing greenhouse gas emissions. Iowa City is fortunate to have access to wind energy, locally grown foods, renewable fuel sources, as well as infrastructure like extensive bike trails, and good public transit. These assets as well as the will power of a progressive and community - minded constituent base make Iowa City very well-positioned to make investments further expanding its sustainability efforts and emissions reductions, resulting in considerable returns such as long-term strength and resilience. In my career in communications, I have gained experience building buy -in from important stakeholders and preparing messaging for diverse audiences. I hope I am given the chance to combine my background in science and experience in communications to serve on this committee. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Landlocked Film Festival committee, 2 Years University of Iowa Digital Media Producers, chair 2 years University of Iowa Social Media Producers, member 2 years How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? Working for the University of Iowa, I would see my network there as a possible pathway for building engagement, interest, and partnership. I am also active in the Iowa City cycling community and gardening community. Age 29 Country of Origin USA Sexual Orientation L Religion none Do you have a disability NO Race, Color or Ethnic Group white, Latina https://www.icgov.org/node/14986/submission/1936 3/13/2017 Submission #211 City of Iowa City Signature of applicant Clarity Guerra Page 3 of 3 https://www.icgov.org/node/14986/subrnission/I936 3/13/2017 Submission #22 I City of Iowa City Submission #22 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 02/15/2017 - 9:54am 199.120.91.85 Date of Application Wed, 02/15/2017 Name Rose Amundson Home Address 1027 Keokuk Street Contact phone number 3193219573 Email Address rosemcandrew@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? I moved back to Iowa City in 2011 Occupation: Environmental Scientist/Hydrologist Gender Female Page 1 of 2 What is your present knowledge of this steering committee? I understand that this steering committee will work with the City -hired consultant to develop guidance (methods and practices) that the City may utilize to minimize the carbon footprint and environmental impact. Further, as a member, you should work to communicate this effort out to the community. Please summarize your employment history and education experiences which you feel qualify you for this position. I hold a BS in environmental science, BA in political science, and MS in hydrology. While completing my undergraduate degrees I was a member of student government and vice president/president of the Environmental Science Club and worked to expand recycling on campus. I have worked in the environmental field since receiving my graduate degree, https://www.icgov.org/node/14986/submission/2186 3/13/2017 Submission #22 1 City of Iowa City Page 2 of 2 specifically working with communities to revitalize underutilized, derelict, or abandoned properties for redevelopment. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I am a Director for the Iowa Groundwater Association, currently in my second year. While in school I was involved in the Environmental Science Club (vice president/president) and involved in student government. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I live in an area with an active neighborhood association (Lucas Farms Neighborhood Association) and I would welcome this opportunity to reach out in to other groups in the community. Age 32 Country of Origin United States of America Sexual Orientation Straight Religion Agnostic Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant Rose Amundson https://www.icgov.org/node/14986/subniission/2186 3/13/2017 Submission #23 1 City of Iowa City Submission #23 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Thu, 02/16/2017 - 5:14pm 38.108.148.156 Date of Application Thu, 02/16/2017 Name Kaveh Mostafavi Home Address 3541 Galway Court, Iowa City, IA 52246 Contact phone number (319)800-9162 Email Address kaveh@ecocaresupply.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 1993 -2004,2014 -present Occupation: Founder/CEO of Ecocare Supply Gender Male Page I of 2 What is your present knowledge of this steering committee? Based on my online research the committee will help formulate plans of action to reduce greenhouse gas emissions. Please summarize your employment history and education experiences which you feel qualify you for this position. 1999-2003: B.S. University of Iowa 2004-2007: Drake University Law School 2008-2014: Licensed Attorney in Arizona 2014 -Present: Founder/CEO, Ecocare Supply: Ecocare is part research and development firm and part distribution company. We source sustainable janitorial, sanitary, food service, office, etc. products from all over the USA. Our main product lines incorporate 100% https://www.icgov.org/node/14986/submission/2266 3/13/2017 Submission #23 1 City of Iowa City Page 2 of 2 recycled paper, green -certified bio -based soaps/sanitizers/cleaners, and ASTM D6400 certified compostable food service products. To date, Ecocare has helped hundreds of businesses reduce their environmental impacts. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Founder/CEO-Ecocare Supply, 2014 -Present: I have spent the past 3.5 years researching more sustainable waste products, mainly recyclables, biodegradeables, green -certified bio - based, and compostables. I have significant knowledge of certifications, reliable/durable product lines, and established laws (i.e California law AB 1826 Chesbro (Chapter 727, Statutes of 2014), San Fransisco Mandatory Recycling and Composting Ordinance ) that mandate commercial organics waste diversion. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? Ecocare services hundreds of businesses a day, and has formulated proven sustainability strategies to reduce environmental impacts. My biggest value in this committee will be to help formulate plans of action to incorporate more sustainable and compostable disposable waste products into businesses to drastically reduce impacts on our landfill. Landfills are the single most sources of methane emissions in the world, and composting directly reduces CO2 and other greenhouse gases. Once these plans are established Ecocare can promote them by educating its current and future clients, while helping businesses source sustainable products, given no conflicts arise by participation on this committee. Age 36 Country of Origin Iran Sexual Orientation Heterosexual Religion Islam Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Kaveh Mostafavi https://www.icgov.org/node/14986/submission/2266 3/13/2017 Submission #24 1 City of Iowa City Submission #24 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Fri, 02/17/2017 - 10:18am 50.81.229.32 Date of Application Fri, 02/17/2017 Name Eric Jones Home Address 821 3rd Ave. Contact phone number 319-325-2370 Email Address eric00jones@gmail.com Is your home address within the corporate limits of Iowa City? yes How long have you lived in Iowa City? 17 years Occupation: Self -Employed Co-owner of Adamantine Spine Moving Gender Male Page 1 of 2 What is your present knowledge of this steering committee? I only know what was posted in the announcement - that the committee will participate in the development of a Climate Action Plan for the Iowa City community and work to identify practical emissions reduction programs. Please summarize your employment history and education experiences which you feel qualify you for this position. I'm a co-owner of Adamantine Spine Moving, a socially and environmentally responsible local and long-distance moving company based here in Iowa City. We've https://www.icgov.org/node/14986/submission/2276 3/13/2017 Submission #24 1 City of Iowa City Page 2 of 2 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I've been a member of the Corridor Business Leaders for the last two years, an Iowa City - based organization of small-business owners that provides support, education, and collaboration to small-business owners in the corridor. I'm currently developing a podcast series for the group that will profile local small business owners and highlight the way in which who business owners are affects how they run their businesses. I'm also a member of the AIR, the association of Independents In Radio, an organization that offers support, mentorship, and training to independent radio producers throughout the country. My skills as both a freelance writer (I'm a graduate of the Nonfiction Writing Program at the U of 1) and independent radio producer could be useful in communicating information about the committee's work to community members. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I'm a member of the Corridor Business Leaders, so I could bring the committee's work to that forum. I'll also be co -hosting a Podcast about small business owners in the community, which could be a platform for influencing others to get involved with some of the initiatives that the steering committee recommends. Age 45 Country of Origin U.S. Sexual Orientation Religion Do you have a disability NO Race, Color or Ethnic Group Anglo Signature of applicant Eric Jones https://www.icgov.org/node/14986/submission/2276 3/13/2017 Submission 425 1 City of Iowa City Submission #25 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Fri, 02/17/2017 - 2:OOpm 129.255.1.141 Date of Application Fri, 02/17/2017 Name Eric Axelson Home Address 928 Canton St Contact phone number 3193417864 Email Address eric-axelson@uiowa.edu Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 19 years Occupation: Research Specialist Gender Male Page 1 of 2 What is your present knowledge of this steering committee? Develop action plan to meet carbon reduction and sustainability goals set out by the council. Please summarize your employment history and education experiences which you feel qualify you for this position. I am an Industrial Engineering grad from the University of Iowa who has been working in medical research in the Department of Psychiatry for the last 13 years. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Sierra Club member https://www.icgov.org/node/14986/submission/2281 3/13/2017 Submission #25 1 City of Iowa City Page 2 of 2 How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? Local communities have to step up when the state and federal actions are lacking in this area. We need to lead Iowa in sustainability by a wide margin. Age 36 Country of Origin USA Sexual Orientation Straight Religion Christianity Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Eric Axelson https://www.icgov.org/node/14986/submission/2281 3/13/2017 Submission #26 1 City of Iowa City Submission #26 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Sun, 02/19/2017 - 7:29pm 129.255.227.42 Date of Application Sun, 02/19/2017 Name Solomon Furious Worlds Home Address 611 S Clinton St., Apt 1 Contact phone number 7608807407 Email Address solomon-worlds@uiowa.edu Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 4 years Occupation: Srudent, ICCSD Intern Gender Page 1 of 2 What is your present knowledge of this steering committee? The steering committee is new and the genesis of the committee will effect the City's energy use and overall impact on the climate of Iowa. Please summarize your employment history and education experiences which you feel qualify you for this position. Science Communications Inten with Iowa Water Center • Research, review, and disseminate recent press releases and news articles on water quality • Attend conferences all over the state of Iowa Fellow with the Climate Narrative Project • Interviewed to receive 1 of 8 spots in a competitive process • Discussed current issues in sustainability and presented on woodland systems https://www.icgov.org/node/14986/submission/2291 3/13/2017 Submission #26 1 City of Iowa City Page 2 of 2 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). During my two years on the University of Iowa's President's Black Student Advisory Committee, I have worked with those involved to help get this new group off the ground. I lead the charge in writing our group's constitution and, in the process, created a new position within the committee. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I have the privilege to be a student at a Big10 institution. In my classes and personal conversations, I will invite students to look into what the city is doing in the ways of climate justice. 1 will also take this same spirit with me to my work place in the local school district, to my spiritual headquarters, and to my peers in the President's Black Student Advisory Committee. Age 21 Country of Origin United States of America Sexual Orientation Religion Do you have a disability NO Race, Color or Ethnic Group Afro-American Signature of applicant Worlds, Solomon Furious https://www.icgov.org/node/14986/submission/2291 3/13/2017 Submission #271 City of Iowa City Submission #27 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 02/21/2017 - 11:29am 50.82.39.106 Date of Application Tue, 02/21/2017 Name Chant Eicke Home Address 904 Juniper Dr., Iowa City, 54454 Contact phone number 319-330-0102 Email Address chant.eicke@gmail.com Is your home address within the corporate limits of Iowa City? yes How long have you lived in Iowa City? 11 years Occupation: Professional Wetland Scientist and Environmental Consultant Gender Male Page 1 of 3 What is your present knowledge of this steering committee? My present knowledge of the committee is only that information which is available through the Iowa City Sustainability website; that this is a 12 person committee, comprised of community business, industry, governmental/education, and other stake holders as well as 5 at -large community members. This 1 year committee will advise the City Council and their consultant regarding programs, outreach, and resources for meeting the greenhouse gas emissions target set forth by the Iowa City Council. I do not know how coordinated Iowa City's Climate Action Plan is with the C40 Cities Climate Leadership Group, but I assume it is at least in part inspired by their efforts and parallel goals. Please summarize your employment history and education experiences which you feel qualify you for this position. https://www.icgov.org/node/14986/submission/2316 3/13/2017 Submission #27 1 City of Iowa City Page 2 of 3 I graduated from the University of Oregon in 2004 with a BA in Environmental Studies and a minor in Spanish language. The University's Environmental Studies department and program provide a broad foundation for understanding the interplay between science, policy, and society that, while highly complex, is crucial to effective implementation of any climate action framework. Working with AmeriCorps, the Bureau of Land Management, the U.S. Fish & Wildlife Service, and as a private consultant at EarthView Environmental Inc in Coralville, IA, I have developed a diverse background in conservation methods, philosophies, and practice, along with a familiarity with public/private/corporate partnerships and realizing effective interaction between these groups. For the past 10 years, I have developed a strong understanding of wide -spread and contentious federal and state regulatory frameworks, including the Section 404 permitting process under the U.S. EPA Clean Water Act, as well as the U.S. Endangered Species Act. I am a certified Professional Wetland Scientist under the internationally recognized Society of Wetland Scientists Professional Certification Program. I have experience in several conservation fields: both public and private sectors. I am also well practiced in business management, project management, and the economic realities of scheduling and budgets as well as the positive and negative impacts that regulatory policy and enforcement can affect across those project. This balanced experience provides insight into the demands put upon governments to effectively and non -contentiously enact positive and effective regulation, as well as the economic development realities and bindings those regulations may effect upon public and private communities and organizations. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Society of Wetland Scientist, current member, 10 years Association of State Wetland Managers, current member, 8 years Wisconsin Wetlands Association, current member, 8 years Lucas Elementary Parent Teacher Organization, current member,''/2 year Loving Arms Early Learning Center Board, former Vice President, % year How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? On a local level, I am engaged with local conservation organizations through my work as a controlled burn and restoration professional. I am an active member of local educational organizations and multiple regional and national scientific communities, as listed above. My major field of educational study was a liberal arts degree involving not just the natural sciences, but also the economic, governmental, sociological, cultural and philosophical components of our anthropogenic environment that shapes human interface with the natural environment. As a species, when it comes to our relationship with the environment, understanding and having good science is key, but as we've seen with the climate debate, good science only provides as much insight and guidance as popular perception and cultural influences will allow. https://www.icgov.org/node/14986/submission/2316 3/13/2017 Submission #271 City of Iowa City Page 3 of 3 I feel that my strength on this committee would be in seeing those connections, challenges, and opportunities where the science and policy interface with the public's education, politics and culture. Effective implementation of any Climate Action Plan and public acceptance of that plan requires a nuanced approach to, and understanding of, these dynamics. Age 39 Country of Origin USA Sexual Orientation straight Religion agnostic Do you have a disability NO Race, Color or Ethnic Group caucasian Signature of applicant Chant Eicke https://www.icgov.org/node/14986/submission/2316 3/13/2017 Submission #28 1 City of Iowa City Submission #28 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 02/21/2017 - 1:49pm 128.255.79.138 Date of Application Tue, 02/21/2017 Name Eden DeWald Home Address 725 Bowery Street Contact phone number 5154502859 Email Address eden-dewald@uiowa.edu Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 1.5 years Occupation: Student/ Intern at the Universiy of Iowa Office of Sustianability Gender Female Page 1 of 2 What is your present knowledge of this steering committee? From my understanding,this committee will be used to help strategize a way for the city to curb its greenhouse gas emissions. Please summarize your employment history and education experiences which you feel qualify you for this position. I am a currently studying to attain a BS in Environmental Science at the University of Iowa. Through my schoolwork, I have an understanding of natural systems, and how the are affected my human interferences. I currently work for an environmental chemistry engineer as a research assistant through the university. Together, we are studying the impact of insecticides from crop run off on Iowa water. I also work at the Office of Sustainability as an https://www.icgov.org/node/14986/submission/2321 3/13/2017 Submission #28 1 City of Iowa City Page 2 of 2 Eco Hawk Intern. Through my work there, I have designed the Eco Hawk GOLD Program: a sustainability education and engagement initiatives for college students. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Round River Radio (a podcast/ radio show about sustainability): Co host: 1.5 years University of Iowa Environmental Coalition: Social/Outreach Executive: 1.5 years Student Garden: Member: 1.5 years Volunteer at North Liberty Community Pantry How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I am very involved with the environmental movement from the capacity of the University, with both of my internships, as well as my student organization activities (listed above). I am also connected to local food professionals such as Grow Johnson County, through my sister, who works at North Liberty Community Food Pantry. Age 19 Country of Origin United States Sexual Orientation Religion Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Eden DeWald https://www.icgov.org/node/14986/submission/2321 3/13/2017 Submission #29 1 City of Iowa City Submission #29 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Thu, 02/23/2017 - 10:15am 63.254.139.28 Date of Application Thu, 02/23/2017 Name Anne Hansen Home Address 908 Roosevelt St Contact phone number 6415124168 Email Address annechristianshansen@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 13 years Occupation: Art Teacher Gender Female Page 1 of 3 What is your present knowledge of this steering committee? My knowledge of this committee goes as far as the advertisement. However, I am a passionate Iowa City citizen who is concerned with climate change and pollution. I brought awareness to the litter along the banks of the Iowa River in 2015. As a result, City Carton recycling cleaned up the area in question. I would be member passionate about our community with a deep investment in climate change and the environment. Please summarize your employment history and education experiences which you feel qualify you for this position. https://www.icgov.org/node/14986/submission/2341 3/13/2017 Submission #29 1 City of Iowa City Page 2 of 3 Masters Degree in Educational Leadership. BFA, 3-D Design I have served as a Middle School Art Teacher in the College Community School District for 9 years. I have also served in a variety of leadership positions including our building's leadership team for 2 years, lab classroom teacher for 2 years and various other positions. As a veteran educator and teacher leader, I would be an ideal candidate to aid in the planning of programs, evaluating success and communicating and teaching the public about new policies, procedures and ideas. My background in Art and 3-D Design would aid the committee in brainstorming creative ways to attack problems and integrate them into the community. As a citizen of our city, state and country, I am an avid news consumer and keep up on environmental issues and discuss them with those around me. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I have been a member of a variety of committees in my current place of employment including: School Climate Committee, Gay Straight Alliance and the district anti bullying council. As of yet, I have not been a member of a city wide committee. I would be a youthful, creative and passionate and active learner if placed on this committee. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? As an educator and artist, I see myself representing this work to the community using personal, creative and educational connections. I understand what best practice is and would infuse that into the planning, designing and communication of this committee. I am also an avid social media user and keep up on city happenings using the many social media facets created. I am connected to the Iowa City artist community, my local gym, IC Fit, my neighborhood, and the downtown district. Age 33 Country of Origin USA Sexual Orientation Straight Religion None Do you have a disability https://www.icgov.org/node/14986/submission/2341 3/13/2017 Submission #291 City of Iowa City RM Race, Color or Ethnic Group Caucasion Signature of applicant Anne C. Hansen Page 3 of 3 https://www.icgov.org/node/14986/submission/2341 3/13/2017 Submission #30 1 City of Iowa City Submission #30 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Thu, 02/23/2017 - 3:22pm 63.152.115.247 Date of Application Thu, 02/23/2017 Name Christian Noyce Home Address 824 Dover St Contact phone number 715.579.2425 Email Address noycechristian@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 6 months Occupation: currently unemployed; environmental organizer and policy wonk Gender Male Page 1 of 3 What is your present knowledge of this steering committee? The steering committee is tasked with developing a climate action plan for the city to reach their greenhouse gas emission reduction targets and will consist of different stakeholders in the community and emissions producing sectors as well as a few at -large members to represent the Iowa City community as a whole. Please summarize your employment history and education experiences which you feel qualify you for this position. I graduated from Grinnell College in 2015 with a bachelor of arts in economics. During my academic career I engaged in environmentalism and climate action in Grinnell, Iowa. I chaired the Student Environmental Committee where we took steps to complete a campus wide sustainability plan, including the creation of a 'green fund.' We organized events to https://www.icgov.org/node/14986/submission/2351 3/13/2017 Submission #30 1 City of Iowa City Page 2 of 3 educate the community and doubled our yearly funding for the committee. I analyzed the Grinnell College environmental curriculum's strengths and weaknesses to determine the appropriate approach towards an environmental studies major. I led weekly meetings with committee members, college faculty, and others to advocate for the construction three industrial wind turbines to reduce the college green house gas emissions by up to 60%. We also oversaw the sustainability efforts for the Social Sciences and Humanities building complex expansion. In my courses I researched different emission reduction policies and their impacts on disenfranchised, minority, and vulnerable communities. I conducted literature reviews of national carbon trading policy and economic analysis of emission distribution and environmental justice impacts of the U.S. Acid Rain Program on Sulfur Dioxide. I also took courses in environmental history, environmental economics, econometrics, and policy analysis that would be applicable toward this steering committee. After graduating from Grinnell College, the League of Conservation Voters employed me for a year to organize and educate volunteers on environmental policies. Taking this energy, we helped citizens hold their officials accountable for their environmental promises. