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HomeMy WebLinkAbout2002-11-19 Appointment NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: ANIMAL CARE AND ADOPTION CENTER ADVISORY BOARD One vacancy - Three Year Term January 1,2003 - December 31,2005 The Animal Control Advisory Board shall provide such recommendations and advice as are required by the 28E Agreement between the City of Iowa City and the City of Coralville, or as may be requested by the City Council or City Manager of Iowa City or by the City Council or City Administrator of Coralville. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa city. Applications must be received by 5:00 p.m., Wednesday, November 13, 2002. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at the Civic Center, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Animal Care and Adoption Center Advisory Board should be directed to Misha Goodman, Animal Shelter Supervisor at 356-5295. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 0 Females: 2 Council Announcement Date: October 8, 2002 Application Deadline: Wednesday, 5:00 p.m., November 13, 2002 Council Appointment Date: November 19, 2002 ANIMAL CARE AND ADOPTION CENTER ADVISORY BOARD One vacancy - Three Year Term January 1, 2003 - December 31, 2005 Term expires for Tammara Meester Kristine Winegarden [] 1763 Louis Place Tammara Meester [] (Currently serving 3-yr term) 1313 E. Davenport Street [] Denotes applicant completed the Confidential page of the application, CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTIAL.~ THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME~ TERM ~ ~J~L~),.~ NAME~ HOME ADDRESS l"~B ~'~ ~aC~ Is your home address (listed above) w~hin the corporate [imits of Iowa City? ~ Yes No How long have you been a resident of Iowa City? ~0~ 'CCUPATION~aCC~ R~t~ ~ EMPLOYER VA ~~ ~ PHONE NUMBER: HOME ~tq' ~' qMq BUSINESS '~ 'O-~-~ .~ O EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~ -- ' -- WHAT IS YOUR PRESENT ~OWLEDGE OF THIS ADVISORY BOARD? If gou fail to answor all tho questions, Council will not consider gout application. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR sTATE REASON FOR APPLYING)? ' ....--~ POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. ' you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED7 '~YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES /~NO {It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. (2) CITY OF IOWA CITY ADVISORY BOARD/COMMISSION q[PPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. A~plicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all appilcatfons during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St,, Iowa City, Iowa. THIS APPMCATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBUC, WITH THE EXCEFTION OF THE LAST PAGE MARKED 'CONFID~NTIALj THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Is your home address (listed above) within the corporate limits of Iowa City? ,~Yes No How long have you been a resident of Iowa City? ' ~f# EXPERIENCE AND/OR ACTIVITIES W1BCH YOU FEEL QUAMFY YOU FOR THIS POSITION: ~ Misrepresentations on this ~pplic~fion ~dl constitute lUSt c~use lot removal ol ~n ~ppo'...~ee. ~t 7:-- If you fBil to answer all the questions, Council will not consider your applicatio~ " I WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR Fleese ident~' any Ix~tantial c, onflicts I~woon m~ml~rship on th~ advi~o~ board and your per~msi int~"ests~ including financial Interests and your duties to an employer, In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. 'Affiliation' includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIRED? ~)~YES . ..NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? . .YES ~/~ NO {It has bean Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) I M isrepresentations 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. ~b~.(~l.~c ~ 2002 (2) NOTICE THE CITY COUNCIL OF IOWA CITY iS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF ADJUSTMENT One vacancy - Five-Year Term January '1, 2003 - January '1,2008 Duties: In appropriate cases and subject to appropriate conditions and safeguards, the Board may make special exceptions to the terms of the Zoning Chapter in harmony with the general purpose and intent of the ordinance and in accordance with general or specific rules contained therein. The Board may grant variances to the Zoning Chapter only in the case of "unnecessary hardship." The hardship must be substantial, serious, real, and of compelling force, as distinguished from reasons of convenience, maximization of profit or caprice. The Board may also hear and decide appeals where it is alleged there is an error in any order, requirement, decision, or determination made by a City official in the enforcement of the Zoning Chapter. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets the second Wednesday of each month at 5:00 p.m. Applications must be received by 5:00 p.m., Wednesday, November '13, 2002. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at the Civic Center, 4'10 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Board of Adjustment Commission should be directed to Jon Adam, Associate Planner at 356-5236. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 4 Females: 0 Council Announcement Date: October 8, 2002 Application Deadline: Wednesday, 5:00 p.m., November 13, 2002 Council Appointment Date: November 19, 2002 BOARD OF ADJUSTMENT One vacancy - Five Year Term January 1, 2003 - January 1, 2008 Term expires for T.J. Brandt No applications as of 5:00 P.M., November 13, 2002 [] Denotes applicant completed the Confidential page of the application. NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF APPEALS Two Vacancies - Five-Year Terms (~i) - Home Builders Association Representative (~1) - Licensed Plumber Jenue~ l, 2003 - December 3~1,2007 It is the duty of members of the Board of Appeals to hold appeal hearings on matters concerning the Uniform Building Code, Uniform Plumbing Code, Netionel Electric Code, Uniform Mechanical Code, Uniform Fire Code, the Dangerous Building Code, and the Iowa City Housing Code. Members must be qualified by experience and training to pass upon matters pertaining to building construction. Iowe City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets the first Monday of eech month et 4:30 p.m. or at the call of the Building Official. Applications must be received by 5:00 p.m., Wednesday, November 43, 2002. The City of Iowa City encoureges diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at the Civic Center, 4~10 E. Weshington Street. Applicetion forms ere available from the Clerk's office upon request or on the Ci~ website et www.icgov.org. Questions regarding the Board of Appeals should be directed to Tim Hennes, Sr Building Inspector at 356-5~i22. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 4 Females: 1 Council Announcement Date: October 8, 2002 Application Deadline: Wednesday, 5:00 p.m., November 13, 2002 Council Appointment Date: November 19, 2002 BOARD OF APPEALS Two vacancies - Five Year Terms January 1, 2003 - December 31, 2007 Term expires for John Roffman, Gary Haman One - Home Builders Association Rep. John Roffman [] (Currently serving 3rd 5-yr term) 1314 Burry Dr One - Licensed Plumber Gary Haman [] (Currently serving 1st 5~yr term) 2703 Brookside Dr [] Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION .aPPLICATION FORM ~:> Individuals serving on Boards/Commissions play an important role in advising the Council or~n-a~ters'~f int_e~s~ t to our community and its future. Applicants must reside in Iowa City. --~ c ~ --J After a vacancy has been announced, the Council reviews all applications during the work iie~s~ion. ~e. ap~pintment. is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. W~shingt~o~ St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME '~o,4~O oF' ,Z].pp~./~ ,S TERM NAME ~O~n ~o~ HOMEADDRESS ~1~ ~rP~ ~C, Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes No How long have you been a resident of Iowa City? ~/ ~ . OCCUPATION ~0~r EMPLOYER ~1 ~ ~ DNENUMBER: HOME 51-31HI BUSINESS ~5~-~l~/ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? 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. cclerX\bdcomapp( 1 )doc April 2002 (1) W' ~AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ~ t/~O£~ ~)LlO~Pte~ (~ ~ I I'~ JgQ.~(,r)~ 3~ ~O~Fl~ ~ POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. I. ~u are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. _- --' i' --':.: IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES (1{ has been Council policy not to permit an individual to serve on {wo Boards or Commissions st the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. f you fail to answer all the questions, Council will not consider your application. cclerk\bdcom~pp(l ) doc April 2002 (2) CITY OF IOWA CITY ADVISORY BOARD/COMMISSION / PPLICATION FORM Individuals serving on Boards/Oommissions play an important role in advising the Co~! .c,i! on .matt%rs of interest lo our commun ~ and ts future App ~n~ must res de n owa ~ ~ ,~ After a va~n~ has been announ~d, the Counc revews a app ~tlons during ~ ~ork'sess~., ~e appointment is made at the ne~ focal Council meeting. ~pointees se~e as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the appli~tion to Ci~ Clerk, 410 E. Washington St., Iowa Ci~, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE ~ST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTO~TICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME ~ ~ ~,:~ TERM ~ ~. NAME ~_ ~. ~/~/ ..... HOME ADDRESS~ ~ ~ ~n~ M~ Is your home address (listed above) within the ~rporate limits of Iowa Ci~? ~ Yes No How long have you been a resident of Iowa City.'