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Organizer, December 2015 to December 2016 League of Conservation Voters Co -Chair, August 2014 to August 2015 Campus Environmental Coordinator, August 2011 to December 2013 Student Environmental Committee, Grinnell College How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I see myself as a pragmatic policy analyst that can translate the jargon of the climate action plan and environmental policies to the environmentalist, university, and millennial communities. I am one who can help placate these groups as we know not all of their demands may be met as we reduce our greenhouse gases. Ideally the plan will bring these communities and constituents into the fold to support it in of its own but that probably will not happen. This committee needs members that can communicate to the community why this plan will be a positive step forward for Iowa City no matter how the ultimate draft turns out. I have strong connections to the environmental community here in Iowa City and broader Johnson County areas. As a younger individual I can bring the initiatives and recommendations to my peers to convince them to initiate these exciting policies and provide feedback on their functionality. These two constituency groups are instrumental in producing a functional climate action plan. They represent our future and the individuals that are passionate about climate action. Age 24 https://www.icgov.org/node/14986/submission/2351 3/13/2017 Submission #301 City of Iowa City Country of Origin United States of America Sexual Orientation heterosexual Religion raised catholic Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant CHRISTIAN NOYCE Page 3 of 3 https://www.icgov.org/node/14986/submission/2351 3/13/2017 Submission #311 City of Iowa City Submission #31 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Mon, 02/27/2017 - 1:23pm 173.28.209.65 Date of Application Mon. 02/27/2017 Name Joel Donham Home Address 2327 Cameron Way Contact phone number 3193214499 Email Address joel.donham@gmail.com Is your home address within the corporate limits of Iowa City? 2327 Cameron Way How long have you lived in Iowa City? Iowa City Occupation: Transportation Engineer (consultant) Gender Male Page 1 of 3 What is your present knowledge of this steering committee? Building on its long history of monitoring city-wide GHG emissions and addressing the impact of municipal operations on climate change, Iowa City is working to develop an action plan to address community -wide emissions. Because this plan will involve actions by private individuals and organizations, the city is striving to get broad based input from a steering committee composed of representatives of numerous organizations around the city, as well as general at -large community members. Please summarize your employment history and education experiences which you feel qualify you for this position. Starting March 27, 2017 Project Manager, Center for Transportation and the Environment https://www.icgov.org/node/14986/submission/2371 3/13/2017 Submission #311 City of Iowa City Page 2 of 3 St. Paul, Minnesota -Manage low -emission transportation projects involving fuel cell and battery electric busses for local transit agencies and technology developers. -identify and develop new opportunities to advance implementation of transportation and environmental technology. 2012-2016 Environmental Engineer, NASA's Goddard Space Flight Center Greenbelt, MD • Awarded the NASA Exceptional Achievement Medal for developing the Goddard Space Flight Center sustainability program in collaboration with the White House, industry and NASA Headquarters. • Managed a research program to develop project options to improve efficiency and environmental outcomes for projects involving transportation, climate change adaptation, water, energy, and facilities. • Presented to VIP groups from government, academia and the public, and wrote communications regarding Goddard's approach to sustainably operating spaceflight hardware production and launch facilities. 2012-2016 Aviation Consultant, Ricondo and Associates Carlsbad, CA and Chicago IL • Modeled and analyzed airport operations and aviation market data to evaluate proposed changes to procedures, airport layouts, and airspace configurations for their ability to accommodate anticipated flight volumes, mitigate noise impacts, and facilitate NextGen navigation procedures. • Developed land use compatibility plans for four San Diego Regional Airport Authority airports, and wrote white papers to explain the impacts of airports on communities. • Served as Air Quality Program Manager for Chicago O'Hare Airport. Eliminated three year required reporting backlog for the Title V air quality program, initiated airport low emissions vehicle program, and developed O'Hare energy management program in eight months. 2009 Intern, The City of Iowa City • Assisted with the initial community -wide GHG inventory for Iowa City. • Initiated the City's energy accounting program which helped correct $72k/yr in billing errors, while supporting measurement and verification of the City's energy conservation efforts. Education M.S. Environmental Engineering --The University of Maryland College Park --2013 M.S. Urban and Regional Planning --The University of Iowa --2009 B.A. Physics --Colorado College --2006 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). All my experiences has been professional, see employment/education section. https://www.icgov.org/node/14986/submission/2371 3/13/2017 Submission #311 City of Iowa City Page 3 of 3 How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? My primary strength is to offer technical expertise in transportation alternatives. This gives me the capability to identify options for fleet operators (busses, landscaping vehicles, construction vehicles, etc.), and develop strategic policy options, promotional campaigns and incentive programs to maximize the environmental benefits of various advocacy strategies for personal transportation. I have personal connections at Durham School Services and Quality Care landscaping that may be responsive to suggestions to promote alternatives to diesel and highly -polluting small engines used in school bussing and landscaping respectively. Additionally, I have contacts in the local construction industry, renewable energy industry and university facilities management that may support building energy conservation initiatives. Age 33 Country of Origin USA Sexual Orientation Straight Religion informal Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Joel E. Donham https://www.icgov.org/node/14986/subniission/2371 3/13/2017 Submission #32 1 City of Iowa City Submission #32 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Mon, 02/27/2017 - 1:46pm 173.20.158.39 Date of Application Mon. 02/27/2017 Name Ryan Hall Home Address 200 S Summit St Iowa City, IA 52240 Contact phone number 7347881810 Email Address ryanryanhall@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 2 months Occupation: Environmental Planning (B.A.) at the University of Iowa Gender Male Pagel of 3 What is your present knowledge of this steering committee? I currently know that this brand new committee seeks to reduce greenhouse gas emissions to meet 26-28% of 2005 levels by 2025 and 80% by 2050. The committee seeks to include diverse array of voices, institutions, and experiences in order to approach emissions goals from many angles. Please summarize your employment history and education experiences which you feel qualify you for this position. My most recent experience with Green Iowa AmeriCorps involved assessment and improvement of the energy efficiency of residential homes, particularly households whose residents qualify as low-income, elderly, disabled, or veteran. Evaluations were conducted through blower -door tests, and efficiency improvements were made through weatherizing https://www.icgov.org/node/14986/submission/2376 3/13/2017 Submission #32 1 City of Iowa City Page 2 of 3 homes (spray foam, caulking, weather-stripping). Outside of home energy audits and efficiency projects, our Green Iowa team conducted or participated in over 40 environmental outreach events, ranging from a 10 -day initiative titled 'Breaking Free from Fossil Fuels', where participants could engage in a local foods exhibit, attend an electric vehicle show, or attend community events focused on reducing energy usage, to conducting solar PV workshops for home -owners, farmers, and business owners. My service with AmeriCorps has afforded me the opportunity to participate in and coordinate emissions -reducing projects and engage with the community in addressing common concerns of sustainability. I am currently studying Environmental Planning at the University of Iowa, and wish to couple my education with practical experience engaging with the community to move rapidly towards a more sustainable future. Participating in the Iowa City Climate Action Steering Committee means bringing practical solutions to the table, bringing the public and the most affected by climate into the conversation, and the ability to move our community forward in a healthy and productive way in regards to action on climate. I believe that through my experience, skills, and passion for climate action and justice, I am a competitive candidate for this steering committee. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). - Three years of national and community service with AmeriCorps > Green Iowa AmeriCorps, Decorah (Outreach Coordinator) September 2015 - August 2016 - BPI Certified as a Building Analyst Professional (Blower -door test, building efficiency) - Organizing community events and actions around environmental efforts > AmeriCorps NCCC, Denver, CO (Corps Member) October 2014 - July 2015 - Wildland Firefighter through US Forest Service in San Isabel National Forest (CO) - Citizens' Climate Lobby (Volunteer) August 2016 - November 2016 > Completed a cross country bicycle trip from Seaside, OR to Washington D.C. speaking to communities throughout the US about implementing a carbon fee and dividend > Lobbied offices of Sen. Grassley & Ernst, and Rep. Young & Blum to consider policy of a carbon fee and dividend and to be leaders in the Republican Party for action on climate How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? As a young person committed to climate action and as a student at the University of Iowa, I see my involvement on campus with organizations such as the the Women's Resource & Action Center (WRAC), and with faculty and students within the Environmental Policy and Planning major in the Geographical and Sustainability Sciences Department as an opportunity to connect more people, particularly University students and departments, to community -wide efforts on climate action. I am also a member of Iowa City Climate Advocates (TCCA), and can connect our efforts to their network and skill sets. Being a potential member of this steering committee means taking collaborative efforts with any groups or individuals who have something to offer or something to gain from climate action (we all do). https://www.icgov.org/node/14986/submission/2376 3/13/2017 Submission #32 1 City of Iowa City Age 23 Country of Origin United States of America Sexual Orientation Queer Religion Pantheism (God and Nature are synonymous) Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Ryan Hall Page 3 of 3 https://www.icgov.org/node/14986/submission/2376 3/13/2017 Submission #33 1 City of Iowa City Submission #33 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Fri, 03/03/2017 - 4:23pm 63.152.109.29 Date of Application Fri, 03/03/2017 Name Cheryl Miller Home Address 1120 Sheridan Avenue, Iowa City IA 52240 Contact phone number (651)653-8133 Email Address camiller@umn.edu Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 3 years Occupation: Retired project manager Gender Female Page 1 of 3 What is your present knowledge of this steering committee? I am familiar with the City Council's recent resolution on GHG emission reduction goals and contributed comments on behalf of the Iowa City Climate Advocates. I am aware that the City is beginning a planning process to develop technical analyses of GHG mitigation options and to obtain community input and, hopefully, support for the best options. I understand the fundamentals of climate change science, greenhouse gas mitigation, and have a grasp of their economic, political, and social implications. I have studied GHG reduction plans adopted in other cities and states. Please summarize your employment history and education experiences which you feel qualify you for this position. https://www.icgov.org/node/14986/submission/2416 3/13/2017 Submission #33 1 City of Iowa City Page 2 of 3 BA in Journalism, University of Iowa, 1970; MA in State Politics and Policy, University of California, 1988. 1 spent 25 years in the field of environmental conservation. From 1990 to 2002, 1 was Wetlands and Watershed Program Director for the Minnesota State Office of National Audubon Society. In this capacity, I participated in legislative and regulatory processes, developed detailed knowledge of many environmental policies, and negotiated stakeholder agreements on large land use issues in the state. From 2002 to 2013, 1 worked as an independent consultant for various government, university, and non-profit groups on collaborative research projects related to GHG reduction strategies, initially assessing land use changes to increase carbon sequestration, and later, community forest bioenergy systems. In this work I developed plans, policy and funding initiatives, demonstration projects, as well as acted as coordinator and communication link between research groups, stakeholders, Minnesota legislators, and broader public. During the 2000's, I also participated in the GHG reduction planning program of the State of Minnesota, primarily focused on options for forest and agricultural bioenergy and sequestration. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Three years ago, I retired and returned to Iowa City. I have worked with Iowa City Climate Advocates (ICCA), starting in 2015 with an effort to bring local groups interested in climate issues together to improve communication and joint action. More recently, I have been helping keep these groups informed about the City Council's climate -related activities and encourage participation. I am also actively involved with the Bur Oak Land Trust (BOLT). In 2015 and 2016, 1 was point person on a joint effort by BOLT, Johnson County Conservation Board, and Linn County Conservation Board to begin holding annual meetings of conservation partners. One outcome of these meetings was establishing listservs on events, initiatives, volunteers, and other topics. I have also been helping BOLT increase outreach to landowners and communities neighboring the organization's properties. Most recently, I wrote an article for the BOLT newseltter about the Eastside Recycle Center as a model for green infrastructure in this growing metropolitan area. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I would continue to play a role in communicating through the TCCA, Johnson County listserv, and BOLT website and publications. I would be very interested in working with the newly - forming steering committee to devise ways to interact with less -connected groups, businesses, churches, etc. One idea is to hold sector -specific forums as the plan is being developed and when the implementation phase begins. Country of Origin USA Sexual Orientation Heterosexual https://www.icgov.org/node/14986/submission/2416 3/13/2017 Submission #33 1 City of Iowa City Religion N/A Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant Cheryl A. Miller Page 3 of 3 https://www.icgov.org/node/14986/submission/2416 3/13/2017 Submission #34 1 City of Iowa City Submission #34 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 03/08/2017 - 1:29pm 173.28.201.92 Date of Application Wed, 03/08/2017 Name Ferman Milster Home Address 12 Notting Hill Ln Iowa City, IA 52245 Contact phone number 319-331-5132 Email Address fmilster@mchsi.com Is your home address within the corporate limits of Iowa City? yes How long have you lived in Iowa City? 26 years Occupation: Retired Gender Male Page 1 of 3 What is your present knowledge of this steering committee? The background and expectations of the committee were discussed with Brenda Nations shortly after the announcement recruiting members. I reviewed the city council resolution forming the committee and other information available on-line. I am familiar with the concept and have done some reading on regenerative cities. Please summarize your employment history and education experiences which you feel qualify you for this position. I retired in April 2015, and have time to devote to this position. Sustainability and climate change were an integral part of my work for the last 15 -years. I am exceptionally well versed in energy and renewable energy technology and development. I was responsible for starting the University of Iowa biomass fuel project. https://www.icgov.org/node/14986/submission/2471 3/13/2017 Submission 434 1 City of Iowa City Page 2 of 3 1991 — 2014 University of Iowa • Power Plant Manager, then Associate Director of Utilities. Gained extensive experience with coal, oil, and natural gas fired boilers and steam turbine electric generator operations and maintenance. Experience budgeting and operating a multi -million -dollar recharge cost center. • Responsible for regulatory compliance and reporting on power plant combustion emissions permits and various other safety and environmental compliance programs. Extensive interface with Iowa Department of Natural Resources. Started and developed the biomass fuel program with the purpose of reducing fossil fuel combustion emissions. Joined Chicago Climate Exchange. Two Iowa Governor Environmental Excellence awards (2004 and 2014). • Spearheaded development of plans to reduce UI carbon emissions 40% below 2010 levels by 2020. To be accomplished primarily by replacing fossil fuel (coal and natural gas) with locally sourced biomass and organic industrial byproducts in power plant solid fuel boilers. • Office of Sustainability (2012-2015 60% part-time phased retirement), developed and started program for local production of Miscanthus x giganteus (Mxg), an energy crop, to support the biomass fuel project. Developed partnership with Iowa State University Agronomy for knowledge necessary to introduce new perennial crop into local area. • Partnered with Johnson County Conservation Commission to pilot timber stand improvements at Kent Park and Chia Fen to supply wood chip fuel for Power Plant fuel tests. 1970 —1990 United States Navy • Specialized in mechanical engineering and gained extensive experience with steam power plants fueled by diesel oil and nuclear power. I have over ten years' experience in shipyards and industrial facilities with ship and submarine construction, repair, and maintenance. • Received a BS in Mechanical Engineering (University of Missouri 1975) and an MS in Mechanical Engineering (Naval Postgraduate School 1984). • Acquired and utilized leadership and management skills, effective in large, mission - oriented organizations. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). City of Iowa City — Conducted investigations with City staff and consultants to study the feasibility of utilizing landfill gas for energy production at the University of Iowa Research Park (Oakdale Campus). Approximately a two-year effort. Experience with numerous consulting engineering firms for University utility system capital project planning, development, and execution. Over twenty years' experience in this area. Oversaw development of a unique partnership with Quaker Oats Cedar Rapids to utilize oat hulls from cereal making to displace coal as boiler fuel. Project involved developing testing methods and equipment, capital planning for plant modifications, financial planning and projections, and air quality permitting. Two year effort from concept to commercial production. International District Energy Association member (15 -years) and Board member (4- years. This association's members operate and maintain energy systems at campuses, airports, cities, and large industrial operations. Their members include consulting engineers and https://www.iegov.org/node/14986/submission/2471 3/13/2017 Submission 434 1 City of Iowa City equipment suppliers. Page 3 of 3 Systems Unlimited board member (2006-2012). This local non-profit provides services to persons with disabilities. The board is a diverse group of individuals with a wide range of experiences and backgrounds. Served as board president (2011). How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I am open to representing and presenting this work as the City would desire. I am comfortable and experienced in public speaking and presentations (Rotary, Lyons Club, college classes, high schools, public interest groups, etc.) I have participated in two Iowa State Fairs representing the biomass fuel project. I would make myself available for public meetings, listening posts, briefings, etc. Age 68 Country of Origin United States of America Sexual Orientation Heterosexual Religion Methodist Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant PF Milster https://www.icgov.org/node/14986/submission/2471 3/13/2017 Submission #35 1 City of Iowa City Submission #35 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Wed, 03/08/2017 - 3:16pm 128.255.26.145 Date of Application Name Blake Rupe Home Address 1106 Marcy Street Contact phone number 6417996047 Email Address blake.rupe@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 10 years Occupation: Sustainable Water Development Program Coordinator Gender Female Page I of 2 What is your present knowledge of this steering committee? A colleague recommended that I apply. I am aware that the committee will work with stakeholders to develop a consensus -based Climate Action and Adaptation Plan for the Iowa City community which will identify priority actions to be taken reach the City's greenhouse gas emissions reduction goals. Please summarize your employment history and education experiences which you feel qualify you for this position. I received my masters in international conservation policy and implementation in 2012. 1 am passionate about sustainability, and after graduation I worked in sustainable technology development. Currently, I work for the The University of Iowa as the Sustainable Water Development Program Coordinator. These positions and my passion make me a perfect fit for this committee. https://www.icgov.org/node/14986/submission/2476 3/13/2017 Submission #35 1 City of Iowa City Page 2 of 2 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I have experiences and connections with the following University organizations that span the past 10 years: Office of Sustainability, Civil and Environmental Engineering, IIHR, International Programs, and the BELL Entrepreneurship Lab. I help run the Engineering Staff Advisory Council at the University. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I see myself presenting and hosting community meetings about this committee. I have connections to the University student population and those students interested in sustainability and green initiatives. I see my self representing this Committee to younger portions of the community. Age 29 Country of Origin USA Sexual Orientation Heterosexual Religion None Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant Blake R. Rupe https://www.icgov.org/node/14986/subniission/2476 3/13/2017 Submission #36 1 City of Iowa City Submission #36 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Thu, 03/09/2017 - 10:26am 75.167.206.5 Date of Application Name John H. Fraser Home Address 2040 Little Creek Lane Contact phone number 319-621-1043 Email Address johnhfraser3@gmail.com Is your home address within the corporate limits of Iowa City? 2040 Little CreekLane How long have you lived in Iowa City? 30 years Occupation: Management Consultant Gender Male Page 1 of 5 What is your present knowledge of this steering committee? I attended the Paris Climate Meetings and became aware of the Compact of Mayors global group. I have subsequently met with Mayor Cownie (Des Moines) and Mayor Throgmorton (Iowa City) about assisting them in their Compact of Mayor initiatives and goals. I volunteered to assist in any way possible both personally and through my role as the President of the Iowa Division of the United Nations Association. I spoke briefly at a City Council meeting in January about the importance of Climate Change action in todays political reality and learned of the new Climate Action Steering Committee. Please summarize your employment history and education experiences which you feel qualify you for this position. CAREER SUMMARY https://www.icgov.org/node/14986/submission/2481 3/13/2017 Submission #36 1 City of Iowa City Page 2 of 5 Experienced management consultant with extensive, strategic planning, organizational development, executive coaching and leadership training background. Significant experience in higher education includes program management, strategic planning, curriculum development and teaching. Key career highlights include: • Lead and directed prestigious executive education program including faculty management and curriculum development for over 100 executive MBA students each year, generating $2.9 million in revenue for the Henry B. Tipple College of Business. • Actively lead industry organizations including the Executive MBA Council as Chair, Past - Chair, Vice Chair and Treasurer. Directed global search for successive Executive Director. • Participated in the design, implemented and administered a joint University of Iowa and Iowa State University degree masters in engineering and business administration program. • Selected by company CEO for critical human resources leadership position in a union environment manufacturing plant employing 2300 people. Reduced step II grievances by 50% through communication and partnership strategy. • Decorated military career including achievement of rank of Naval Captain, Commanding Officer of a Naval Reserve Anti -Submarine Warfare squadron, and two tours of duty in Vietnam as a Search & Rescue Pilot for Helicopter Combat Support Squadron 1. • Appointed by the Secretary of Defense and currently serving on the Board of Visitors at the National Defense University in Washington D.C. The Board advises, through the President of National Defense University, the Chairman of the Joint Chiefs of Staff on all aspects of advanced education and leadership development for both U.S. and allied forces senior leaders. EXPERIENCE OGO (Organizational Growth Optimization) Associates, Iowa City, Iowa, 1995 — present Owner - Independent Management Consultant • Management consulting for organizations from highly diverse industries with emphasis on organizational change management, strategic planning, organizational development and executive coaching. • Currently enrolled in a two-year Polarity Thinking master training program and is PACT assessment certified. • EQ -1 2.0 and MBTI certified. Expense Reduction Analysts, Cedar Rapids, Iowa/Addison, Texas, 2011 — present Regional Director, Client Acquirer, Client Manager and Corporate Trainer • Consult with CEO/CFO level organizational leaders in reducing overhead expenses. • Train new Seat Holders in all aspects of Expense Reduction Analyst's business plan, sales process, client management best practices and operational processes and procedures. UNIVERSITY OF IOWA, TIPPIE COLLEGE OF BUSINESS, Iowa City, Iowa, 1997 — 2011 Director, Executive MBA Program/Director, Executive MBA Recruiting • Lead, direct and manage executive education program providing leadership and graduate business education curriculum to top executives from sponsoring companies. Manage relationships with more than twenty tenured and adjunct faculty. https://www.icgov.org/node/14986/submission/2481 3/13/2017 Submission #36 1 City of Iowa City Page 3 of 5 • Collaborate with executive leadership at sponsoring companies to continually realign curriculum to address relevant business topics and maintain germane skill development. • Conceptualize, design and implement annual international student trip. Develop, maintain and enhance corporate relationships abroad to organize company visits and student learning as an integral part of international management education. • Develop, design and execute dual degree masters in business administration and masters in engineering program in partnership with Iowa State University. Launched in 2000, program has generated $5 million in revenue and initiated unique inter -University collaboration. • Recruit an average of forty participants annually, exceeding recruitment goals each year. AMANA APPLIANCES, INC., Amana, Iowa, 1974 — 1997 (Formerly division of Raytheon Company; acquired by Goodman Holding Company in 1997) Manager Human Resources — Amana, Iowa Operations (1995 — 1997) Selected by Amana Appliance CEO to champion new contractual labor-management partnership concept. Managed all plant human resources functions in a union environment for 2300 employees. Supervised team development, training, education, and environmental health and safety efforts in a high performance manufacturing organization. • Promoted and implemented a contractual labor-management "Partnership Agreement' based on open and honest communication. Vastly improved trust between management and labor employees which resulted in a 50% reduction in Step II Grievances. • Designed and recruited for a voluntary, comprehensive, job related college credit education program. Attracted 300 hourly factory worker participants; earned statewide recognition. • Saved $6 million over a 12 month period by implementing team training using nontraditional bargaining unit trainers. Provided 500 factory production workers 12 hours of performance management training; rapidly led to high performance, self -managed work teams, and a 10% productivity increase in fulfilling operational commitments. Manager Sales Training/Major Home Appliances, Amana, Iowa (1987 — 1995) Managed all sales training for 30,000 retail and 130 corporate major home appliance salespersons. • Conceived and delivered senior and middle management training in concept selling, account development strategies, coaching and leadership management resulting in a shift from traditional command and control to a more participative culture. Introduced "Concept Selling" skills training to wholesale sales force resulting in a $9 million increase in sales over a four year period. • Introduced new wholesale proprietary feature/benefit presentation materials for concept selling and sales training resulting in enhanced professionalism and a 10% increase in sales. Branch Manager/Amana West Coast, San Francisco, California (1985 — 1987) Branch Sales Manager/Amana West Coast, San Francisco, California (1977 — 1985) West Coast Regional Sales Manager, San Francisco, California (1975 — 1977) West Coast Direct Account Sales Manager, San Francisco, California (1974 —1975) MILITARY EXPERIENCE https://www.icgov.org/node/14986/submission/2481 3/13/2017 Submission #36 1 City of Iowa City Page 4 of 5 UNITED STATES NAVY Retired from Naval Air Reserve at the Rank of 0-6 (Navy Captain) Commanding Officer of Helicopter Anti-submarine Squadron 85 (HS -85) Search & Rescue Pilot, Helicopter Combat Support Squadron 1 (Two Viet Nam tours) Graduated Naval Flight Training COMMUNITY LEADERSHIP President, Iowa Division of the Iowa United Nations Association NATIONAL DEFENSE UNIVERSITY —WASHINGTON, D.C., 2011- present Appointment by the Secretary of Defense - Member, Board of Visitors EXECUTIVE MBA COUNCIL, 1997 — 2010 International association with over 330 executive MBA programs offered by 225 schools globally. Bud Fackler Service Award , 2010, for contributions to Executive MBA programs worldwide. Past Chair, 2008 — 2009 Chairman of the Board of Trustees, 2006 — 2008 Vice Chair, 2005 — 2006 Treasurer, 2004 — 2005 JUNIOR ACHIEVEMENT OF WEST DES MOINES Member, Board of Directors, 2007 — 2011 FRIENDS OF THE LIBRARY, UNIVERSITY OF IOWA, 2005 — 2011 Member, Board of Directors TEACHING EXPERIENCE UNIVERSITY OF IOWA, TIPPIE COLLEGE OF BUSINESS, Iowa City, Iowa, Adjunct Faculty, MBA Corporate Communications course, 2008 - present Adjunct Faculty, Leadership course, 2007-2009 Adjunct Faculty, Foundations of Business course, 2004 — 2010 Adjunct Faculty, Business Policy course, 1998 — 2004 • Received highest evaluation scores among adjunct faculty every semester DALE CARNEIGE & ASSOCIATES, INC. Certified Instructor, Sales and Human Relations Courses, 1987 - present EDUCATION UNIVERSITY OF IOWA, Iowa City, Iowa, 1996 Master of Business Administration SAN DIEGO STATE UNIVERSITY, San Diego, California, 1974 Bachelor of Science, Zoology 1998 — present https://www.icgov.org/node/14986/submission/2481 3/13/2017 Submission #36 1 City of Iowa City Page 5 of 5 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). United Nations Association; 2014 -present (President) National Defense University, Washington, D.C. ; 2011 - present (Vice -Chair) Iowa City Noon Rotary; 2011 -present (Chair of New Member Committed and Member ofFund Raising Committee) How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I will leverage my role as President of the Iowa Section of the United Nations Association, my federal connections at the National Defense University, my University of Iowa associates and my Rotary network to support Iowa City Climate Change initiatives. Age 73 Country of Origin USA Sexual Orientation Heterosexual Religion Protetant Do you have a disability NO Race, Color or Ethnic Group Caucasian Signature of applicant John H. Fraser https://www.icgov.org/node/14986/subniission/2481 3/13/2017 Submission #371 City of Iowa City Submission #37 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Sun, 03/12/2017 - 4:52pm 63.152.86.34 Date of Application Sun, 03/12/2017 Name Todd Edwards Home Address 837 Walnut Street Contact phone number 3126080466 Email Address todd.j.edwards@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 3 years Occupation: Advisor - Global Climate Change Gender Male Page 1 of 3 What is your present knowledge of this steering committee? I have had conversations with Mayor Jim Throgmorton about the steering committee roles and responsibilities. Please summarize your employment history and education experiences which you feel qualify you for this position. Professional Experience: 1) Advisor - Cities & Transport, Mission 2020, www.mission2020.global, Sep 2016 — Present 2) Program Officer - Climate Change, The Stanley Foundation, www.stanleyfoundation.org, April 2014 - June 2016 3) Principal Sustainability Consultant, TE SEMCO, Independent, Nov 2010 — Apr 2014 4) Director of Sustainability, Sieben Energy Associates, www.siebenenergy.com, Apr 2006 - https://www.icgov.org/node/14986/submission/2516 3/13/2017 Submission 437 1 City of Iowa City Page 2 of 3 Nov 2010 Education: 1) Ph.D. Political Science - Global Climate Change Governance, Vrije Universiteit Brussel, 2015 2) M.A. International Relations, Brussels School of International Studies, 2003 3) B.S. Economics, DePaul University, 2002 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Volunteer: 1) Founder & Steering Committee, Galvanizing the Groundswell of Climate Actions, www.climategroundswell.org, Sep 2014 - Present 2) Member, Mission Iowa City, Fall 2016 - Present 3) Founder & Board of Directors, Dill Pickle Food Co-op - Chicago, www.dil[pickle.coop How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? With many years of experience representing climate change and sustainability related projects, programs, campaigns, and city engagements, I see myself as a respected thought - leader and advocate for an ambitious Iowa City climate action plan. My local activities and connections include: 1) Mission Iowa City 2) Iowa United Nations Association 3) CIVIC 4) Little Village independent writer: (http://littlevillagemag.com/the-paris-agreement-marks- an-unprecedented-opportunity-to-quell-the-tide-of-climate-change/ and http://littlevil lagemag.com/a-g rou ndswell-in-new-york-tackl ing-climate-change-and- sustai nable-development-from-the-bottom-u pn Age 36 Country of Origin USA Sexual Orientation n/a Religion n/a Do you have a disability NO Race, Color or Ethnic Group n/a https://www.icgov.org/node/14986/subniission/2516 3/13/2017 Submission #37 1 City of Iowa City Signature of applicant Todd Edwards Page 3 of 3 https://www.icgov.org/node/14986/submission/2516 3/13/2017 Submission #38 1 City of Iowa City Submission #38 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Mon, 03/13/2017 - 1:21 pm 104.201.69.194 Date of Application Mon, 03/13/2017 Name Eric Tate Home Address 1234 Santa Fe Drive Contact phone number 8033972686 Email Address ericctate2@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 5.5 years Occupation: Professor Gender Male Page 1 of 3 What is your present knowledge of this steering committee? Limited. From my reading, the focus is to identify and prioritize climate adaptation options for policy implementation, as well as to help to increase the visibility of this work. Please summarize your employment history and education experiences which you feel qualify you for this position. Education Ph.D., Geography, University of South Carolina, 2006-11 M.S., Water Resources Engineering, University of Texas, 1997-99 B.S., Environmental Engineering, Rice University, 1989-93 Work experience https://www.icgov.org/node/14986/submission/2521 3/13/2017 Submission #38 1 City of Iowa City Page 2 of 3 Assistant Professor, University of Iowa Dept. of Geographical & Sustainability Sciences, 2011 -Present Software Development Manager, Lenocker & Associates, Orange, CA, 2005-06 Project Engineer, ABS Consulting, Irvine, CA, 1999-2005 Associate Project Engineer, Roy F. Weston, Inc., Houston, TX, 1993-98 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). My work experience with the most relevance to the committee position is my current position teaching and conducting research at the University of Iowa. I teach two classes related to climate adaptation. The first is a large freshman introductory course called "Contemporary Environmental Issues," where we explore the science of climate change, adaptation strategies from household international scales, and climate links with energy use, water resources, human health, and biodiversity. The second course is "Environmental Justice", in which we examine the social justice implications of a changing climate. I also conduct research in these areas, primarily focused on the development of social and environmental indicators to highlight areas of need, and measure progress. This includes participation on indicator project several years ago to aid the University of Iowa in the selection of fuels for electricity generation (https://sustainability. u iowa.ed urinitiatives/biomass-fuel-project/biomass-sources/biomass- energy-sustai nabi lity-indexn. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I envision myself as a link between the committee's work and student education and research at UI. Through my roles as instructor, student advisor, faculty member in the UI Water Sustainability Cluster, and frequent colloquium speaker on campus, I can help broaden the reach of the committee's work. Age 45 Country of Origin USA Sexual Orientation Heterosexual Religion Christian Do you have a disability NO Race, Color or Ethnic Group Black https://www.icgov.org/node/14986/submission/2521 3/13/2017 Submission #38 1 City of Iowa City Page 3 of 3 Signature of applicant Eric Tate https://www.icgov.org/node/14986/submission/2521 3/13/2017 Submission #39 1 City of Iowa City Submission #39 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Mon, 03/13/2017 - 3:52pm 192.234.91.20 Date of Application Mon, 03/13/2017 Name Becky Soglin Home Address 65 Rita Lyn Ct Contact phone number 319-351-6410 Email Address bsoglin@yahoo.com Is your home address within the corporate limits of Iowa City? Yes. How long have you lived in Iowa City? Almost 25 years. Occupation: Sustainability Coordinator for Johnson County Gender Female Page 1 of 4 What is your present knowledge of this steering committee? I read the RFP for the consultant services as well as the news release and resolution—I understand there are stakeholders from designated areas (e.g. UI, builders association), and five open seats. I know that the city wanted to complete its STAR rating process before embarking on the climate action plan effort. I serve on a professional organization with Brenda Nations, who mentioned the efforts. I am very excited about Iowa City embarking on a climate action plan. The groundwork has been laid for the steering committee to be effective, especially with the STAR participation, the Iowa City Comprehensive Plan 2030 and the Sustainability Assessment 2013 https://www.icgov.org/node/14986/submission/2531 3/13/2017 Submission #391 City of Iowa City Page 2 of 4 Please summarize your employment history and education experiences which you feel qualify you for this position. I have strong skills in sustainability and planning as well as public engagement and communications. I understand how economics, social equity, public health, and environment are intertwined and relate to climate action. Familiar with differences between mitigation and adaptation approaches. May 2012 to present: Johnson County Department of Planning, Development and Sustainability. Started as Sustainability Assistant; now Sustainability Coordinator. • Track energy use for the county and facilitate energy conservation and efficiency projects ($200,000+ garnered in utility rebates by working with MidAmerican Energy Co.). Very familiar with commercial and residential rebate programs. • Helped JC Board of Supervisors develop five energy goals in 2014, including reduce energy use; we have set a new goal to do a new greenhouse gas inventory. • Key player in adding five solar arrays to County operations • Completed STAR 21 Indicators (STAR "light' program) and helped Iowa City get data for their STAR application. • Attended many climate action webinars and conference sessions. • Develop waste management strategies and education on reduce, reuse, recycle. • With social services developed sustainability grants program for small nonprofits in Iowa City. • Develop educational outreach to for employee and public awareness and practical skills on climate, energy, etc. • Have provided info and responded to requests by local climate activists. • Comprehensive planning project including working with consultants on public input sessions and focus groups. Sustainability is a key part of the future plan. In addition: • LEED Green Associate since 2012 • Aug 2014 to June 2015: Worked for C -Wise architecture to document LEED buildings and develop educational presentations on climate change, walkability, GHG. • As a paid project intern October 2012 to January 2014, wrote several sections of Linn County's comprehensive plan; pulled together input from a 16 -person steering committee and five sub -study groups, including one on topics related to renewables, etc.; developed implementation strategies and timing. • 2012 earned M.S. degree in urban and regional planning from the UI. Focus on land use and environment including hazard mitigation. Completed a year-long project to identify how homes/residents in Dubuque could be identified and engaged in a healthy homes and energy efficiency program. Worked with the UI Office of Sustainability for one semester to produce a report related to their use of woody biomass for the power plant • Internship May to November 2011 for the City of Iowa, including work for historical preservation commission and help developing messaging for IC's comprehensive plan update. • 1998 to 2010: health news writer for University of Iowa Health Care. Skilled at translating complex terms and ideas for the general public, • MFA -degree in nonfiction writing from the University of Iowa • Have lived abroad in China (one year) and France (one year) • Trained IOWATER volunteer (water quality), Master River Steward, Iowa Tree Steward. https://www.icgov.org/node/14986/submission/2531 3/13/2017 Submission #39 1 City of Iowa City Page 3 of 4 Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). • Heartland Sustainability Directors Network: member for almost five years of this professional organization to which Brenda Nations also belongs. I have visited other Midwest cities to get insights on community gardens, waste management projects and more. I helped Brenda with meetings related to the Climate in the Heartland document. I also helped develop processes so the 20 -person Heartland group could work more efficiently. • Sustainability Working Group of Johnson County. Under direction of JC Board of Supervisors, established this umbrella group in fall 2015 for primarily staff at other municipalities, Kirkwood, UI Office of Sustainability and school boards. I organize all meetings, take notes, etc. • MPO Regional Trails and Bicycle Committee and ECICOG Regional Trails Advisory Committee, member on both since spring 2016. Frequently raise equity issues related to trail / commuter needs. • Iowa River Trail Steering Committee: member since last fall; we have one more meeting. Raised equity issues. • Iowa City Board of Adjustment: Board member since January 2013 (4+ years). Decisions we make relate to land use. I currently am board chair; my term ends December 2017. • Served on the University's Campus Planning Committee for one year as a student representative How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? In my role as sustainability coordinator for Johnson County, I have made connections to Green Iowa Americorps, biking groups and bike businesses, UI planning students, solar installers, local landscapers, Iowa Waste Exchange, Backyard Abundance, 100 Grannies, Physicians for Social Responsibility, Iowa City Climate Activists. I am obviously also connected with Johnson County staff — many of whom are Iowa City residents. I also coordinate with our Local Foods Planner and our Soil and Water Conservation Specialist and could help connect the city with individuals in and even outside the city who could help meet climate goals. I also have volunteered for the Bur Oak Land Trust and the Johnson County Soil and Water Conservation District and still have connections in these places and with local IOWATER experts. I could help be a liaison to University of Iowa Health Care (former place of employment) and the UI in reaching out to both the temporary and permanent campus community. Through the Sustainability Working Group, we could connect with other municipalities and perhaps find economies of scale or simple friendly competitions to help Iowa City engage residents and meet the goals. Age 53 Country of Origin https://www.icgov.org/node/14986/submission/2531 3/13/2017 Submission #39 1 City of Iowa City United States of American Sexual Orientation straight Religion Do you have a disability NO Race, Color or Ethnic Group secular Jew Signature of applicant B. Soglin for myself Page 4 of 4 https://www.icgov.org/node/14986/submission/2531 3/13/2017 Submission #40 1 City of Iowa City Submission #40 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Mon, 03/13/2017 - 4:12pm 75.167.215.54 Date of Application Mon. 03/13/2017 Name Grace Ehlinger Home Address 216 E Market St, Apt. 2, Iowa City, IA 52245 Contact phone number 319-899-3392 Email Address grace-ehlinger@uiowa.edu Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 2 1/2 years Occupation: Environmental Policy and Planning student Gender Female Page 1 of 3 What is your present knowledge of this steering committee? I have been looking for ways to get involved with sustainability in the community, and this committee's role in overseeing the Climate Action and Adaptation Plan is of significant importance to the future of Iowa City. I am very interested in contributing to the development of this plan in whatever way I can. Please summarize your employment history and education experiences which you feel qualify you for this position. I am earning my Certificate in Sustainability from the University of Iowa along with the following work experience. Wetland Intern April 2016 — Aug. 2016 https://www.icgov.org/node/14986/submission/2536 3/13/2017 Submission #40 1 City of Iowa City Page 2 of 3 MMS Consultants, Inc., Iowa City, IA • Delineated wetlands in project sites • Monitored wetlands that were created as part of mitigation plans for projects • Put together wetland reports including delineation data, plans for mitigation, and the history of the project site • Wrote Storm Water Pollution Prevention Plans (SWPPs) for land development clients Research Assistant June 2015 — Aug. 2015 University of Iowa, Geography Department, Iowa City, IA • Measure and identify trees within specified sites throughout Iowa City • Enter GPS coordinates of each tree into database and keep maps marked with individual tree locations • Measure and determine site boundaries • Observe site characteristics such as impervious surface cover, canopy cover, and vegetation cover • Update PI on progress and coordinate with other research assistants on current locations • Create a scientific research poster for an undergraduate research festival and present to graduate students and the public Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Member, University of Iowa Solar Car Team Oct. 2014 — March 2015 • Work with other students to construct a working solar powered car • Weld structure of car • Organize public outreach to. increase interest in solar car project • Coordinate between president of team and graphic designer for team's logo How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I am a part of a strong network of students at the University of Iowa who are always looking for ways to do more for the community and to get the community to do more for sustainability. As an employee at Cambus, the University of Iowa's transit system, I am able to discuss sustainability initiatives with those who oversee the system. As a lifelong Iowan, I am always looking for ways to represent the knowledge and implement the strategies I have learned about environmental issues to the surrounding communities, even on my family's farm. Age 21 Country of Origin United States Sexual Orientation Heterosexual https://www.icgov.org/node/14986/submission/2536 3/13/2017 Submission #40 1 City of Iowa City Religion Catholic Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Grace Ehlinger Page 3 of 3 https://www.icgov.org/node/14986/submission/2536 3/13/2017 Submission #411 City of Iowa City Submission #41 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Mon, 03/13/2017 - 4:38pm 128.255.44.193 Date of Application Mon, 03/13/2017 Name Matthieu Biger Home Address 519 N JOHNSON ST Contact phone number 3193217852 Email Address mbiger@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 6 3/4 years Occupation: Admin Services Coordinator Gender Male Page 1 of 3 What is your present knowledge of this steering committee? I have sought and read all available documentation with regards to the committee and understand that members will "help oversee the development of a community -wide climate action plan." I understand that said plan, to be developed by an outside consultant, is not yet finalized and that Committee details will depend on this plan. Please summarize your employment history and education experiences which you feel qualify you for this position. I have worked at both the Iowa City Public Library and the University of Iowa, in capacities that have taught me much about the community and its members. As part of a business writing class, I drafted a memo entitled "Sustainability policy for incoming students and Student Org/Greek Leaders," which may be viewed at https://tinyuri.com/UI-sustainability- https://www.icgov.org/node/14986/submission/2541 3/14/2017 Submission #41 I City of Iowa City Page 2 of 3 policy -memo. I had prefaced the Worshop submission with "The scenario I chose for this Policy Memo entails a real workplace, The University of Iowa, and protagonists. My role reflects a position I had once unsuccessfully applied for, and is therefore fictitious. My employer in this piece, the UI Office of Sustainability, was established in 2008 and has a current headcount of three staff, three interns, and a graduate assistant. The Office serves as the "green" arm of the University of Iowa, whose campus is home to over 33,000 students — active in 500 organizations — and 23,000 faculty and staff." This well-received submission was inspired by my application to the position I mention, at the behest of the UI's former Recycling Coordinator. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Since becoming a UI employee over three years ago, I have acted as departmental liaison for Recycling Optimization Projects, RecycleMania, Earth Month Bike Challenge (e.g. "Most Encouraging Rider" for #winterwarrior2016), and Sustainability efforts as a whole. I am an EcoHawk proselytizer. I have been an At -Large Director of the Northside Neighborhood Association's Steering Committee since July 2012, partaking in discussions (e.g. PIN Grant applications), seasonal Market Square gardening, and attending pertinent ICCSD and city council meetings. Also on a personal, but relevant note, I strive to live life following climate -friendly principles — including such eco -buzzwords as "walkability" and "waste not, want not" and looking upstream of a product. I have applied this same logic with purchasing decisions at work as well. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I am an active "campus communicator" of sustainability efforts, a vocal advocate for neighborhoods, bike commuting, and the well-being of people and our planet in the face of already observed climate change. I see myself representing the work of the Climate Action Steering Committee with the same optic of "connectedness" that drives my advocacy. I would endeavor to make the most of the intricate relationship between the City of Iowa City, the University of Iowa, the ICCSD, student housing property owners, and the many corporate entities - large and small - that share this vibrant community. I would leverage my membership in or knowledge of community partners such as Backyard Abundance, the University of Iowa Environmental Coalition, the Bike Library, Think Bicycles, and UI Gardeners in joining forces to implement initiatives of the Steering Committee. As a foreign national with European roots, I would also bring a possibly complementary cultural view on sustainability and Climate Action. I would also apply my personal and professional social media experience to the task of inspiring others to action. In addition, I plan to apply for a soon-to-be open Staff role on the UI's Sustainability Charter https://www.icgov.org/node/14986/submission/2541 3/14/2017 Submission #411 City of Iowa City Committee. Page 3 of 3 I will close with my personal Mission Statement: "To live and work with full -hearted and inclusive dedication to my higher -ed customers and employer, keeping in balance my spouse, family, community, and the environment. To be guided by life-long learning, personal and societal values, empathy, and appreciation for my self-worth and that of all human beings." Age 35 Country of Origin France Sexual Orientation Male Religion Catholic Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Matthieu YA Biger https://www.icgov.org/node/14986/submission/2541 3/14/2017 Submission #42 1 City of Iowa City Submission #42 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 03/14/2017 - 8:44am 65.156.255.208 Date of Application Tue, 03/14/2017 Name Anne Russett Home Address 14 Forest Glen Contact phone number 312/504-4038 Email Address amrussett@yahoo.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 2 years, 7 months Occupation: City Planner Gender Female Page 1 of 3 What is your present knowledge of this steering committee? I understand that the City of Iowa City recently set greenhouse gas reduction targets. In order to achieve those targets, the City is moving forward with the development of a Climate Action Plan. An important component of the plan includes public outreach, which will come in many forms. One form is the creation of steering committee, which is charged with actively participating in the development of the plan, bringing ideas to the table on how to reduce emissions, and also educating members of the public on how they can participate in reducing emissions. Please summarize your employment history and education experiences which you feel qualify you for this position. https://www.icgov.org/node/14986/submission/2546 3/14/2017 Submission #42 1 City of Iowa City Page 2 of 3 I am a public sector planner with nearly a decade of experience in land use, transportation, and housing policy. Currently, I am employed as a city planner with the City of Cedar Rapids where I work on a variety of long-range planning initiatives. I am also a member of the City's interdepartmental sustainability committee, known as iGreenCR. Prior to joining the City of Cedar Rapids, I worked for the Oregon Department of Transportation where my work focused on efforts related to reducing greenhouse gas emissions. Specifically, I completed the Statewide Transportation Strategy Short -Term Implementation Plan, which outlines various programs for ODOT to implement to help the State of Oregon achieve its GHG reduction goals. In addition, I managed the development of the Strategic Assessment of Transportation and Land Use Plans for the Corvallis Area, which won the Federal Highway Administration's 2015 Excellence in Air Quality Improvement and Climate Change Award. A coordinated effort between the State and the Corvallis Area Metropolitan Planning Organization, the strategic assessment evaluated whether adopted plans and trends would achieve the region's GHG reduction goals. My role in this project included coordinating with the Corvallis Area MPO on identifying strategies to reduce emissions. I have a Master's degree in Urban and Regional Planning from the University of Iowa. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I am relatively new to Iowa City. In addition to working full-time I am a mother to a 9 -month old. I see the steering committee as an opportunity to better connect with my community and actively address an issue I am both knowledgeable and passionate about. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? My work on greenhouse gas reduction plans provides me not only with knowledge of GHG reduction strategies, but also their co -benefits. Strategies that reduce emissions can also reduce household transportation costs, improve air quality, and generally improve livability and quality of life. In discussing this work with others in the community I would not only articulate the goal of reducing emissions, but also present information on the variety of co - benefits. My experience has taught me that there's no silver bullet to addressing climate change. Instead, it will require the implementation of a variety of strategies and many of these strategies will need to be implemented by the City. As a public sector employee I understand the challenges that local government's face. 1 understand budget constraints and competing interests. I would like to help the City identify strategies that are feasible, supported by existing projects, and ultimately help to achieve the reduction targets. Finally, climate change is a global issue. I hope to bring some of the lessons learned from this planning process back to my colleagues at the City of Cedar Rapids and inspire others in the region to tackle climate change. https://www.icgov.org/node/14986/submission/2546 3/14/2017 Submission #42 1 City of Iowa City Age 38 Country of Origin U.S.A. Sexual Orientation Heterosexual Religion Atheist Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Anne Russett Page 3 of 3 https://www.icgov.org/node/14986/submission/2546 3/14/2017 Submission #43 1 City of Iowa City Submission #43 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 03/14/2017 - 3:04pm 173.24.118.140 Date of Application Tue, 03/14/2017 Name Riley Samuelson Home Address 606 Westgate St. Apt. 30 Contact phone number 5633797700 Email Address samuelsonrj@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? Since August of 2016 Occupation: Full-time Graduate Student, Part-time Reference Assistant Gender Male Page I of 4 What is your present knowledge of this steering committee? Presently, my understanding of this steering committee is rather limited. Most of what I can infer seems to be rather straightforward — that the purpose is to develop a plan that aims to make Iowa City a more sustainable and environmentally conscious community; with this plan emerging out of engagement with the community and the insight of the committee itself. I also am assuming that there will be a fair amount of research and education for the committee members to undertake in order to make informed decisions. Whatever the exact details and duties turn out to be, I find this to be an exciting opportunity. Please summarize your employment history and education experiences which you feel qualify you for this position. https://www.icgov.org/node/14986/submission/2551 3/14/2017 Submission #43 1 City of Iowa City Page 2 of 4 Work: Before I moved to Iowa City for graduate school, I worked as a library assistant at my local library — Decorah Public Library — for the past seven years (throughout high school and college); and, for the past few summers, I worked as an assistant in the Clerk's office of the City of Decorah. In both work environments, I spent a significant amount of time working with individuals of the general public (especially at the library). During my time at the Decorah Public Library, besides fulfilling general operational duties, I had a lot of interaction with people that was focused on educating people on the library's policies, in using resources and programs that we offered, and in helping them find appropriate resources for their needs. Along with this, I listened and communicated people's concerns and visions for the library. In a smaller capacity, I contributed to the conversation of library future plans, programs, and community engagement (in regards to both the library as a whole and to individual library programs). I also served as the library's main graphic designer — mostly having to do with promotional materials for library programs, resources, and initiatives. (I still volunteer my graphic design services from time to time) Currently, I work part-time at Hardin Library for the Health Sciences, University of Iowa's medical library. My position there is a Reference Assistant. I help various individuals (medical professionals, medical/health science students, and occasionally, community members) learn about, find, and access the resources that they require. Education: I attended Decorah High School and then Luther College. At Luther, I majored both in Art and in Environmental Studies, with a concentration in Environmental Policy (GPA of 3.56, Cum Laude). For the Environmental Studies major, my coursework involved a large breadth of classes: Relevant courses include: • ENVS-485 Environment and Community • POLS-258 Environmental Politics & Policy • ECON-255 Environmental Economics • ECON-130 Principles of Economics • ECON-139 ST:Prin of Macroeconomics • POLS-355 Constitutional Law • REL -243 Environmental Ethics • PHIL -140 Environmental Philosophy • HIST -291 Environmental History • BIO -151 Principles of Biology: Ecology/Evolution/Biodiversity • ANTH-101 Cultural Anthropology • ENVS-134 Environmental Geology • ENVS-133 Environmental Conservation A significant facet of the environmental studies program involved the consideration and balancing of several sorts of factors and peoples. Ultimately, providing students with the skills to make insightful choices that are in the interests of the environment while also understanding the human context and the impacts of those choices. The program also provided students with the knowledge and understanding of a large variety of sustainability and environmental initiatives, along with the strong skillset necessary for learning about and understanding new ideas and practices. Luther College is very serious about its sustainability efforts, and because of this, its students (like me) have been exposed to the large variety of initiatives necessary for creating a sustainable future for such a complex institution. https://www.icgov.org/node/14986/submission/2551 3/14/2017 Submission #43 1 City of Iowa City Page 3 of 4 Currently, I am a graduate student, at the University of Iowa, in the School of Library & Information Science. On my current track, I hope to achieve a MLIS in May of 2018. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Ultimately, I have never been a part of a serious committee or equivalent sort of entity. However, I believe that the several long-term, group projects that I have been involved in during my graduate and undergraduate education have filled a similar experiential role (these being class assignments). Often, I would take a leadership role in these projects. One example was our semester project for Environment and Community; my group decided to try to work with the City of Decorah — particularly the Park & Rec office — in order to establish more prairie in underutilized locations. We researched and developed a suggested plan for the city to follow, met with various city officials (who 1 had already had a good relationship due to my employment by the city), attended Park & Rec board meetings, and provided them with a grant proposal for the suggested project. Ultimately, due to limited grant opportunities at the time and to conflicting interests/other projects, our vision didn't become a reality, but I believe that all of it — from the research to the meetings — provided me with valuable experiences that would be in line with the goals of the Climate Action Steering Committee. I was a member of ECO, which is a sustainability/environmentally focused student organization at Luther College. My role was solely as a member and participatory in nature (when my work schedule didn't conflict with events). The group focused on campus sustainability initiatives and education — with weekly programs and agendas. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? As a student and an employee of the University of Iowa, I feel like this is the most apparent connection that could be used to inspire others to pursue the initiatives of this committee. Specifically, this connection is strongest in the context of my work environment (Hardin Library for the Health Sciences) and my education environment (my SLIS cohort and professors). However, I do have some interaction with some of the librarians of Main Library. Also, my roommate works for Green Iowa AmeriCorps, at the Iowa City site, which I believe is a beneficial connection that would work in favor of the Committee's initiatives. Along with this, it would be beneficial for communication and partnerships between the two entities. Age 23 Country of Origin United States of America Sexual Orientation Gay Religion Agnostic; Raised Lutheran (ELCA) https://www.icgov.org/node/14986/submission/2551 3/14/2017 Submission #43 1 City of Iowa City Page 4 of 4 Do you have a disability NO Race, Color or Ethnic Group White/Caucasian Signature of applicant Riley J Samuelson https://www.icgov.org/node/14986/submission/2551 3/14/2017 Submission #44 1 City of Iowa City Submission #44 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 03/14/2017 - 3:41 pm 152.132.11.8 Date of Application Tue, 03/14/2017 Name Stacey Hockett Sherlock Home Address 2513 Potomac Dr, Iowa City, IA 52245 Contact phone number 319-321-7220 Email Address shockett77@gmail.com Is your home address within the corporate limits of Iowa City? yes How long have you lived in Iowa City? 14+ years Occupation: Research, University of Iowa, Internal Medicine Gender Female Page I of 2 What is your present knowledge of this steering committee? The Iowa City City Council passed a resolution that aims to reduce 25 to 28 percent of Iowa City's greenhouse -gas emissions by 2025 and 80 percent by 2050. The Climate Action Steering Committee will engage with community stakeholders to develop strategies to achieve these targets. Please summarize your employment history and education experiences which you feel qualify you for this position. My education includes a Masters in Applied Anthropology with a concentration in Environmental Resource Management. My work is centered in understanding variety of viewpoints and working toward sustainable collaborative solutions. I have over 12 years of experience collaborating on large, multi -center studies with qualitative and quantitative https://www.icgov.org/node/14986/submission/2556 3/14/2017 Submission #44 1 City of Iowa City Page 2 of 2 components. My expertise is in qualitative research methods including designing, planning, directing and analyzing studies and quality improvement projects. My local employment history is through the University of Iowa Hospitals and Clinics, Iowa City VA Health Care System, University of Iowa Public Policy Center, and University of Iowa Department of Epidemiology. Prior to moving to Iowa City, I lived in Maryland and worked on collaborative projects within the US EPA, NOAA National Marine Fisheries Service, and Chesapeake Bay fisheries. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). Future Problem Solving Program International, Volunteer Coach, 2014 -present. I lead a weekly after-school program for students in grades 4th -7th. Future Problem Solving program teaches a creative problem solving methodology through research on futuristic topics. We research and generate creative solutions for international topics, including environmental and energy use issues. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I would like to work with various groups and places in the community to create actionable guides to change that are reflective of the unique group. I am connected to the Iowa City school district, Johnson County 4-H, local daycare and after school groups, University of Iowa various departments, University of Iowa Hospitals and Clinics, Iowa City VA Health Care System, local church, community artist groups, community writers' groups, farmers market vendors, local gyms, and local activist groups. Age 39 Country of Origin USA Sexual Orientation Religion Do you have a disability NO Race, Color or Ethnic Group White Signature of applicant Stacey Hockett Sherlock https://www.icgov.org/node/14986/submission/2556 3/14/2017 Submission 445 1 City of Iowa City Submission #45 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 03/14/2017 - 4:52pm 66.104.45.66 Date of Application Tue. 03/14/2017 Name Vanessa Fixmer-Oraiz Home Address 437 S. Governor St. Iowa City IA, 52240 Contact phone number (919)923-6211 Email Address vfixmeroraiz@gmail.com Is your home address within the corporate limits of Iowa City? Yes How long have you lived in Iowa City? 4.5 Years Occupation: Planner Gender Female Page 1 of 3 What is your present knowledge of this steering committee? This is a new steering committee that is being formed to assist in creating the City's first Climate Action and adaptation Plan. I believe that this is a really exciting venture and am very happy to see the City take on such a plan! Please summarize your employment history and education experiences which you feel qualify you for this position. I am currently a community planner with HBK Engineering, here in Iowa City. As a community planner I am privileged to work with a wide range of professionals and communities who are facing the reality of Climate Change impacts and taking steps to address their specific challenges. Previously I was a graduate student at the UI's School of Urban and Regional Planning where my focus was Environmental Planning. I was fortunate https://www.icgov.org/node/14986/submission/2561 3/14/2017 Submission 445 1 City of Iowa City Page 2 of 3 to have Dr. Scott Spak as my advisor, a nationally recognized Climate Scientist, who shaped my tenure. He encouraged me to explore watershed planning as an intern with the English River Watershed Management Authority (ERWMA). At the ERWMA I learned the importance of regional planning that works not along political boundaries, but watershed boundaries, where flooding and water quality impacts are most immediately felt. I came to Iowa via the Philippines, a country of origin for me, where I studied Climate Change impacts on rural bamboo farmers as a Fulbright Scholar. My year-long research grant afforded me the opportunity to live and work alongside bamboo farmers who were being disproportionately impacted by Climate Change impacts, such as shorter growing seasons for rice and stronger typhoons. In my undergraduate career at the University of North Carolina, Chapel Hill, I was lucky to study with Robert Cox, former Sierra Club President and Climate Change champion, who shaped the Sierra Club's response to Climate Change impacts and drew national attention as an environmental communication scholar. I attended Durham Technical Community College before transferring to UNC, and it was at community college where I first became aware of Climate Change. I was a member of my Science Club and drove to Washington DC to attend a PowerShift Conference that introduced Climate Change impacts to me in a way that was very compelling. I returned from that conference committed to becoming a part of the Climate Change solution. As you can see, a position on the Climate Action Steering Committee would be a continuance of that work and life-long passion! Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). BambooPhil- Member for 3 years, Communications Board member for 1 Clear Creek Flood Resilience Action Group - Just started, 2 months Sierra Club - member 5 years Association of Flood Plain Managers - 1.5 years Indigenous Iowa - 6 months Mississippi Stand Solidarity Network - 6 months How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? As I stated above, working as a planner at an engineering firm affords me the professional space to discuss Climate Change in ways that are unique to my role. I often find that I can talk about Climate Change without using the term, and instead discuss other measures to communicate similar risks, such as impacts to health or the environment. I work with archeologists, historians, Native communities, engineers, architects, City and County planners, watershed coordinators, Soil and Water Conservation District staff, urban conservationists, etc. I came to Planning out of community organizing and I am deeply committed to making Iowa City as sustainable and progressive as possible, particularly when it comes to Climate Change impacts! Age 38 Country of Origin USA https://www.icgov.org/node/l4986/submission/2561 3/14/2017 Submission #45 1 City of Iowa City Sexual Orientation Queer Religion Spiritual Do you have a disability NO Race, Color or Ethnic Group Filipino -American Signature of applicant Vanessa Fixmer-Oraiz Page 3 of 3 https://www.icgov.org/node/14986/submission/2561 3/14/2017 Submission #461 City of Iowa City Submission #46 Submission information Form: Climate Action Steering Committee Application Form Submitted by Anonymous (not verified) Tue, 03/14/2017 - 4:53pm 24.218.80.61 Date of Application Tue, 03/14/2017 Name Ranan Fattal Home Address 229 S Dubuque St, Iowa City, IA Contact phone number 3195125088 Email Address ranan-fattal@uiowa.edu Is your home address within the corporate limits of Iowa City? 229 S Dubuque St How long have you lived in Iowa City? Iowa City Occupation: Student Gender Female Page 1 of 3 What is your present knowledge of this steering committee? I have become increasingly aware of the development and the mission of the steering committee through research as well as personal conversation with current City Council members. I have learned that the committee was established as a means to take tangible steps towards achieving the objectives of the Climate Action Plan; that is, the goal of reducing the carbon emission level by 26-28% by the year 2025 and by 80% by 2050. This committee is expected to be comprised of up to 5 at -large members, as well as members from selected institutions such as MidAmerican Energy. I am dedicated to furthering the mission of the steering committee through planning, implementation and education, and deeply believe that my past involvements and the skills have acquired will serve as valuable assets for this team. https://www.icgov.org/node/14986/submission/2566 3/14/2017 Submission #46 1 City of Iowa City Page 2 of 3 Please summarize your employment history and education experiences which you feel qualify you for this position. I have underwent a rigorous summer training in the environmental sciences as pertaining to policy implementation at Brown University. This program has helped me gain skills in recognizing environmental issues we are facing and consequently devising practical, effective, short- and long-term strategies to tackle these issues. Please list your experience with any organizations that you have participated in that might be relevant to this steering committee and include your role in the organization (number of years you have been a member, any positions held, etc.). I am deeply passionate about staying up to date regarding all environmental issues and constantly find myself engaging with sustainability -related initiatives in my community. After transferring to the University of Iowa a year ago, I have become involved in a number of sustainability -oriented groups. I currently sit on the sustainability committee of the University of Iowa Student Government (UISG), and am the Diversity Coordinator of the University of Iowa Environmental Coalition (UIEC) and a member of the University of Iowa Gardeners. In Lebanon, where I had lived prior to transferring, I worked with the Lebanese Ministry of Environment to devise a strategic plan for sustainable landscaping. In addition, I partnered with various groups to formulate solutions for the garbage crisis we had faced. Moreover, I have always been involved in environmental groups at the institutions I have attended with the aim of formulating and implementing sustainability initiatives as well as engaging the public in our environmental discussions. How do you see yourself representing this work to others in the community? What groups of people, places of employment, etc. are you connected to that you could inspire others to begin some of the initiatives that the steering committee recommends? I look forward to educating the public on the work of the committee with the hope of sparking inspiration and providing tangible plans of action within the various community sectors, such as the healthcare, business, and education sectors. I believe that community education is a very promising mode of outreach when done strategically. In this case, this may be achieved by the empowerment of various groups through engagement in the discussion of sustainability and providing the relevant resources. In particular, as a student who has fostered close ties with administrative as well as student groups, I see myself reaching out to members of the University including professors, administrative representatives, the numerous student organizations, and campus partners/stakeholders. This work may also be easily represented by it on the members of UISG who will surely be driven to utilize it in effecting change. Moreover, in light of the hospital's prominent standing in our community, I believe that my well-established connections with numerous associates will surely be an advantage. In addition, the work of the UISG sustainability committee, which I currently sit on, has allowed for advocating for a sustainability coordinator within the hospital. I look forward to establishing close ties with this coordinator, with whom the work of the committee will be definitely communicated. I am especially passionate about furthering the mission of the steering committee, as I recognize the importance of integrating sustainable practices in all aspects of our community, especially as climate change is the greatest challenge of our century. Through https://www.icgov.org/node/14986/submission/2566 3/14/2017 Submission #46 1 City of Iowa City Page 3 of 3 tactical planning, efficient implementation, and appropriate community education and engagement, I believe that the efforts of this committee will be far-reaching. Age 20 Country of Origin United States Sexual Orientation Heterosexual female Religion N/A Do you have a disability NO Race, Color or Ethnic Group Middle Eastern Signature of applicant Ranan Fattal https://www.icgov.org/node/14986/submission/2566 3/14/2017 12c NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION One vacancy to fill an unexpired term Upon appointment - January 1, 2020 Duties of the Commission include: • disseminating information to educate the public on illegal discrimination and civil rights, such as organizing and facilitating educational public forums that address one or more of the broad range of topics included within the rubric of human rights; • making recommendations to the City Council for such further legislation concerning discrimination as it may deem necessary and desirable; • cooperating within the limits of any appropriations made for its operation with other agencies or organizations both public and private whose purposes are not inconsistent with those of Title 2 of the City Code (Human Rights Ordinance) • planning programs and activities designed to eliminate racial, religious, cultural and other intergroup tensions including but not limited to sex, color, creed, disability, gender identity, sexual orientation, marital status, age, and national origin. • Iowa City -appointed members of boards and commissions must be at least 18 years of age and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. • The Human Rights Commission meets the third Tuesday of each month at 6:00 p.m. in the Lobby Conference Room at City Hall, 410 E. Washington Street. • Applications must be received by 5:00 p.m., Tuesday, March 14, 2017. 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/Commission Application Cover Board/Commission: Human Rights Commission On vacancy to fill an unexpired term Upon appointment -1/1/2020 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 1/17/2017 Application Deadline: 3/14/2017 Council Appointment Date: 3/21/2017 Date of Non -Gender Appointment: 4/17/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: 1 Male Current Gender Balance: Female: 5 Male: 3 Gender Name and Address Male Ahmed, Ali Male 1520 McKinley Pl. Female Anderson, Ingrid Female 226 Woodridge Ave. Female Bergen -Jackson, Kim Female 15 Brunswick Court Male Besher, Nidal 2604 Bartelt Rd Male Borger Germann, David 108 Colchester Dr. Female Brown, Damita 216 E. Bloomington St. Female Bushman, Emily 100 Petersen Hall Female Christensen, Julie 254 Black Springs Circle Female Davidovic, Jovana 630 Fairchild St Male Drabek, Matt 815 N Johnson St Female Dudley, Sarah 517 Iowa Ave. Female Ferdig, Jessica 18 Dunuggan Ct. Female Fixmer-Oraiz, Vanessa 437 S. Governor St. Male Gerlach, Peter 3346 Tulane Avenue Female Lambertz, Angela 1710 Hollywood Blvd. Female Mahajan, Maya 417 Monroe St Female Maxwell Leckband, Sarah 134 Ashford Pl. Female McDonald, Sharon 1216 Jensen St Female Noon, Erin Michelle 1513 McCleary Lane Female Pacer, Grace 612 South Dodge Street Male Pena, Tahuanty 1026 Meadowlark Dr Male Petersen, Nolan 603 E. Burlington St. #1 Male Retish, Paul 66 Pen Fro Dr Female Richard, Nicole "AJ" 2801 Hwy 6 E. Female Rose, Clare 928 E Bloomington St Female Taylor, Angel 2247 Plaen View Dr. Male Vogel, Jeremy 720 S Dubuque St Apt 6 Male Warren, Ezra 715 Carriage Hill #1 Male Worlds, Solomon 611 S Clinton St. Apt 1 Female Young, Heather 502 3rd Ave. r , 41 '""®'mom Advisory Board/Commission/Committee CITY OF IOWA CITY Application Form UNESCO CITY OF LITERATURE This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. Advisory Board/Commission/Committee Name A HIS a i jai14 S tri n% rA I s V � n' y - Date of Application o � rn / Name I 1 V� V\9- Home Address \ S L r, Contact phone number 31 (_ ��`j I o c�Email Address �i LI* * an w, Qq �� r� 9t M01VA &r� Your home address must be within the corporate limits of Iowa City? How long have you lived in Iowa City? S'; v\ Occupation: _ SQ� Gender: Male Female Experiences and/or activities which you feel qualify you for this position: (Whatyour present knowledge of this advisory board? 1 Coeviyn HISS Io��lr , }mwci CSA i1 S"\L2 Z� t V -1G) (�� Ih � � I'r1 � n� III 12V -1i I � � 0 VLI C1 �p l yp �} t V 9 poc1V n` h1 Vrv\V�R r u�l 1� 1-�� �vC1 c / _ +Ite S_,e �tnuL 1 ��t r1 -2 Please contact the city attorney at 319-356-5030 to discuss questions or concerns regarding a potential conflict of interest. Potential Conflict of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision—making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, agreement with respect to the proceeds of the federally—assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. Section 362.5 City Council Resolution #15-300 established a policy that the following persons shall not be eligible for appointments to Boards and Commissions. A council member's spouse, domestic partner or partner in cohabitation, children, step children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, sister-in-law, grandparents, and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, poster child, persons who are parents of the same child, and persons whom the employee is in an intimate relationship. Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full terns in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. I Do you currently have a conflict of interest? YES_ NO List potential conflicts of interest (See last page for information regarding conflict of interest) Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS Do you currently serve on another Iowa City board or commission? YES_ NO If so which one do you prefer? The City Council values all types of diversity on its boards and commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the board and commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age Country of Origin j L F'1 Sexual Orientation Religion S Vy\ Do you have a disability? YES_ NO A Race, Color or Ethnic Group *Note: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise finance and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Contact information is attached. I = Advisory Board/Commission Application Form rY _ ra �1 y w�1°fi' t This application is a public document and as such can be reproduced and distributed for ' the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF UTE"TURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 3/14/2017 First Name Ingrid Last Name Anderson Home Address* 226 Woodridge Ave. City IOWA CITY State IA Zip Code* 52245 t. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-541-3342 Email Address* igronstal@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 9 years 3. Occupation:* Environmental Compliance Specialist (attorney) 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have a strong interest in Equity and Human Rights, and I am excited about the opportunity to give back to the love City community. I am an attorney by training. As a student at the University of Iowa College of Law, I took multiple human rights law courses, and I participated in a Citizen Lawyer Program project to help immigrant victim of domestic violence obtain immigration status through the VAWA and LI -Visa programs. Additionally, I served as a Note Editor on the journal Transnational Law and Contemporary Problems, and I was involved in several student organizations, including the Organization of Women Law Students and Staff, Law Students for Reproductive Justice, and the Environmental Law Society. I also worked in the UI College of Laws Legal Clinic. My work included representing indigent clients, primarily women in family law and domestic violence cases, and a project advising the City of Cedar Rapids Civil Rights Commission regarding a proposed amendment to the city civil rights ordinance to include source of income as a protected class. While the provision was not ultimately adopted, this project gave me valuable experience regarding both the work of this type of commission and the functioning of human rights ordinances. These experiences helped me understand and advocate for diverse individuals and viewpoints and take a holistic view of problem solving regarding human rights concerns. I think this experience will be valuable on the Human Rights Commission. My current position at the University of Iowa includes advising various departments about regulatory requirements and compliance programs as well as considerable relationship building, networking, and community outreach. As a manager of our Biomass Fuel Project, I have organized public events and given presentations educating the public and the community about our project. These skills will likely be beneficial as a Cornission member. In addition to my background in human rights and law, I am experienced with volunteer work on committees and boards, and I am an active member of the Iowa City community. I previously served as a board member for the National Alliance on Mental Illness (NAMI) Johnson County. As a University of lows employee, I currently serve as a staff representative on the UI Council on the Status of Women and the UI Bicycle Advisory Committee. Within the Iowa City community I am a board member of the Iowa City Cycling Club and love City Women's Cycling. I am also a board member for the Iowa Bicycle Racing Association and I serve as the state's women's racing coordinator. I enjoy participating in these organizations and I am thankful for the opportunity to serve my community. 6. What is your present knowledge of each advisory board you are interested in?* I understand that the Human Rights Commission provides the Iowa City community with valuable information and programming intended to educate citizens about discrimination and human rights as well as reduce related tensions within the community. The commission also makes recommendations to the City Council regarding discrimination and human rights and manages the commission's appropriations. The Committee meets monthly, and while I have not yet attended a meeting, I am eager to learn. Having worked with the Cedar Rapids Civil Rights Commission (discussed above), I have some background in the activities and duties of this type of organization. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with wham they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 34 10. Country of Origin USA 11. Sexual Orientation I leterosexual 12. Religion WA 13. Do you have a disability? No 14. Ethnicity White non-Hspanic 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down NOTE: Must be 16 years of age and live within city limits of Iowa City to apply Date of Application 2116/2017 First Name Kim Last Name Bergen -Jackson Home Address* 15 Brunswick Court City IOWA CITY State IA Tip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-471-2994 Email Address* k. bergen.jackson@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 2000 3. Occupation:* PhD, RI -Board Certified, Administrator 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* Advisory Board/Commission Application Form rY _ ,� y�Olfr�t This application is a public document and as such can be reproduced and distributed for -Fay._ the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY Of LITEMMU NOTE: Must be 16 years of age and live within city limits of Iowa City to apply Date of Application 2116/2017 First Name Kim Last Name Bergen -Jackson Home Address* 15 Brunswick Court City IOWA CITY State IA Tip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-471-2994 Email Address* k. bergen.jackson@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 2000 3. Occupation:* PhD, RI -Board Certified, Administrator 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* i am part of the Iowa City community and an Executive at work. I feel strongly that people are treated equally without regard to our differences. I want to become more active in my community. I have faced discrimination in my lifetime as a lesbian. I was told I could not rent an apartment once because "people like you don't east" I will never forget how that made me feel. I also fight for my children's rights as they grow up with two mons. While I appreciate the bubble Johnson County provides us in protections, when we travel, we are worried. I never want anyone to feel unsafe in Iowa City for any reason. 6. What is your present knowledge of each advisory board you are interested in?* I understand there are monthly meetings and planning activities in the community to improve human rights education. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDGlHOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following 9. Age 50 10. Country of Origin USA 11. Sexual Orientation Lesbian 12. Religion None 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* cA M' 5-tp�01—A& r Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down A Advisory Board/Commission Application Form Iftt This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CIN considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 11/2912016 First Name Nidal Last Name Besher Home Address* 2604 Bartell Rd City IOWA CITY State IA Zip Code 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 6822180860 Email Address nidalfreel5@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 2.5 years 3. Occupation:* employee at Reach of Potential company 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* I am active in human rights and writer about issues related to human rights like democracy , civil rights , discrimination , privacy , women rights .. and i think i have abilities to make change and helping other people and do positivist actions . 6. What Is your present knowledge of each advisory board you are interested in? human rights Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneraly, prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-ir-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full tens in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 6. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 45 10. Country of Origin Sudan 11. Sexual Orientation hetrosexual 12. Religion muslem 13. Do you have a disability? No 14. Ethnicity 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I I Adviso Board/Commission Application Form Advisory _ '�t ��C��I% This application is a public document and as such can be reproduced and distributed for ray._ the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY Of LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 3/2/2017 First Name* David Last Name Borger Germann Home Address* 108 Colchester Dr. City IOWA CITY State IA Zip Code* 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193332380 Email Address* david@sanctuaryic.org Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City? 21 years 3. Occupation:* Clergy 4. Gender:* Male 5. Experience and/or activities which you feel qualifyyou for this position:* - My current role at Sanctuary Community Church includes executive duties within our nonprofit organization (supervising staff, overseeing budget, ensuring vision alignment across all programs, publicity, and facility management to name a few). We are a highly collaborative organization, so I share all of these responsibilities with other staff. This approach requires cultivating healthy communication, constant negotiation, and a commitment to broad goals over personal agendas. - I oversee about a dozen staff and work alongside hundreds of volunteers. Our organization is diverse in age, ability, sexual orientation, gender identity, race, ethnicity, and country of origin. - Our church is a member of the Consultation of Religious Communities that provides funding for local nonprofits as well as performing outreach and service in the community. I attend CRC meetings regularly so I continually learn about community -wide efforts as well as participate in decision making regarding where we invest money and resources. - 1 help establish and monitor our annual budget (about $475,000), working to manage programs and staff effectively. - Our church is committed to supporting local nonprofits through financial donations. For example, every Easter our church gives a $10,000 donation to a local nonprofit. In 2016, DVIP received that gift. In 2015, Shelter House received the donation. We also connect with nonprofits through volunteering time and hosting collection drives. - I recently helped launch a new fafth-based student organization at Iowa called Love Works. A gay student who was prohibited from serving as a leader at two other faith -based student organizations met with me last fall and shared his story. We decided to start a new organization that would be LGBTQ-inclusive and service- oriented. Love Works meets every other week and engages in regular service activities. (I love serving alongside students!) - I serve on the executive team of Lemma Elementary PTA. This position allows me to hear about the needs within our diverse city and how those needs affect children and schools. - One note about our church that may be helpful to know. We practice an inclusive Christianity that recognizes and affirms the equality and dignity of every person. This approach allows us to form broad alliances with all people and organizations working towards the common good. I personally am very passionate about building partnerships with diverse organizations, businesses, and public entities for the sake of human flourishing. 6. What is your present knowledge of each advisory board you are interested in4* I have read the agendas and minutes from the previous Humans Rights Commission greetings. I also attended one meeting to observe and learn how a meeting is organized. I am familiar with almost all of the organizations seeking funding or hosting events that intersect with the commission's goals. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-iMaw, daughter-in-law, mother-iMaw, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same chill, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 39 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity White `NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ziww'3ieo" C'tvtn ~ Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down City of Iowa City Advisory Board/Commission/Committee N Application Form THIS APPLICATION ISA PUBLIC DOCUMENT WITH THE EXCEPTION OF TI.19?-,�LS`T Pig MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR'P1,�LVE MONTHS AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURIl\' 'v T Advisory Board/Commission/Committe,Name OUWtGN lak�STetm,_' 1 NAME�rr i',t rU cJ V, HOME ADDRESSZ i (e G R o dysr h r o Is your home address within the corporate limits of Iowa City? Yes k No— How long have you lived in Iowa City? t•c (0rh Gender. Male _ Female Contact# 30 yZ� �j � L Email Address 7 1 i t ow�i.,Z Unaa__til. CDtM CONTRIBUTION AND/OR ACTIVITIES WHIC POSITION: H YOU FEEL QUALIFY YOU FOR THIS I -t. h cs.� i S rv+u .� f.�n!�0�'la..� e i>oiE,agli,l uno(rr �G�SJagr�.duaat.33tieQ�t�tgLho� S-lv dry r-� Gr ir1 j ce. �-I-+�>Z'E1.wr.D @ r'c'4) e. ro - Oar or l.wry c,-li2ens as Ceaclers a�o�ss C�1 z ",OL L . n o+l-,o_ r ci)v a � � iii cc�'�` a •� c o rv"p S �va WHATISee c, -s.,•..•, - non eases i �� YOUR PRESENT "0 EDGE OF THIS ADVI OS RY BOARD?�� \S ' P t�ectS � eti'le'C pp III QL l tx L1 0.r (Utl0. 1 /� �iir yt^0.ti 6r] 45e,Ct�A 1�f.1 y LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest I w i L( s o a r 6.9— p o w4 --(-{ rr Q -e w, X10 e. r~ 4L --Q ( owc, CCA-tj ?\)W l:c Li lova+r V, i�DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? _Yes No (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application Illi constitute just eauca for removal of an appointee, If you fail to answer all the questions, Council may not consider your application. June 2016 Page2 of—7 �' ©u vycars l lave. bee" roux.",-* q �o C'vri,vxvn,'� ;/l one u✓a J or a n o+Jv r-,. VJ ke f 6\-e r 4,N a f yvLe u r%s 5 o� qk' 0�Ace1fir- A �DctI cr'v;��� rr'5•hts 04-�hiza�i`� S -e r v i nj 6 n i'�u- S T-2-�-1^ �• /1� f'� yrt ✓N !' e, f�P 0rgpni2n��orl O� �uackr`7�c 6,1 doUrS 40 V'ais2 A L'Oa ewes "� be,s,:,C--I,atI r'ssv -es . 1 5�z t,+ e-o,,Y-5 S-FVy(,n3 SUrne c% +t j vhp5� �+^2SSI-L5 1 SSVcS I rh C\l YlvvnA� y i� �tS C.hd �rniS w or k lnag u- A -c a Welt vqO r-,cLxa uhc�ArS ► 0�i�o� o� mcacvo 0^0t mt`cro d-yrti+Mk cs o -c SUojc[j P3 (Jica ( aVr% 2 cz�rt,�mi r i fc4 on homenv� r� s u) ov k n Qr>l;K ca) Su`ev�ce, rLt +�,e L)Ak\vE�s7ha l)oas�„;5��� O•Inot in ki sin 3�-Co�g�iOUShl55 q{ CAL N)fvi ic, PW Pare vv � 1'0 Se(V,e� br1 l�,e i rna ; ) h+S CO YIN V'Vl l5 5 1' b Y\ PJ IJ i sGY''�/ Grave 2lso� "�'1 ��h��C��S-.}1��{;-as @ ►�'�;1�5 rell�e�e � �k-� O!