? t~¢ ~ ff OCCUPATIONO~,~-~ o~ ~'o~,~ ~,~ ~ EMPLOYER ~ F ONE NUMBER: HOME .~/~,~.~-.~/~ / BUSINESS ,~/~-~/- ~.~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? 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. cclerk\bdcomapp( I } doc April 2002 (1) V'" 'AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? POTENTIAL CONFLICTS OF INTEREST Please identify any potential ~nflicts be~een membership on the advJso~ board and your personal interests, including financial interests and your duties to an employer. In padicular, if you are applying [o be a member of a board or commission which makes re~mmendations to the City Council about the allo~tion of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affilia[Jons must be examined on a ease by ease basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with ce~ain impo~ant 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. I, ~u are uncedaJn whether a poten[Jal conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact ~he City Attorney's o~ce at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO B~ NOTIFIED? YES NO DO YOU CURRENTLY SERV~ ON ANOTHER IOWA CI~ BOARD OR COMMISSION? YES ~ NO (It has been Council policy not to permit an individual to se~e on ~o Boards or Commissions at the same time.) IMisrepresentations on this application will constitute just cause for removal of an appointee. f you fail to answer all the questions, Council will not consider your application. I' cclerk\bdcornapp( 1 ) doc April 2002 (2) NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION Three Vacancies - Three Year Terms January 1,2003 - January 1,2006 The duties of the members of the Human Rights Commission are to receive and to determine the merits of human rights complaints alleging unfair or discriminatory practices in the area of employment, credit, public accommodation, education, and housing. The Commission shall provide conciliation and the enforcement necessary to further the anti-discriminatory goals of the Human Rights Ordinance and to protect citizens from unfounded charges of discriminatory practices. The Iowa City Human Rights Commission has an obligation to investigate and study the existence, character, cause, and extent of discrimination in Iowa City in order to eliminate discrimination by education, conciliation, and/or enforcement. It is also the duty of the Human Rights Commission to draft revisions to the Human Rights Ordinance if necessary to eliminate prejudice, intolerance, bigotry, and discrimination. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Human Rights Commission meets once a month at 7:00 p.m. Applications must be received by 5:00 p.m., Wednesday, November 13, 2002. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at the Civic Center, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Human Rights Commission should be directed to Heather Shank, Human Rights Coordinator at 356-5022. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 3 Council Announcement Date: October 8, 2002 Application Deadline: Wednesday, 5:00 p.m., November 13, 2002 Council Appointment Date: November 19, 2002 HUMAN RIGHTS COMMISSION Three Vacancies - Three Year Terms January 1, 2003 -January 1, 2006 Term expires for Jan Warren, Charles Major, Nick Klenske David Shorr [] 1705 Morningside Dr Billie F. Townsend [] Forrest M. Friedow [] 713 Whiting Ave 20 S. Lucas Street Susan Henningsen [] 2211 Hollywood Blvd Kathryn Gerken [] 3161 E. Washington St Garry Klein [] 628 2"d Avenue Alice L. Mathis [] 1741 Gryn Drive Jill A. Jack 728 Dearborn Maureen Howe [] 411 Reno Street Nick Klenske [] (Currently serving unexpired term) 1039 W. Benton #5 [] Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION . .PPLICATION FORM I0: I Individuals serving on Boards/Commissions play an important role in advising t.he I~t~Ci! ~t~m.etters of interest to our commumty and ~ts future. Apphcants must reside ~n Iowa C~ty. After a vacancy has been announced, the Counc~ rewews a appmabons dunng the wO~~mon. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A B~CK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE ~ST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME J'"Jt.)lvlAN J~,IGHT5 ~51'tc4i.¥$1oN' TERM NAME ~AV I'D Is your home address (listed above) within the corporate limits of Iowa City? M/Yes __ No How long have you been a resident of Iowa City? ~ I/~. YRS. OCCUPATION INTF..~.N/~TioI,~L po~-IC-',,/ P~OVC:ChTE. EMPLOYER "-.)O't-ANLEY ~"OUNDATIoN PHONE NUMBER: HOME L~a(o-cJ'.~'Tc~ BUSINESS 5G3-~..