\ (S5 1l"11m.An RI�Ch 1-S . J N d DUY r�: v r o Iff BOARD, COMMISSION AND COMMITTEES © „--..,Hit BUSINESS LISTING r� 15I of IbWA CITY Name of City d rte' �U Board/Commission/CommitteeCD Name 3orhwat+l,v 6 rec �� 'Lards Dtivwi A`lgro -j 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. NAME NOTE: A new form must be completed if the above information changes or an ownership interest is acquiredjp-an additonal business. Applicant 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 ' April 2015 Page 3 of 7 f TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30% Median Income 50% Median 11 % Median 60% Median Income Median y "I (Poverty Level) Income Income (low income) Income 1 516,700 $27,850 $33,420 $44,550 $55700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79.500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63.000 1 ae nnn 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, 10 Age ® Gender Income (see table) Sexual Orientation ElOther (Please explain below) V�) V J Religion %) o Disability Race, color or ethnic group s 4� National origin numdn KIgnis E-Ommission Application i February 2015 page 4 of 8 N Q O y "I numdn KIgnis E-Ommission Application i February 2015 page 4 of 8 g - Advisory Board/Commission Application Form rY _i rI i`A-2 -, nr®�' This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNFSOOOTV OF UT Wm NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 3/8/2017 First Name* Emily Last Name Bushman Home Address* 100 Petersen Hall City IOWA CITY State IA Zip Code 52242 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 6304530038 Email Address* emily-bushrrian@uiom.edu Boards & Commissions Select a Board or Commission you are interested in:* Civil Service Commission Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 8 Months 3. Occupation:* Student 4. Gender:* Female 5. Experience andlor activities which you feel qualify you for this position:* I am an honors student at the University of Iowa studying business. I am a member of the Iowa Women's volleyball team and actively participate in the American Marketing Association group on campus as well. I volunteer with the Program Fuel Up to Play 60 with Mich I help leach children howto live a healthy lifestyle. Growing up, my family moved often which exposed me to many new people and experiences. I experienced diversity in every aspect of my fife and have many friends that come from diverse backgrounds. I really value diversity and wish to see our community grow in acceptance of equality, this is something that I am passionate about and Wsh to be more involved with. I self identify as a feminist while also fighting against racial, gender, ethnic, or any kind of discrimination. 6. What is your present knowledge of each advisory board you are interested in? I have just learned about these advisory boards from a presentation in law class that peaked my interest and prompted my to apply for a position to get involved and take action. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted acfivity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneralty prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. CityCouncil Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with wham the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No S. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 19 10. Country of Origin us 11. Sexual Orientation Heterosexual 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity Caucasion *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* r� Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down City of Iowa City Advisory Board/Commission/Committee 161 L E D Application Form 2016OCT 26 k,„0: 2? a BF. CON O C{!U!`iV11 idil,k nsV PAG1: MARKED"CONFlI1ENTIAL.^' THIS APPLICATION WILL UF. GONSID � MONTHS AND AUTOhLATiCALLY CON SiD rr// ll FOA A IN,,,Y11.eYACA�A' A DUIL,INC'1' /L1f TIME. Advisory Board/Commission/Commlllee Name V/ i lYI'J Term _C21nil _JGIn, / Z( C Jh / 1 NA14IE. i 1Yl$� _ HOME ADDRESS Is yourhome address within the corporate limits of Iowa City? Yes ✓ Nn w. How long have you lived in Iowa City?. 3 Wwli_ g Gender. Male Female y_ all) (T�onµ (� 1 s -ids N Email Addrtss 1 f! � h �iCrl�. CONTRIBUTION AND/OR ACTIVITIES WHICH VoiFEEL QUALJFF1pUFORTRIS rti ed,4 Pomrr inx. SLe. 41&aq I.t WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? See. cl�aciu j LAST POTENTIAL CONFLICTS OF INTEREST. See page 1 for information regarding Conflict of Interest DO OU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? `Yes VINO (If yes, please indicate which board would be your first choice to serve on.) "Mircpreseamtmns on this application will eonsRtnfe just cause for removal of au fall to aoswer all the questions, Council may not consider your appllcstioa Addendum to application — Human Rights Commission, City of rt.- �IM €.J Applicant: Julie J. Christensen ME; OCT 26 Ail 10: 2" CITY CLE i ('nntrihutinn and/hr artivitipcwhirh vnu fppl nualifv vnu fnr ti,pp;`Noit"TY. IOl";s'1 In full transparency, I am new to Iowa City, having moved to the area just 5 months ago from Upstate NY. However, one of the first things that I did when I arrived was look for opportunities to get involved In the community. Due to my deep commitment to social justice issues, I quickly found the Iowa City Human Rights Commission's web page, and was able to connect with Stefanie Bowers early in the summer. The intent wasjust to get a sense of what is happening in the community as I look for ways to get involved and give back as a new Iowa City resident. Perhaps 1 should be a resident longer before throwing my name into consideration for a vacancy on the Commission, but I thought it worth noting some of my background and experience —which I offer as a potential Commission member, or simply as a resident who supports the work of the Commission. I am a social worker by training, and have focused about a decade of my career on working with academically and behaviorally at -risk students in Rochester, NY. Working in a district where over 90% of students were living at or below poverty, I because quickly immersed In community coalition building to support struggling families. I also worked at a teen runaway and homeless youth shelter as a part-time counselor for 8.5 years, where I provided crisis support counseling, and worked within a community consortium that focused on combating chronic homelessness, as well as serving the unique transition needs needs of families impacted by such issues as mental health, gender identity, and resettlement (refugee and asylum families). In the past years, I worked at the University of Rochester focusing on creating inclusive communities— and specifically addressing the needs of individuals with Intellectual and developmental disabilities. It is in this capacity that I was recruited to come to the University of Iowa to work at the Center for Disabilities and Development, where I am engaged in public policy, research & evaluation, and technical assistance and training. This provides a brief snapshot of my experiences and interests. in my short time in Iowa City, I see many of the same systemic and community issues faced here as were areas of concern in Rochester. I believe strongly in coalition building, and that the community has a responsibility to care for all of its members. in this respect, I am excited to get involved as a community member in Iowa City to work towards inclusive communities for all citizens. What is your present knowledge of this advisory board? In my meeting with Stefanie Bowers, she provided an overview of the work of the Commission, Including a history of the many events and programs that the Commission has sponsored over the years. I also had an opportunity to read past meeting minutes from the past 2 years, which gave me a good sense of some of the discussions and issues on the forefront. I am particularly attracted to the Commission's focus on civil rights, social justice, aUalihC;iin�ating discrimination of all kinds in our community. I also had the honor of attending the Awards Breakfast this morning, and was thrilled and moved by the great work th1trgWTSni44q 10'tg6community. CI'T'Y Ci E'Z ; •i,��, i� List of Potential Conflicts of Interest: ;�r�� v..� Cis I • I� at -' None r BOARD, COMMISSION AND COMB ,7 ng BUSINESS LISTINGF� 7M QC Y 26 Fid b-W1'0F 1DVJA CITY Name of City y�- E"7,.' Board/CommissionlCammittee _ L-11 TlY i _n, `` /�� UVI'IQbt CIj_ M')��C(l5'.'t7�ate'� tD�2L I(p Name c I�llir' V &1-1Lv'tcn,,n 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 352.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole propdetor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. NAME NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant 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 April 2015 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIOW. 90rt It3—OkK &ITY Effective May 1, 2014 ° ' '� 1'IaaSahatd 30°,6 Median Income 60% Median —801; -Media n iQ.s� '-"-ui '' IaS Income Median Size {Poverty level} Income income pow incom ,; Income _ _ $18.700 $27,850 _ $33,420 '''fjp��r;"r 2 19,100 31,800 T 38,10613 {�tiiF. ,90h'�- - 3600 3 4 —_ V--_ _ 21,500 35.8130 23,860 42,960_ 572513 71,600 ' 39,750 47,700 _ 63,600 79 500 5 25,600 42,950 51,540 68,700 85,900 6 7 27,700 46150_ 29,600 49,300_ 55380 73,800 92,300 E_ --a.. 31,500—�-- 62.500 1 58,160 az ;An 78,900 88,600 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." IOrd. 94-3647, 11-8-94) OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. df 2 Age LCvtu Gender tart Income (see table) 5El(A Sexual Orientation n t1 Other (Please explain below) Human Rights Commission Application February2015 page 4 of 8 s <✓ Religion Y10WQ = Disability ritJC�+StGtrt _� Race, color or ethnic group %s—a _+ National origin ta Advisory Board/Commission Application Form �2% w®'moi This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITU OF U FERATURE NOTE: Must be 18 years of age and live Wthin city limits of Iowa City to apply Date of Application 11/16/2016 First Name Jovana Last Name* Davidovic Home Address* 630 Fairchild St City IOWA CITY State IA Zip Code IF 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-321-4573 Email Address* jovana-davidovic@uiowa.edu Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 4.5 years 3. Occupation:* Philosophy Professor 4. Gender:* Female 5. Experience andlor activities which you feel qualify you for this position:* I am a professor of philosophy whose primary teaching duty is teaching undergo and grad classes on human rights at the University of Iowa. I also write extensively on conceptual and practical issues related to the human rights, like issues of transitional justice, international law, humanitarian military intervention, terrorism, etc. I have also years of experience working as the Global Links Coordinator- putting on informative cultural programs at University of Maine. 6. What Is your present knowledge of each advisory board you are interested in?* I have read through the recent agendas and have seen this board present or participate in a number of events I have been a part of. ft seems to me its primary roles are pronation of human rights and prevention of violations of human rights, through publiciang human rights issues (for promotion) and through affecting local ordinances and advising the city council on issues that might relate to human rights. 0 seems to me that today it is more than ever important for this board to remain active and vocal- which is why I am hoping to be a part of it. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son -!Maw, daughter-in-law, mother-ir-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister -in, -law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opporturities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* 0 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 38 10. Country of Origin Yugoslavia 11. Sexual Orientation Heterosexual 12. Religion Atheist 13. Do you have a disability? No 14. Ethnicity Serbian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. I ? -4 ".010 CITY of IOWA CITY UNESCO CITY OF LFFERAMF E Date of Application 2/16/2017 First Name" Matt Last Name Drabek Home Address* 815 N Johnson St City IOWA CITY State IA Zip Code* 52245 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application well be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 502-693-2926 Email Address* matt.drabek@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City? * 2007-2011; 2012 -Current 3. Occupation:* Content Specialist 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* rve been a ten year resident of Iowa City and a 20+ year resident of other cities, meaning that I have both the experience of someone who has spent substantial time in Iowa City and the experience of someone who moved to Iowa City from somewhere else, as have so many of our residents. I have been a student at the University of Iowa, a faculty merger of the University of Iowa, and also an employee of one of lova City%s largest non - university employers, which allows me to bridge significant and different Iowa City communities. 1 believe having a wide understanding of the different communities who live in lova City, and the ability to speak with people and discover the pertinent issues, is important for this position. My record of service, research, and activism has focused mainly on issues concerning gender and sexuality, though also to some degree race and socioeconomic status. This record includes service on a University of Iowa committee aimed at creating a sustainability certificate (which was successful, and the sustainability, certificate is now a part of the university's curriculum), local activism with groups focused on feminism and gender issues, and several articles (on topics ranging from the social effects of scientific classification to the social impact of pornography) and one book (Classify and Label: The Unintended Marginalisation of Social Groups, Lexington Books, 2014). 1 hope to bring my analytical training to bear on discussing and investigating human rights concerns. 6. What is your present knowledge of each advisory board you are interested in?* My understanding of the Human Rights Commission is that its important function is to receive and evaluate complaints of human rights violations as defined by lova City's human rights ordinance/human rights code. it also grants annual Human Rights Awards. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domesfic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, fattier -in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is riot to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* M S. Do you currently serve on another Iowa City board or commission?* Nb Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 33 10. Country of Origin United State of America 11. Sexual Orientation Bisexual/Queer 12. Religion Atheist/None 13. Do you have a disability? No 14. Ethnicity White NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Ir , ljl;zlkr� Advisory Board/Commission/Committee CITY OF IOWA CITY Application Form UNESCO CITY OF LITERATURE This application is a public document and as such can be reproduced and distributed';for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. Advisory Board/Commission/Committee Name i A a 2n p SCI l ] ())I Date of Application Fehl`W 17A 9 K t6 [ "1 Name Home Address �2 1 1 1C �1\"(I Il Ajf l ffl j cT 0 1 C�; [A (-'( �3 -I-C \i ,p Contact phone number L1�� V )����% ail Address aC (, Ql/v� edq Your home address must be within the corporate limits of Iowa City? How long have you lived in Iowa City? -2-mon-His- Occupation: on -H sOccupation: er def+ ^ L Gender: Male Female AW Lt 0, C Wy t h* - Experiences , j ( y r Experiences and/or activities which you feel qualify you for this position: U e_i1 fi _ k- yoh �L(rn� y«e ,��stc� }eozzc�- L7le&e sY k (L LK) u,illWCP IBM>�er 4o a�- coey& ►n on an1zc 11 �� I old assumePeah'P %Ea�y�rn'Iz�ssadc�'� �flif� � j1LtC1�Cc11 '�cc�1'1� das� What is your present knowledge of this advisory board? am al r lmoCie �I,� mg Oemerb!) dna �1�1c� cF 1, ad iooc��l ��'51� IS my UPdek-4 ord) �h,4 th in meds arl edaft oirw l a�. �v)d(r c d� nrhes .' M�a Mand cec� (0)11e Inc, clon n�cecla -�t-e nahQ 1�l Ie 9 Please contact the city attorney at 319-356-5030 to discuss questions or concerns regarding a' potential conflict of interest. Potential Conflict of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDGIHOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision—making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, agreement with respect to the proceeds of the federally—assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. Section 362.5 City Council Resolution #15-300 established a policy that the following persons shall not be eligible for appointments to Boards and Commissions. A council member's spouse, domestic partner or partner in cohabitation, children, step children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, sister-in-law, grandparents, and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, poster child, persons who are parents of the same child, and persons whom the employee is in an intimate relationship. Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full tern in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boa s or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of interest? YES NO List potential conflicts of interest (See last page for information regarding conflict of interest) Please indicate if there are none. Do you currently serve on another Iowa City board or commission? YES NO ✓ If so which one do you prefer? The City Council values all types of diversity on its boards and commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the board and commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age Ii— f � Country of Origin l �yr�� CO %�e Sexual Orientation Religion 010 Do you have a disability? YES_ NO Race, Color or Ethnic Group Pa *Note: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise finance and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Contact information is attached. City of Iowa City Advisory Board/CommisslOn/COMnI tate Application Form 2016 SEP 28 t14' 5 TH1S APPLICATTON INA PUBLIC DOCUMENT WITH THE EXCEPTTON OF HE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICAIION WILL BE CONSIDERED FOR TWELVE MONTHS -.AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name i-�_U M r� (7�� - �{-S Term _�t"ati JFxs±On 1, ZOZ� NAME_JpZica F'cr,At_HOMF,ADDRES5I .,Uuru. r Is your home address within the corporate limits of Iowa City? yes_X N How long have you lived in Iowa City9_ A9-41.0.1ESL_ Gender. Male__ Female___ Contact##3iq_—U(� --a11 Email Address —SSS CONTRIBUTION AND/OR ACTIVITIES WMCR YOU FEF L QUALIFY YOU FOR THIS �CO"k0-k,at. onOFoQKuP� Q "uQjftwwttv6l�cweons cotlkn �ro"tYw+,iintiwtn.ttiatrhherueeu_ Aaic,C\u,Is, of Kto kJAs K vvrdim&Vr of wea, TogeA-t-r, aU1NC reWAX-ch /tC[xutiing Pf*thdan(-r- less -ems OF ufCH 's eatcxtifi5 ?t-Cbr C_QrkW-rtnc# WHAT IS YOUR PRESENT KNOWLEDGE OF TRIS ADVISORY BOARD? kd t�u+crs� /ordtncl�. tkMB-�S ekc�r-e--sit�c on G, u tout C4'1U,cbVo as c4stus�ed w lt, Jae flat\ Govt , cr•- Dfr " ?GvibuS ProGttSat 5 LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest N/A i ___-- DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION XNo (If yes, please indicate which board would be your first choice to serve on.) ? Yee ^••-• ter• cacu,aum rallvna on flus application will constitute j answeust cense for removal of appointee. If you tall to the questions, Council may not consider your application. i BOARD, COMMISSION 14N D COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee JAOYri0.r 12�Sh}C v�i,� r��*t „°� •ate CITY OF IOWA CITY Date 4X4-?— .E, Name 1c S% cz 'FP �, 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 ADDRESS DOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant 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. Generaloplication April 2D15 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR 101111A CITY Effective May 1, 2014 Household Size 30% Median Income (poverty Level) 50% Median Income 60% M is C Income ,�g�'h;'Mgdiepuncome (low income) Median Income 1 $16,700 $27,850 _ $33,420, _$44,550 $55,700 2 19,100 31,600 38,160 50,900 63,600 3 21500 35,800 _ 42,960 57,250 71,600 4 .23,850 39,750 47,700 63,600 79,500 5 _ _ 25,80042,950 51,540 88,700 85,900 6 27,700 46,150 55,380 73,800 7 29,600 49,300 59.160 78,900 .92,300 98,600 8 31,500 52,500 63,000 84,000 105,000 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COfAMISSiOAJ 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. F? -y Age Gender Income (see table) (aeXp Sexual Orientation Other (Please explain below) Human Rights Commission Application February 20115 page 4 of 8 O 2 Religion Nixes Disability Race, color or ethnic group �i•SA National origin ray. CITY OF IOWA CITY UNESCO CITY OF LITERATURE Date of Application 3/7/2017 First Name Vanessa Last Name Fiwner-Oraiz Home Address* 437 S. Governor St. City IOWA CRY State IA Zip Code It 52240 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application Will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 919-923-6211 Email Address* vfixrr*roraiz@gmil.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 5 years 3. Occupation:* Community Planner 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I am a gender -queer, queer, person of color who has worked to empower the voices of other marginalized communities throughout my adulthood (I am a b0 surprised that the 'Gender' categories of this application are so limited!). My mother immigrated to the United States from the Philippines Men she was nine years -old and Men she met and married my father much later in life, I was raised in a household that celebrated our mixed - race culture. In the past I have volunteered with Planned Parenthood's Teen Council program to talk with youth about queer issues and reproductive health. Previously I worked as an education outreach coordinator for a Rape Crisis Center and engaged with a wide range of ages on the importance of body sovereignty and have experience organizing with IGBTQ youth and families. I have served as a panelist for a United Action for Youth event to discuss queer relationships with local youth and their parents. As a non -gender conforming citizen I feel as though this work is important in our community given that I have experienced hate crimes first-hand in love City. My work as a community planner offers me the privilege of working with marginalised communities on many topics, from clean water access to native sovereignty issues. Our current political climate has emboldened a side of the American people that is fundamentally detrimental to the well-being of our communities and 1 believe there is a responsibility for those of us who can respond to these attacks to do so at every level of our society. I feel as though the work of the Fluman Rights Commssion serves the Iowa City community in a way that feels more Important than ever 6. What is your present knowledge of each advisory board you are interested In?* I have been to events sponsored by the Human Rights Commission and read their agendas online; thus I am familiar with the duties involved. 1 also know and respect Kim Hanrahan and am grateful for all of the years of service she has given our community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerelly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission w411 be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* Nb 8. Do you currently serve on another Iowa City board or commission?* Nb Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 38 10. Country of Origin USA 11. Sexual Orientation Queer 12. Religion Spiritual 13. Do you have a disability? No 14. Ethnicity Philippine -American *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down �.ro CITY OF IOWA CITY VNESCOCIT OF LITEPAMU Date of Application 3/6/2017 First Name* Peter Last Name Gerlach Home Address* 3346 Tulare, Avenue City IOWA CITY State LA Zip Code 52245 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319.325.5361 Email Address* peter.a.gerlach@grnaii.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 3.5 years 3. Occupation:* International Student Advisor 4. Gender:* Male 5. Experience and/or activities which you feel qualifyyou for this position:* Experience as an AmeriCorps and Peace Corps volunteer has engrained in me a commitment to giving back to my community, both on the local and global level. I have also had the good fortune of going to graduate school in a department of Guttural Foundations of Education, a social -justice oriented program focusing on issues such as race, class, gender, and disability. In my current role as International Student Advisor, I am the primary contact for international students, for all immigration concerns, as well as advancing internationalization at Coe College. I also serve on the Gender Task Force and as a Title IX sexual misconduct investigator. My focus on social justice, higher education, service, and globalism, I think, in many ways, stems from my childhood and being raised in a bkouhural and bi-lingual household with parents who valued these things. My father was an immigrant from Germany and my mother was raised in a conscious -aware 1960s and 70s US. At this point in my life, a new father and a new home owner, it is the right time for me to be more engaged again and to give back to the city where I live. 6. What Is your present knowledge of each advisory board you are interested in?* My understanding of the Human Rights Commission is, if appointed by the City Council, I would be one of a panel of 9 residents focusing on eliminating human rights offenses and abuses of all kinds in Iowa City and also educating citizens about civil rights more generally. This would include, among other things, sharing educational information with the general public, holding public forums monthly (or more as needed), working with other public and private groups to advance a welcoming and respectful community, and engaging with the community to proactively confront bias, discrimination, and crime. Additionally, and crucially, this commission would work together, with others in Iowa City, to recommend legislation around civil and human rights that advances a fair, responsible, and collaborative agenda for Iowa City. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decisiort-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federalty-assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother -int -law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister -int -law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest7* 0 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 36 10. Country of Origin United States 11. Sexual Orientation Heterose)wal 12. Religion Unitarian 13. Do you have a disability? W 14. Ethnicity White "NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Advisory Board/Commission Application Form 1 �w rit This application is a public document and as such can be reproduced and distributed for the public. This application Will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY Of LITERATURE NOTE: Must be 18 years of age and live within city lirnits of Iowa City to apply Date of Application 2/22/2017 First Name* Angela Last Name IF Lambertz Home Address* 1710 Hollywood Blvd. city IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196219837 Ercall Address* cawfee73@gmeil.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 3 years 3. Occupation:* Content Specialist I, Technical 4. Gender:* Ferrule S. Experience andlor activities which you feel qualify you for this position:* I have lived in various unsafe buildings because of lack of funding for affording safe housing. I am an LGBTQ activist who would like to participate more directly in the government of my community. 6. What is your present knowledge of each advisory board you are interested in? I have attended a couple City Council meetings and keep up to date on local news through social media outlets and the local newspaper. I have read through the Duties descriptions of each advisory board on the iowa- city.org website. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom fine employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* Kb 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following 9. Age 43 10. Country of Origin United States 11. Sexual Orientation Bisexual 12. Religion Wiccan 13. Do you have a disability? No 14. Ethnicity Caucasian `NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* * Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down = b Advisory Board/Commission Application Form _ r6 `1 "01i�f'f;'"t A This application is a public document and as such can be reproduced and distributed for m the public. This application will be considered for twelve months only and automatically CIN OF IOWA CIN considered for any vacancy during that lime. UNESCO OTY OF LFEERANRE NOTE: Must be 18 years of age and live within city lirrits of Iowa City to apply Date of Application 3/8/2017 First Name Maya Last Name* Mahajan Home Address* 417 Monroe St City IOWA CITY State IA Tip Code 42256 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193831283 Email Address* maya.mahajan@me.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* Around 8 years 3. Occupation:* Philosophy major at the University of Iowa 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have served on the Iowa City School District Equity Committee for around a year, and am currently Secretary of this committee. Before this, I was chair of the West High School Student Senate Task Force Committee, and I worked to get programs implemented to target high achieving minorities and encourage them to take AP and honors classes. I also worked with the school's diversity club to push for implicit -bias training for our teachers and administrators. 6. What is your present knowledge of each advisory board you are interested in? I am currently enrolled in a Law and Legal Studies Seminar and Stephanie Bower just gave a presentation to us about the responsibilities of the Commission. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following descrlbea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 6. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 18 10. Country of Origin United States 11. Sexual Orientation Straight 12. Religion Atheist 13. Do you have a disability? No 14. Ethnicity Hspanic, Indian, white 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* eA-- Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down City of Iowa city Advisory Beard/Commission/Committee App Reation Form THIS APPLICATION PUBLIC DOCUMENT WITH THE EXCEPTIONTHE LAST PAGE MARKED "CONFIDENTIALTHIS APPLICATION WILL BE CONSIDERED ED FOR TWELVE AUTO141AT'CALL Y MONTHS AND CONSIDERED FOR ANY VAD CANCY URWGTIIAT TXyiE Advisory Board/Commission/Committee Name Wv*vi P')01 kf. NAME aVrn h MGI2(u'f LI Le Ho DRESS 13q Is your home address within the corporate limits of Iowa Cityy yesNo 076-'61-sy`tS—p� ipy- How long have you lived in Iowa City7 I q y e G(, ✓f nder: Male _ Female x Contact#515"q�3"035ZEmail Address _�t"?. Woe CONTRMUTI_ONAND/OR ACTIVITIES VVMCH YOU FEEL QUALIFYYOU FOR THIS Pncrrrnta. 16LM 6L V) A,tfb it ln-ev) r c ww e vet I � Sht r� YLC'nc, ibvvr� o f .e..ct �l A-. s c t� i al-, i V"l d - WHAT IS YOURPRESENT RNOWLEDGE OF THIS ADVISORY BOARD? 1 lx -AVG Pe-o'eA- ' -1 e d -t 3C4.1'"`d -I t7f +-CNC C.s V -V i S Sri 61--� cr-v) F e L; N aS whit l rtis C`e rlLsS r�1c �tS t^e LOx:4 11) t e. Gc✓V�-� Y G. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding ConDict of Interest DO YOU CURRENTLY SERVE ON ANOTIIER IOWA CITY BOARD OR COMM SSION? ryas ?—(No (If yes, please indicate which board would be your first choice to serve on.) i' Misrepresentations on this application w10 constitute just cause for removal of an appoiutee; If fait to answer all the questions, Council maynot consider your application. t June 2036 -• ' cit i'age2 of 7 �.. � r BOARD, COMMISSION AND COMMITTEES Q -- BUSINESS LISTING wr.A°O CITY OF IOWA CITY Name of City Board/Commission/Committee _jjVLt u�-v� K i o� k4-1 (4-y 4,-i Date 91A o I t Name—k"-A/-1 KAA I\" --Q 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. 140TE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant %V (.t, CJ -� Cil Misrepresentations on this applicationwill constitute just cause for removal of an appoa�tee. If yqu fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of W TASLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63,000 84,000 105,000 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 ® Gender 140 6 Ic +{ Income (see table) k-4i+tiVl ✓ exualOrientation Other (Please explain below) Ck-,,-r S f -1n Religion Disability CM t C as 1 vi Race, color or ethnic group (/i S /i- National origin N O T 0 C3 i Human Rights Commission Application February 2015 page 4 of 8 cn i Human Rights Commission Application February 2015 page 4 of 8 _ t _4 Advisory Board/Commission Application Form "1 jEA__-, This application is a public document and as such can be reproduced and distributed for ®�'the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNFSCOCHT OF UT WU NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/16/2017 First Name Sharon Last Name McDonald Home Address* 1216 Jensen St City IOWA CrrY State IA Zip Code* 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196318270 Email Address* smdonald2l28@gmaii.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 29 3. Occupation:* Director, non-profit campus based child care center 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* My organizing for Obama since 2011 has made me very aware of the issues faced by our immigrant and refugee community. I have had the pleasure of interacting with many international families at my center. I did a lot of canvassing in my precinct, which included the section 8 housing off Walden and parts of the Pheasant Ridge community. I went to help Iowa City become as inclusive as it can be, I want to advocate for human rights for all, especially our marginalized communities. I also worked part time nights for 14 years (ending only two years ago). That work put me in close contact with a very diverse population. I would like to know that we're doing as much as we can, as a community, to make everyone in our community feel included and valued. 6. What is your present knowledge of each advisory board you are Interested In?* Sadly, I have to admit I don't know much. However, 1 am a quick study and I really wan to make a positive contribution to our community, especially in this arena. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneralty prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-ir-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. 415-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 6. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin us 11. Sexual Orientation private 12. Religion 13. Do you have a disability? Yes Please explain: I have double scoliosis. My spine has been fused tucks. The few un -fused vertebrae in my neck have begun to curve again, into my lung. It makes walking difficult but I get around vdth a walker and/or a cane. I also have pretty severe arthritis, which combined with my body's general curvature, gives nre trouble. 14. Ethnicity caucasion 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* �.f'ee4cor �rn�arnld Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down 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 2015 Page 1 8 City of Iowa City Advisory Board/Commission/Committee Application Form THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR TWELVE MONTHS AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name: Human Riehts NAME Erin Michelle Noon HOME ADDRESS 1513 McCleary Lane Iowa City, IA 52245 Is your home address within the corporate limits of Iowa City? XYes No_. _ How long have you lived in Iowa City? I YR Gender: Male X Female Contact#Email Address Enoon25(a)=ail.com CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR rms POSrfION: • Active Disabilities Advocate • Disabilities Blogger-Social Justice/Lack of Representation in the Workforce • Active Advocate for Other Disenfranchised groups WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Duties of the Commission involve educating the public on civil and human rights, including planning programs and activities to eliminate unlawful discrimination. The Commission also makes recommendations to the City Council for Social Justice and Racial Equity Grant funding, as well as for additional local legislation as it relates to discrimination. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of R t ! hiterest- N/A 3 , DB YC�F CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? _Yes 2Vo (If yes, please indicate which board would be your first choice to serve on.) lWsrepresentations 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 f June 2016 Paget of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Human Rights Name Erin Michelle Noon CITY OF IOWA CITY Date 9.21.2016 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. ivv.in;anew .ronnmust oc.completed itthe above ntormationchanges.oranownershipinterest.isacquired in an additional business. of BUSINESS NAME BUSINESS ADDRESS N/A 47 •—� � f ter_ .. J ivv.in;anew .ronnmust oc.completed itthe above ntormationchanges.oranownershipinterest.isacquired in an additional business. of Applicant Signature &.t n, -Mi.JL / o -O -m Misrepresentations on this application will constitute j fail to answer all the questions Council may not consi General Application April 2015 Page 3 7 cause for removal of an appointee. If you c'� N cuna .. 0 N cause for removal of an appointee. If you ILI THANK YOU FOR YOUR PARTICIPATION IN THIS SURVEY. TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective Mav 1. 2014 Household W/" Median Income (Poverty Level) Median Income y Median Income 80% Median Income (low income) Median Income 1 $16,700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 42,960 50,900 57,250 63,600 711600 3 21,500 35,800 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31 ,500 52,500 ♦ TT 63,000 84,000 105,000 ri t I AUMV1r 1N I I U APPLICATION FOR THE f ° ' HUMAN RIGHTS COMMISSION It is the asrission "of the Iowa City Human Rights Commission to protect residents of the city from discrimiflatioh as defined in the Human Rights Ordinance. In order to further this goal, the city strives to 'ensu ,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, 1 1-8-94) OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. 27 Age Female Gender Income (see table) 2 Sexual Orientation -- ---1 Religion Cerebral Palsy -Physical Disability White Race, color or ethnic group National oriein Other (Please explain below) In a committed relationship of 8 _ Advisory Board/Commission Application Form 11 I = -rI ry y w=111- li tThis application is a public document and as such can be reproduced and distributed for may` the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCOCiTY Or LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/28/2017 First Name Grace Last Name Pacer Home Address* 612 South Dodge Street city IOWA CITY State IA Zip Cade* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 8159803945 Email Address* gracepacer@cemcast.net Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* Since Fall 2017 3. Occupation:* Server at Etre Restaurant Group 4. Gender:* Female 5. Experience andlor activities which you feel qualify you for this position:* I am an International Relations Major at the University of Iowa with a strong interest in international mechanisms for the protection and promotion of human rights. I have experience both in leadership and event planning for various organizations. As a gay woman I feel compelled to work for equality for all marginalized members of our community. 6. What is your present knowledge of each advisory board you are interested in?* I recently attended a presentation by Stefanie Bowers which outlined the history, activities, and responsibilities for members of the Human Rights Commission. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Cityconttracl. CityCouncil Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, sonrirt-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* W 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 20 10. Country of Origin United States 11. Sexual Orientation Lesbian 12. Religion None 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* C-0tQ J/DezrM-t Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down ' = Advisory Board/Commission Application Form t'Y _ 4 A``11 S Si°1 N.. �.1 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/16/2017 First Name Tahuanty Last Name Pena Home Address* 1026 Meadowlark Dr City IOWA CITY State IA Zip Code* 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 2488355452 Email Address* tahuanty_pena@hotmaii.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 2 years 3. Occupation:* Physician 4. Gender:* Male 5. Experience andlor activities which you feel qualify you for this position:* During my lifetime I have been able to experience the different ways human rights can be violated and that has definitely helped me have great respect and desire to preserve them. Having grown up in a third world country made me experience how monetary and political power was constantly above human rights without any mechanisms to regulate it. Having moved to the 115 over 10 years ago made me also realize that even though we live in a great democracy there are still ways to dismantle human rights at different levels, reason why I feel we should all do our part to preserve and further advance them. 6. What is your present knowledge of each advisory board you are interested in? My current knowledge of the human rights commission at Iowa City is minimal but its goals and duties are extremely important for me as a member of the community. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally, prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policythat the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable informa0on to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following 9. Age 38 10. Country of Origin Dominican Republic 11. Sexual Orientation Heterosexual 12. Religion None 13. Do you have a disability? No 14. Ethnicity Hispanic 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ���� fi; lVpl 'Q Y C/Qww Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Advisory Board/Commission Application Form ry OVENi This application is a public document and as such can be reproduced and distributed for ' the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF UTERANRE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/16/2017 First Name Nolan Last Name Petersen Home Address" 603 E. Burlington St. #1 City IOWA CRY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 563-209-1997 Email Address* nolan.petersen@gmaii.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 8 years 3. Occupation:* Realtor 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* As a queer -identified man, who also works to be a social justice advocate in my personal and community life, I see the Human Rights Consnission as one which fits into my worldview and sense of civic duty. I also hold a strong value of making my presence make a difference, and this position may give that value even more weight in my daily life. As for qualifications, I don't know if there would be specific qualifications for an appointment like this: I have extensive exposure to people from all over the world, I am lucky to have lived in near -poverty as well as comfortably middle -Gass, and I realize the privilege I hold as a white, cis -gender man in US society --and my duty to use that privilege to push against the systems that allow people like me to have undue influence in our culture and society. 6. What is your present knowledge of each advisory board you are interested in?* I have a limited understanding or exposure to the work done on the Human Rights Commission of Iowa City, truthfully. I have yet to fully find a way to engage, eagerly, in local government, but I believe this commission may be just that opportunity. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagerierally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same chill, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is rat to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* Wo 8. Do you currently serve on another Iowa Cityboard or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 26 1D. Country of Origin USA 11. Sexual Orientation Queer 12. Religion Generally Faithful 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* �( W'zw Soe t'hw Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I r , Advisory Board/Commission/Committee CITY OF IOWA CITY Application Form UNESCO CITY OF LITERATURE This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. -� Advisory Board/Commission/Committee Name Q11, i (�h IS ( J»�-,, r J s Date of Application Name — --C�?/ �— ✓L — P (_ f h�^. - — - Home Address Contact phone number3&.>'S'!_ ,}_J (_�_ Email Address � ! (� -/!a IBJ (c_ ULcw ei Your home address must be within the corporate limits of Iowa City? How long have you lived in Iowa City??/ _rt/ r _ Occupation (e i ✓'rr �__- rU.-rPf54,' c �a/I Gender: Male Female Experiences and/or activities which you feel qualify you for this position: J G kf Cm i,.r ts(. --611 ]Kr "Y ---,•/r� a -r'( /' �c7j.Y What is your present knowledge of this advisory board? —rJ l 4Y11 Wer/e ,��.C' �et✓,i �/GJi I. f 11 'Gi :1 ..`d Z, i;uil 710E Please contact the city attorney at 319-356-5030 to discuss questions or concerns regarding a potential conflict of interest. Potential Conflict of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision—making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, agreement with respect to the proceeds of the federally—assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. Section 362.5 City Council Resolution #15-300 established a policy that the following persons shall not be eligible for appointments to Boards and Commissions. A council member's spouse, domestic partner or partner in cohabitation, children, step children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, sister-in-law, grandparents, and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, poster child, persons who are parents of the same child, and persons whom the employee is in an intimate relationship. Res. #I5-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of interest? YES_ NOZ Do you currently serve on another Iowa City board or commission? YES_ NO + If so which one do you prefer? ZZ Atwl "101 The City Council values all types of diversity on its boards and commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the board and commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age _7 Country of Origin V S yT Sexual Orien—tatiion _ lac �� S eV I Do you have a disability? YES_ NO t/ Race, Color or Ethnic Group LL/ *Note: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertisefinance and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Contact information is attached. 1 LG ;t_,i ilw CRY off'Iowa City Advisory Board/Commission/committeeApplication Form . 201 b SEP 25 THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF•T HE LAST PAGE MARKED "CONFIDENTIAL."THIS APPLICATION WILL BE CONST DEICED FOR TWELVE MONTHS AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY -DURING TIIAT TIME Advisory Board/Commission/Committee Name tin Term 0 NAME rt •�rlevn^`v&ol%,EADDRESS nvLt4v (O to IoKe, Cr=►�rl rH�1 Is your home address within the corporate limits of Iowa City? YesA No How long have you lived in Iowa City? 5 Irl C e .Tit re, y —QL Gender: Male Female Contactli3(9_ 4 be. -fore, �— ��r%,�Email Address_ Q 690mQ I'(, Cprp CONTRIBUTION AND/OR ACi'IVITIES WHICHYOUFEEL QUALIFY yO[I kOR THIS POSITION: St v- A41at ht rl WHAT IS YOUR PRESENT KNOWLEDGE OF T21S ADVISORY BOARD? See GL41ache cl LIST POTENTIAL CONFLICTS OF INTEREST: See page I for information regarding Conflict of Interest See CLAJ ache of ,{DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? No (If yes, please indicate which board would be your first choice to serve on.) Yes Ndisrepresentations on this application will constitute just cause for removal of an uppointee.lf you fail to answer all the questions, Council may not consider your application. City of Iowa City Advisory Board/Commission/Committee Application Form n Name: Nicole Jeanette "AJ" Richard 2016 SEP 26 [-. 1 !' -'- Address: 2801 Hwy. 6 E, Lot 421, Iowa City, IA 52240 I have lived in Iowa City since June 2015. I lived in Iowa City previously between 2006 and 2009. I returned to Iowa City because I love the city. Contact: 319480-8673 Email: airichard999@gmail.com CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Camp Fire USA member, 1976-1982 YMCA basketball coach, 1989 Founder and President HURT (Humans Unlearning Racism Together), Des Moines, IA 1992-1995 Volunteer community radio talk show host, KUCB 89.3FM Des Moines, IA 1992-1995 YMCA Downtown Teen Program working with at -risk youth, Des Moines, IA 1992-1995 Des Moines Educational Equaity Committee, IA 1993-1994 Very Important Partners volunteer with Polk County Juvenile Court, 1993-1994 Volunteered leading therapeutic poetry group for adjudicated teen girls, Des Moines, IA 1996-1998 Gender Inclusion organization, Univ. of Northern Iowa, 2001-2004 LGBTQA organization, Univ. of Northern Iowa, 2001-2004 President Club SOLE (Student Outdoor Leadership Education), Univ. of Northern IA, 2003-2004 Special Olympics volunteer, 2004 Foster parent, IA 2008-2009 Baseball For All Nationals Committee member (creating opportunities for girls to play baseball in a traditionally all-male sport, 2015 -Present Professional working with individuals with disabilities including as a summer camp counselor, Communications Director, and Services Coordinator, 1999 -Present Diversity Awareness Facilitator (volunteer), 1992 -Present National Youth Sports Coaches Association, 2016 BA from Univ. of Northern Iowa in Leisure/Youth/Human Services, 2004 Awarded: Dean's List, Educational Excellence Award WHAT IS YOUR PRESENT KNOWLEDGE OF THE ADVISORY BOARD? The Human Rights Advisory Board works to protect all residents of Iowa City from discrimination. Members are volunteers. The Board meets monthly. The Board works to educate and public about civil and human rights. The Board plans programs and activities to eliminate unlawful discrimination. The Board also recommends funding for Social Justice and Racial Equity grants to the City Council of Iowa l City. I Nicole "AJ" Richard continued Human Rights Advisory Commission Application LIST POTENTIAL CONFLICTS OF INTEREST I work for Reach For Your Potential. My previous employer was Camp Courageous in Monticello, IA. I was terminated from my'position there after many years and filed a complaint with the Iowa Civil Rights Commission 1 �-ch is still being investigated. I do not own property. I am not on any other boards. I volunteer with Baseball For All and plan to coach baseball in the Iowa City area beginning in 2017. RESUME AND REFERENCES PROVIDED UPON REQUEST I ? r n•� BOARD, COMMISSION AND COItAMMEES & BUSINESS LISTCW6- """�"� CITY OF IOWA CITY Name of City 16 Sro 25 (i 41 Board/Commission/Committee 14 MCI rl S Date Name / )e- - ItLv7 PA 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 iff there are none. NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant 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 April 2015 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30F. Medlan Income 50% Median 60% Median 80% VMedian Income Median (Poverty Level) Income Income I Income 1 $16,700 $27,850 $33,420 4 $44,550 $55,700 2 3 19,100 31,800 38,160 SD 900; 63,600 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 _ 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63,000 84,000 105,000 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 PRWDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. © Age -�] Gender ioOe� Income (see table) Sexual Orientation EDOther (Please explain below) NA ran Rights Commission Application February 2015 page 4 of 8 Religion Disability A I;sm T/ bre MYA giot-' Race, color or ethnic group I Hry�-Prl ('/jrt ! National origin Was � p�,��,nL� resrcl�n+ a F Lanae a. _ t 4 Advisory Board/Commission Application Form ,CPlii�tt This application is a public document and as such can be reproduced and distributed for the public. This application Will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNES000"OF MEMNRE NOTE: Must be 18 years of age and live Within city limits of Iowa City to apply Date of Application 2/16/2017 First Name Clare Last Name Rose Home Address* 928 E Bloomington St city IOWA CITY State IA Zip Code* 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3192130477 Email Address* cmrtin204@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 24 years 3. Occupation:* Technical Project Manager 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* I am currently a technical project manager for the accessibility group at Pearson. My job is to ensure that legal and web content standards are follovsd in our products allowing people with disabilities equal access to content. As a result of this work I am familiar with details of the ADA, and ESSA Additionally, I received my bachelor's at the University of Iowa in Political Science, with an emphasis on Middle East studies. I studied abroad in Amman, Jordan and worked on research projects on the IsraelVPalestinian conflict and refugee issues. During the summer of 2005, 1 also interned for a small social justice think tank in Washington DC called the SpiritHouse Project which was run by Ruby Sales, a prominent player in the SNCC during the height of the civil rights movement. 