(oq- 15OO EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: '~ HAVE AN WHAT IS YOUR PRESENT ~NOWLEDGE OF THIS ADVISORY BOARD~ ~ ~c~Y ~o~loH I Misrepresentations on this application will constitute just cause for removal of an appointee. I If you fail to answer all the questions, Council will not consider your application. clef k\allbdcomapplli.doc April 2002 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR POTENTIAL ~ONFLI~T8 OF INTEREST Please identify 8,y potential conflicts between ~embers~ip on the advisory board and ~our personal interests, including financial interests and your duties to an employer. I~ ~articular, if you are applying to be a member of a board or commission whic~ makes recommendations to {~e CiW Council abo~t t~e allocation of City funds, please list any present affiliations you ~ave wit~ agencies t~at apply for funding from the City. 'Affiliatio," includes being 8 board me~ber or employee of t~e agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. If you are uncertain whether a potential conflict of interest exists or have questions abo~ection~62.5 of the Jode of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? J YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES Y NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) IMisrepresentations on this application will constitute just cause for removal of an appointee. I If you fail to answer all the questions, Council will not consider your application. .,erk~hrcornapp(1 ).doc Apd12002 (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median S~e (Pover~ Lev~) Income Income Oow income) Income 1 $13,600 $22,700 $27,200 $36,300 $45,400 2 15,550 25,900 31,100 41,450 51,800 3 17,500 29,150 35,000 46,650 58,300 4 19,450 32,400 38,900 51,850 64,800 5 21,000 35,000 42,000 56,000 70,000 6 22,550 37,600 45,100 60,150 75,200 7 24,100 40,200 48,200 64,300 80,400 8 25,650 42,750 51,300 68,450 85,500 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 I°~xv--s'rer~o'r'' Religion Gender ~ o~4'E~ Disability Income (see table) ~ lYE- Race, color or ethnic group Sexual Orientation I,/~ "3'~4 ~5.1q National origin Other (Please explain below) cITY OF IOWA CITY ADVISORY BOARD/COMMISSION /' opLICATION FORM ~1 ~ of interest to our Individuals se~Jng on Boards/Commissions play an impo~ant role in advising the ~UV¥':.q communi~ and its future. Appli~nts must reside in Iowa After a Varney has been announ~d, the Council reviews all appli~tions during the wo~ session. The appointment is made at the ne~ focal Council meeting. Appointees sewe as unpaid volunteers. PL~AS~ US~ A BLA~ IN~ P~N. Return the appli~tion to Ci~ Cle~, 410 E. Washington St., Iowa Ci~, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND A8 8UGH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE ~SZ PAGE MARKED "O0~FID~TI~L." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VAOANOY DURING THAT TIME. Is your home address (listed above) within the ~rporate limits of Iowa Ci~? /Yes No ~ow long have you been a resident of Iowa Ci~? /~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR rillS POSITION: WHAT IS YOUR PRES~hT KNOWLEDGE OF THIS ADVISORY BOARD?~/ 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. ccler~bdcomapp{ 1 ) doc April 2002 (1) POTENTIAL CONFLICTS OF INTEREST ~lease identify any potential conflicts between membership on the advisory board and your personal interests, ncluding financial interests and your duties to an employer. n particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply ~or funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. fou should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a ~ember of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is ~ttached. f ~ou are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code )f Iowa, please contact the City Attorney's office at 356-5030. F YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? I~f:YES NO 30 YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES /./'NNo It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. .i you fail to answer all the questions, Council will not consider your application. cclerk\bdco~T~pp( 1 ) doc April 2002 (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (Iow income) Income 1 $13,600 $22,700 $27,200 $36,300 $45,400 2 15,550 25,900 31,100 41,450 51,800 3 17,500 29,150 35,000 46,650 58,300 4 19,450 32,400 38,900 51,850 64,800 5 21,000 35,000 42,000 56,000 70,000 6 22,550 37,600 45,100 60,150 75,200 7 24,100 40,200 48,200 64,300 80,400 8 25,650 42,750 51,300 68,450 85,500 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 Religion f Gender Disability Income (see table) /~,[~ /~',d~Race, color or ethnic group Sexual Orientation National origin Other (Please explain below) Ituman Rights ARachment.doc April 2002 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPBODUCED AND DISTRIBUTED FOB THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MABKED ~CONRDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME NAME .