6. What is your present knowledge of each advisory board you are interested in?* My knowledge is fairly limited as this is my first attempt to become involved in human rights issues in my community, however I have read through the Human Rights Commission's duties and feel that I have a good understanding of these duties and my potential role in them. I have also studied Title 2 of the Iowa City City Code. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract CityCouncil Resolution # 15-300 established a policythat the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full tens in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* ND 8. Do you currently serve on another Iowa City board or commission? Pio Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 34 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Atheist 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant's 61e'01A Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down City of Iowa City Advisory Board/Commission/Committee 3 L E D Application Form 2016 OCT - 7 PN 4: 17 I HZ AFFLICATION IS A PUBLIC DOCUMENT WITH THE EX(09177XHE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL 13Ft'6 r7j :g6p TWELVE MONTHS AND AUTOMATICALLY CONSIDERED FOR A bbliING THAT TIME. Advisory Board/Commission/Committee Name Tenn NAME K tHOME ADDRESS U r] I // jg4a o � l ( Is your home address within the corporate limits of Iowa City? Yes�No How long have you lived in Iowa City?_ _ ,3 /� O n ,) Gender: Male _ Femalec'� Contactff3A- j9q—jyn-i Email Address TI f TY(L i�n 0 lji(, �GM CONTRIBUTION AND/OR ACTIVITIES WHICH YOUFEEL QUALIFY YOU FOR THIS POSITION: hc�)L b o n�ouga+ _ Pck- (1y rbc l l nclu}�Own- C? V(i U1 Lc)' -fwd C4 l,t)4�l'Ck t�� 'hour,- WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? LIST POTENTIAL CONFLICTS OF INTEREST: S page I for information regarding Conflict of Interest DO,YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? _Yes o (If yes, please indicate which board would be your fust choice to serve on.) 67 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. June 2016 Paget of 7 s , BOARD, COMMISSION AND COMMITTEES Jil `u� � BUSINESS LISTING Name of City Boa rd/Commission/Committee Name -� t. *TY OF IOWA CITY a^ i 0 7 Date' Section 362.5 of the Code of Iowa generally o —a g y prohibits, with certain important exceP,tidris, a�rnember of a city Board or Commission from having an interest in a city contract. A copy of SeC'tion 3635 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. NOTE: A new form must b�e_cgQmpleted if the above information changes or an ownership interest is acquired in an additional busifiess. /moi Applicant Signatu GG II Misrepresentations on this application will constitute just cause for removal of an appointee. if you fail IJ to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 = 71,600 4 23,850 39,750 47,700 63,604 c,=) 7RBCO 5 25,800 42,950 51,540 68,7A0 -t "8'5'900 6 1 27,700 46,150 1 55,380 73,80 M` a 92,300 7 29,600 49,300 59,160 78,98 98 00 8 31,500 52,50D 63,000 84,009,'_ FS5'a000 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. F Age L-7 Gender Income (see table) ISexual Orientation Other (Please explain below) ' Human Rights Commission Application February 2015 page 4 of 8 Religion Disability Race, color or ethnic group National origin _ Advisory Board/Commission Application Form rY }; :P:I'r Mt This application is a public document and as such can be reproduced and distributed for �y Ems' the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNES000" OF LITMANRE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/22/2017 First Name Jeremy Last Name Vogel Home Address* 720 S Dubuque St Apt 6 City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 4026504556 Email Address* jeremy-vogel@outlook.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 3 1/2 years 3. Occupation:* Student / food service 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* I have been involved with various human rights awareness groups on the University of lova campus during my time as a student. I have helped plan events such as the annual Human Rights Awareness Week and the annual UISG Multicultural Formal. I have also served in student government where we evaluated funding requests ranging from $1500 to $5000. 1 feel these a)periences directly relate to the duties that the Human Rights Commission is assigned. 6. What is your present knowledge of each advisory board you are Interested in? * I understand that the Commission primarily works to provide education, resources, and advice to the City Council and the public in relation to human rights, civil rights, and bias. There is also a funding component in which the Commission revievs applications for funding support for initiatives and programs related to the goals of the Commission. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. CityCouncil Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-irrlaw, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 22 10. Country of Origin United States 11. Sexual Orientation Queer 12. Religion Non -religious 13. Do you have a disability? No 14. Ethnicity White `NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* "w;� Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down w.r._ CITY OF IOWA CITY UNESCO CITY OF LITERATURE Date of Application 3/9/2017 First Name Fra Last Name Warren Home Address* 715 Carriage Hill #1 City IOWA CITY State A Zip Code 52246 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of lows City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 5632606811 Email Address* effa.warren24@gmil.com Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City? 8 years 3. Occupation:* Student/Parks and Recreation 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* I was originally a freshman at Iowa in 2007. After two years I dropped out due to some health issues. In that time I worked for 5 years at New Pioneer coop here in Iowa City and really started to feel "at home", in bora City. I then moved back to Muscatine for two years Mere I earned my associates degree in business management, Mile also working for the City of Muscatine parks department. After earning my associates degree I returned to lows City to finish my Bachelors degree in Sport and Recreation Management. I've worked the last year as the park management Intern for the city of lows City. I have also spent time working for the University athletic department with the turf management and facility management staff as well. I am on track to graduate this December. With all of my combined experience I feel I have a unique sense of Mere Iowa City vas 10 years ago, I have seen the changes lova City has endured in that time, and I have a sense the places Iowa City can potentially go. I also have strong connections with UIHC, having lived there a month and ultimately having my fife saved after a traumatic brain injury in 2005. All of these experiences have made it so I feel a strong connection with the city of Iowa City and it's residents. it would be an honor to have the opportunity to apply my experiences and knowledge in order to help Iowa City blossom by serving on the Human Rights Commission. 6. What is your present knowledge of each advisory board you are Interested in?* I really don't know too much about the Human Rights Boards other than the general ideas, theories and issues around Human Rights. I have taken several ethics classes (Business Ethics & Sport Ethics) as well as Flumen Relations and the University of lova's Career Leadership Academy program. I believe that from these classes I have a solid foundation surrounding ethical issues, topics, and other concerns in regard to overall human rights Issues. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDGfHOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or far one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 27 10. Country of Origin United States 11. Sexual Orientation Male 12. Religion Christian/Agnostic 13. Do you have a disability? Yes Please explain: I have weakness in my right leglarm as well as epilepsy and major depressive disorder/ptsd which I developed after my Traumatic Brain Injury/Surgeries in 2005. 14. Ethnicity Caucasian *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* zo" L 6x^' Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down `; i c rL y ,�2f E we.E. 4. rays CITY OF IOWA CITY UNESCO CITY Of LITERATURE Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/18/2017 First Name Solomon Last Name Worlds Home Address* 611 S Clinton St. Apt 1 City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 7608807407 Email Address* solomn-mrlds@uiom.edu Boards & Commissions Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 4 years 3. Occupation:* Student, ICCSD Intern 4. Gender:* Male S. Experience and/or activities which you feel qualify you for this position:* I am a facilitator with the LGBTt7 Safe Zone Project, work in the school district's Equity and Engagement department, assist the Mayor Pro Tempore, and advise with the University president in my role as a member of the Black Student Advisory Committee. 6. What is your present knowledge of each advisory board you are interested in?* I know that the board for human rights has great people involved and I knowthat they are present in the community. I also know that I am excited and would love to have a chance to work with those individuals. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and hall -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 6. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 21 10. Country of Origin United States of America 11. Sexual Orientation Heterosexual 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity Afro- American 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 0(4z 14 Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down City of Iowa City Advisory Board/Commission/Committee Application Form THIS APPLICATTON IS A PUBLIC DOCUMENT WITH THE F,RCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL," THIS APPLICATION WILL BE CONSIDERED FOR TWELVE MONTHS AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING TIIAT TIDIE. Advisory Board/Commission/Committee Namearm NAMEc�' I{OAfE ADDRESS �O = 1p ; {-o wGr t� Is your home address within the corporate limits of Iowa City? YesNo How long have you lived in Iowa City? S CMS . Gender: Male _ Female ContactN..(�-.aca Email CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL POSMAN• QUALIFY YOU FOR THIS WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? LIST POTENTIAL CONFLICTS OF INTEREST: See page I for information regarding Conflict of Interest i DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? -4No (If yes, please indicate which board be Yes would your first choice to serve on.) Misrepresentations on this application will constitute Just cause for removal of tall to answer all the questions, Colonel] an appointee. If yRy may not consider your application. 0 Juoe 2016Paget of 7 , �+y.q =icy m M M _ � V W Powered by MachForro ; t i i BOARD, COMMISSION AND COMMITTEES N1 1�"+t BUSINESS LISTING"�� CITY OF IOV<<A CITY Name of City Board/Co �m (miss io r ln ./C ,,om -mittee /4 (J. �3-r\ a' q' �O/17y37 %5 5i pate Name Nt-C.Lt�tU t 1Nti-- Section 362.5 of the Code of ioiva genevraliy 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. NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business, Applicant S Misrepresentations on this application will constitute just cause for removal ofF appftee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 Y5 r V) W �7 Y5 I TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30% Median Income 50% Median 60% Median 80% Median Income Median (Poverty Level) Income Income (low income) Income 1 $16,700 $27,850 $33.420 $44,550 2 3 19100$55 31,800 38,160 50,900 63,600 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 fi81700 85,900 6 7 27,700 46,150 55,380 73,800 92,300 29,600 49,300 59,160 78,900 98,600 8 31,500 1 sq snn I�� ....., 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 E�J Gender Income (see table) Sexual Orientation ElOther (Please explain below) Nar2 Religion Disability -� Race, color or ethnic group S National origin M Human Rights Commission Application r ! February 2015 page 4 of 8 . -I)� GJ e� Human Rights Commission Attendance Record Key X = Present 0 = Absent O/E= Absent/Excused R = Resigned — = Vacant TERM 2/16 3/15 4/18 5/17 6/21 7/7 7/19 8/16 9/20 10/18 11/15 12/20 t/17/ NAME EXP. 16 16 16 16 16 16 16 16 16 16 16 16 17 Barbara 1/1/2020 — — — — — — — — — X X X X Kutzko Jeff Falk 1/1/2020 — — — — — — — — — — — — X D'Angelo 1112020 — — — — — — — — — X X O/E R Bailey Joe D. Coulter 1/12019 X X X O/E X X O/E X O/E X X X X Adil D. 1/12019 0 O/E O X X X X X X X X X X Adams Eliza Jane 1/12019 O/E X X X X X X X X X X X X Willis Andrea Cohen 1/171018 X X X X X I X X X X X X OIE X Kim 1112018 X O/E X X X X X O X X X X X Hanrahan Shams 1/12018 X X X X X X X X X X O/E X X Ghoneim Key X = Present 0 = Absent O/E= Absent/Excused R = Resigned — = Vacant -nr-7- 12d NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: SENIOR CENTER COMMISSION Two vacancies — Three -Year Term January 1, 2017 - December 31, 2020 The duties of members of the Senior Center Commission are to: • Serve in an advisory role to the City Council with regard to needs of the Senior Center. • Make recommendations with regard to policies and programs at the Senior Center • Join staff and other interested persons in seeking adequate financial resources for operation of the Senior Center. • Encourage full participation by senior citizens in the programs of the Senior Center. • 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. • 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 at least 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, March 14, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Senior Center Commission should be directed to Linda Kopping, Senior Center Coordinator at 356-5225 Board/Commission Application Cover Board/Commission: Senior Center Commission Two vacancies to fill three year terms 1/1/2017-12/31/2020 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 2/21/2017 Application Deadline: 3/14/2017 Council Appointment Date: 3/21/2017 Date of Non -Gender Appointment: 12/19/2016 After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Gender Male Male 2 Male Female:4 Male:1 Name and Address Honohan, Jay 1510 Somerset Ln Schulein, Thomas 811 Cypress Court Serving 6`h term Male Webber, Hiram R. 320 E. Washington St., Apt 7H I Advisory Board/Commission Application Form 'Iftt ��.... This application is a public document and as such can be reproduced and distributed for r wy� the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO On Or MMMU NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/13/2016 First Name* Jay Last Name Honohan Home Address* 1510 Somerset Ln City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319 338-6990 Email Address* nroamer@aol.com Boards & Commissions Select a Board or Commission you are interested in:* Senior Center Commission 2. How long have you been a resident of Iowa City?* 66 years 3. Occupation:* attorney 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* I have been cormussion chair for several years. I am a volunteer attorney at the Center. I attend classes and events at the Center. I am active in community affairs. I am the President of the Center's Foundation. I have served on the Ad Hoc Comnttee for Seniors. I have served as police judge and City Attorney for Iowa City. I know the rule about serving consecutive terms but would like the Council to waive that rule in my case. This will be my last hurrah on the Commission. I want very much to serve in helping the goal of the City and the Commission to increase the non -tax funding of the Center. 6. What is your present knowledge of each advisory board you are Interested In?* Having served on the Commission since 1998, 1 know the Commission's role and have worked well with the staff over the years. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to ft City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functiors or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family fies, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneralty prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son -it -law, daughter-iMaw, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* nIo S. Do you currently serve on another Iowa City board or commission?* hio Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and ft groups(s) which it serves, please provide your information for the following: 9. Age 86 10. Country of Origin USA 11. Sexual Orientation Married to my wife for 58 years 12. Religion Methodist 13. Do you have a disability? No 14. Ethnicity Irish to the core. Father's side County Cork, Mother's side County Tyrone 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* e? `j r. `yyOWA?w Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. i i_ CITY OF IOWA CITY UNESCO CRY OF LITERATURE Date of Application 3/2/2017 First Name Thomas Last Name* Schulein Home Address* 811 Cypress Court City IOWA CITY State LA Zip Code 52245 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-351-6598 Email Address* thoms-schulein@uiome.edu Boards & Commissions Select a Board or Commission you are interested in:* Senior Center Commission 2. How long have you been a resident of Iowa City?* almost 38 years 3. Occupation:* Retired dentistry associate professor 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* I have been involved with Senior Center activities for several years. I have lectured extensively at the Center on a variety of topics, mostly centered upon lowa City history. I have gotten to know a great many of the folks Mo attend the Center, so I think I could somewhat have the pulse of the people in mind or could certainly query them, when appropriate. 6. What Is your present knowledge of each advisory board you are interested in? I know several of the present members on this advisory board, including Kathy Mitchell and Lorraine Dorfman and have learned some from them, particularly from Kathy, who has served longer than has Lorraine. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneralty prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for wham the Council Member assumes parental responsibility, mother, father, son --in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-ir-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with wham the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 71 10. Country of Origin United States 11. Sexual Orientation 12. Religion Lutheran 13. Do you have a disability? No 14. Ethnicity White Anglo-Saxon *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 06a wv (i'R 1511f�/�sli/ Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down r -n...._ Advisory Board/Commission/Committee CITY OF IOWA CITY Application Form UNESCO CITY OF LITERATURE This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. Advisory Board/Commission/Comm' tee Name C,0-16 „y � �� Y d Lt4q, Date of Application%� 17 Name ft, 1 V �L1M{ \ UV qN� �" h -q, Home Address Contact phone number Email A dress rt,Y V r, ei L) � WICK Your home address must be within the corporate limits of Iowa City? How long have you lived in Iowa City? Occupation: V'e h e / Gender: Male b_ Female Experiences and/or activities hich you feel qualify you for this position: AdI , siw 1{itr �w l What is your preset knowledge of this advisory board? ; Y IA.��wvyvy'�'M��JJ . I Please contact the city attorney at 319-356-5030 to discuss questions or concerns regarding a Potential conflict of interest. Potential Conflict of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision—making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, agreement with respect to the proceeds of the federally—assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, member of a city Board or Commission from having an interest in a city contract. Section 362.5 City Council Resolution #15-300 established a policy that the following persons shah not be eligible for appointments to Boards and Commissions. A council member's spouse, domestic partner or partner in cohabitation, children,. step -children, children for whom the Council Member assumes parental responsibility, mother, father; son-in-law, daughter-in-law, sister-in-law, grandparents, and grandchildren, aunt, uncle, niece, ,nephew, first cousin, foster parent, poster child, persons who are parents of the same child, and person's whom the employee is in an intimate relationship. Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. Do you currently have a conflict of interest? YES NO List potential conflicts of interest (See last page for information regarding conflict of interest) Please indicate if there are none. Do you currently serve on another Iowa City board or commission? YES NO If so which one do you prefer? The City Council values all types of diversity on its boards and commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the board and commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age —b— Country of Origin Sexual Orientation Religion A I ct 'eQ Do you have a disability? YES �A NO l��t Ori G Race, Color or Ethnic Group *Note: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community intent, when possible to'14ave-¢ person with expertise finance a. Signature of rpment Commission strives to satisfy its purpose and one person th expertise in construction, at least one ?yr tyho ceive4ental assistance. (Resolution) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Contact information is attached. Approved Minutes December 8, 2016 Senior Center Commission Attendance Record Year 2016 Name Term Expires 2/18/16 3/17/16 4/21/16 5/19/16 6/11/16 6/16/16 7/21/16 8/18/16 9/15/16 10/20/16 11/17/16 12/8/16 Joy Beadleston 12/31/19 X X NM O/E X NM O/E -- — -- -- -- Cheryll Clamon 12/31/18 X X NM O/E X NM X X X NM X X Jack Hobbs 12/31/16 X O/E NM X X NM X O/E O/E NM X O/E Mark Holbrook 12/31/18 X X NM X O/E NM X X X NM X X Jay Honohan 12/31/16 X X NM X X NM X X X NM X X Kathy Mitchell 12/31/19 X X NM X X NM O/E X X NM X X Margaret Reese 12/31/17 X X NM O/E X NM X X X NM X X Key: X = Present O = Absgnt O/E = Absent/Excused NM = No meeting — = Not a member "3' -'Ni" 12e NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: TELECOMMUNICATIONS COMMISSION One Vacancy— Unexpired term Upon appointment—July 1, 2017 • The duties of the Telecommunications Commission include serving as a review board to resolve disputes between any subscriber or potential subscriber and the cablevision company • reviewing and auditing reports by the cable company to the City as required by the Cable Television Ordinance; working with the public, the media, the City, and the cablevision company for the purpose of making recommendations on various issues; • monitoring and promoting community programming and the use of the local access channels by a wide range of individuals, institutions, and organizations; • informing and educating citizens on matters related to cable TV and other communications systems; and monitoring and reviewing State and Federal legislative and regulatory action or change Iowa City appointed members of boards and commissions must be 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, March 14, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Telecommunications Commission should be directed to Ty Coleman, Media Production Services Coordinator, at 356-5454. 3/14/2017 Board/Commission Application Cover Board/Commission: Telecommunications Commission One vacancy unexpired term Upon appointment - 7/1/2017 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 2/21/2017 Application Deadline: 3/14/2017 Council Appointment Date: 3/21/2017 Date of Non -Gender Appointment: 12/19/2016 Gender Balance Requirement: Current Gender Balance: After date above Council may appoint without regard to gender 1 Female Female:1 Male:3 Gender Name and Address No applications