~U~V'~ ~Y~IYI~'~J~ H;MEAD~RESS Is your home address (l~sted abo~e) within the corporate limits of IoWa City? /Yes How long have you been a resident of Iowa City? ~ ,.XPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR _ ._ I Misreprosentations on this application will constitute just cause for romoval of an appointeo. If you fail to answer all the questions, Council will not consider your application. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? [~x ~ {A/')~IYI~' ~ [A,~(~V'~Hd~ ~i4:L~ y'y/.4,~.J/- ~ ~ ~ ~ POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisor~ board and your personal interests, including financial interests and your duties to an employer. In pa~icular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally pr~ibits, with ce~ain impo~ant 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. If you are unce~ain whether a potehtial conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT ~ELECTED, DO YOU WANT TO BE NOTIFIED? v' YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (Iow income) Income 1 $131600 $22~700 $27~200 $36,300 $45,400 2 15,550 25,900 31,100 41,450 51~800 3 17~500 29~150 35~000 46,650 58,300 4 19~450 32,400 38,900 51 ~850 64,800 5 21~000 35~000 423000 56~000 70~000 6 22,550 373600 45~100 60,150 751200 7 24,100 40,200 48,200 64,300 80~400 8 25,650 42,750 51~300 68,450 85,500 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 . Religion Gender Disability Income (see table) Race, color or ethnic group Sexual Orientation National origin Other (Please explain below) CITY OF IOWA CITY ADVISORY BOARD/COMMISSION ~PPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a Vacancy has been announced, the Council reviews all applications dudng the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Retum the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME '~t.~.~'~. X",, ~',,,t,,~'-X~'S ~.~"~,~'~ TERM ...... .¢ s yo ome ddress ( ~sted above) wi h~n the corporate ~m~ts of Iowa C~ty Yes No How long have yo.~u been a resident of Iowa City? ~.~. - \ qX~ \~%~\~-.~ - ~'F OCCUPATION ~~k~' ¢~ .~. EMPLOYER~ .x,,~,,c. A,~o, AC~W~,S W,~C. YOU ..,, QUAU,V YOU .O. ~,~s.osmo~ ~:~ --. 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. cclerk,~ app( )dc ~ ~ ~ ~ ~ .... ~ April 2002 (1) WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR Please identify any potential conflicts be~een membership oRt~ adviso~ bo~d and your personal interests, including finan cia l interests and your duties roan employer. ~~ ~~ ~~. In padicular, if you are applying to be a member of a board or ~mmission which m~es re~mmendations to the City Council about the allo~tion of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with ce~ain impodant exceptions, a member of a city Board or Commission from having an interest in a ci~ contract. A copy of Section 362.5 is attached. ~u are unce~ain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? '~ YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES /'~ NO (It has been Council policy not to permit an individual to serve on Iwo Boards or Commissions at the same time.) IMisrepresentations on this application will constitute just cause for removal of an appointee. 'f you fail to answer all the questions, Council will not consider your application. I' cclerk/bdcomapp(1 ) doc Apd12002 (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income 1 $13,600 $22,700 $27,200 $36,300 $45,400 2 15,550 25,900 31,100 41,450 51,800 3 17,500 29,150 35,000 46,650 58,300 4 19,450 32,400 38,900 51,850 64,800 5 21,000 35,000 42,000 56,000 70,000 6 22,550 37,600 45,100 60,150 75,200 7 24,100 40,200 48,200 64,300 80,400 8 25,650 42,750 51,300 68,450 85,500 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 Religion ~_ ~---~(3,._~(~ender Disability ~.\ ~X~'h Income (see table) Race, color \ or ethnic group Sexual Orientation Nationa~figin Oth (PI pl i bel ) I luman Rights Attachment.doc April 2002 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION .PPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Co¥~1,q~4~3' m~t~t~er~,c~f interest to our commun ty and ts future Appl cants must reside ~n Iowa C ty. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILl BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVlSORY OARD/COMMISSIONNAME TERM :r.v, /.; zoo NAME ~r~ ~[<',~ HOME ADDRESS ~Zff 2~ ~, Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes ~ No How long have you been a resident of Iowa City? ~ ~ ~CUPATION ~8¢C~ ~Ci~ EMPLOYER ~ /,CE. PHONE NUMBER: HOME ~-~00 BUSINESS ~q/-Z~l~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOB THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I M isrepresentations 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. cler k\allbdcoms~p(1 Ldoc April 2002 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR 'l, I . ~ ~ I I I POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In pa~icular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the ~ode of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? /YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) I M isrepresentations 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. clerk~hrcomapp( 1 ).doc Apd12002 (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income 1 $13,600 $22,700 $27,200 $36,300 $45,400 2 15,550 25,900 31,100 41,450 51,800 3 17,500 29,150 35,000 46,650 58,300 4 19,450 32,400 38,900 51,850 64,800 5 21,000 35,000 42,000 56,000 70,000 6 22,550 37,600 45,100 60,150 75,200 7 24,100 40,200 48,200 64,300 80,400 8 25,650 42,750 51,300 68,450 85,500 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. Income (see table) /~///~ Race, color or ethnic group Sexual Orientation ~,5, ~';4.~Z~' ~ National origin /~//fi( Other (Please explain below) c~rkVvc, oma~(l).Ooc ;~ ~pnl ~2 . ._V CITY OF IOWA CITY r- ADVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on Boards/Commissions play an impo~ant roe n advising the ~ouncil on matters of nterest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A B~CK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, iowa. THiS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME Human Rights Commissio, TERM NAME Alice L, Mathis HOME ADDRESS 1741 Cryn Drive~ Iowa City~ IA 522z+6 IS your home address (listed above) within the corporate limits of Iowa City? ;¢ Yes __ No How long have you been a resident of Iowa City? Four years. OCCUPATION University administrator EMPLOYER ~he University of Iowa PHONE NUMBER: HOME 319-887-9688 BUSINESS 319-335-3119 EXPERIENCE ANO/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: As an African American woman who is a single mother of two teenage sons~ I believe I am qualified to be a voice and resource to the Human Rights Commission as it seeks to ensure that individual and "community" rights are not violated or abused. In my position as a student affairs administrator (which I have been in for nearly twenty years), I have had the opportunity to be an advocate for underrepresented students and student organizations. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? My knowledge re~arding the Human Rights Commission quite frankly is rather limited. In fact other than knowing that the commission exists and that it has previously supported the LGBT community on some publicized issues and that it recosnizes the contributions and committment or community members through its annual breakfast~ that's all I a~ aware of. I M isrepresentations 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. clef k\~lt bdc om,~pP ( 1 ) .d Dc April 2002 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I believe my experiences and knowledge would add greatly to the diversity of the con~ission. I am in search of an opportunity to contribute to helping Iowa City become a better community for all of its residents and I believe this commission would provide me an opportunity to make that contribution which would be of great benefit to the citizens of Iowa City. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" inctudes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. I do not believe it would be a conflict of interest~ however as Director of Student Life, on occassion I have the opportunity to lead initiatives which are a collaboration with the City of Iowa City such as the annual Weeks of Welcome. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? × YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES x NO (It has been Council policy not to permit an indlvldual to serve on two Boards or Commissions at the same time.) Misrepresentations on this ap¢lication will constitute iust cause for removal of a~l~'¢~oint~. II If gou fail to answer all tho questions, Council will not consider gout application. -:~ derk~r~pp(~ ).doc ~ ~ ~ hi 2~ (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (Iow income) Income 1 $13,600 $22,700 $27,200 $36,300 $45,400 2 15,550 25,900 31,100 41,450 51,800 3 17,500 29,150 35,000 46,650 58,300 4 19,450 32,400 38,900 51,850 64,800 5 21,000 35,000 42,000 56,000 70,000 6 22,550 37,600 45,100 60,150 75,200 7 24,100 40,200 48,200 64,300 80,400 8 25,650 42,750 51,300 68,450 85,500 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 Protestant Religion Female Gender Disability $49~000.00 Income (see table) African Amer. Race, color or ethnic group Sexual Orientation _ .,s National o_rr[gin Other (Please explain below) (7 ~, ": CITY OF IOWA CITY ADVISORY BOARD/COMMISSION ,APPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the C~¢iI (~3 ~_~Iters of interest to our community and its future. Applicants must reside in Iowa City. lO~t,4A (~:] [,,F- ©~VA After a Vacancy has been announced, the Council reviews all applications during the work session. ~l-he appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME ~.~-,,-~- c~., %g:1~ C,~,~.,.~, ~ ~ TERM 2ooa NAME ~1~ ~. ~c~ HOME ADDRESS ~ D~o~ Is your home address (listed above) within the ~rporate limits of Iowa Ci~? ~ Yes No How long have you been a resident of Iowa Ci~? q ~s L, ~" / ~,sT, EMPLOYER ~~ ~. OCCUPATIQN F .ONE NUMBER: HOME D~O-~G~ BUSINESS ~-~G~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: [.~,,~- t WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~ ~+~ ~  M isrepresentations 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. cclerk~bdcomapp( 1 )cicc April 2002 (1) V""4AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? t POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. I. Ju are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. ./ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? '~YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION'? YES (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the.same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. f you fail to answer all the questions, Council will not consider your application. ccler k\bdcor~pp( 1 )do~; April 2002 (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income 1 $13,600 $22,700 $27,200 $36,300 $45,400 2 15,550 25,900 31,100 41,450 51,800 3 17,500 29,150 35,000 46,650 58,300 4 19,450 32,400 38,900 51,850 64,800 5 21,000 35,000 42,000 56,000 70,000 6 22,550 37,600 45,100 60,150 75,200 7 24,100 40,200 48,200 64,300 80,400 8 25,650 42,750 51,300 68,450 85,500 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Cormnission 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 f Religion Gender ~ ~ s Disability Income (see table) ~.-~-,~ ( ~ ~,~ Race, color or ethnic group Sexual Orientation D .5 .g- Nation ngln ~ Other (Please explain below) 'i~!~ '.~ co ,.< I luman Rights Attachment.doc April 2002 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION . PPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Counm~r~mat~,~rs of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN, Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADV,SORY BOARD,COMM,SS.ON NAME TERM ZO0 - oo . NAME aB~'~C.4~ {~-~t~._ HOME ADDRESS HII '~o Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes __ No How long have you been a resident of Iowa City? { C~ 3CUPATION~.x~m~Y~,'~I-'~ ~¢~'~,Cm~,~.~' ~-~-J~c EMPLOYER~-~SUJ, tl I.~J.~;~W,*_~ ~C (~.E,. /o~ PHONE NUMBER: HOME ~lq' ~'~. ctSc~l BUSINESS ~-~lq, EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~ ~,~ WHAT IS YOUR PRESENT KNOWLEDGE OF~RIS ADVISORY BOARD? ~ ,~ ¢~ ~j If gou fail to answor all tho quostions, Council will not considor gout application. clef kXall~comapp( 1 ).doc April 2002 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR ,~PPLYING)? /~ yO~.. l~.,t.o~,~ ,,~,4b,'1~¥-( POTENTIAL CONFLICT~ OF INTEREST ~ Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030, IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES /NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) IMisrepresentations on this application will constitute just cause for removal of an appointee, I If you fail to answer all the questions, Council will not consider your application. clerk~hr~omapp( 1 ).doc Apd12002 (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (Iow income) Income 1 $13,600 $22,700 $27,200 $36,300 $45,400 2 15,550 25~900 31,100 41,450 51,800 3 17,500 29~150 35,000 46,650 58,300 4 19,450 32,400 38,900 51,850 64,800 5 21,000 35,000 42,000 56,000 70,000 6 22,550 37,600 45,100 60,150 75,200 7 24,100 40,200 48,200 64~300 80,400 8 25,650 42,750 51,300 68,450 85,500 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. t~Age Religion ~V~Gender Disability ~Income (see table) Race, color or ethnic group ~Sexual Orientation National origin (P1 pl ) Other ease ex ain below -:~. ~ April 2~ CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa, THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTIAL.' THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME ~'~D~ ~,.,~1~)~ 5 TERM ~) OO ~ . ~ NAME /~/*,~,< \~,.,~s~_e HOME ADDRESS I~ ~, ~O~ ~ Is your home address (list~ above) within the corporate limits of Iowa City~ ~ Yes ~ No How long have you ~n a reside~ of Iowa City? ~ ~ :CUPATION L~W ~ ~e~ EM~OYER ~; ~ PHONE NUMBER: HOME ~ ~ ~ ~ 0 BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~ r~ ~ ~ Misrepresentations on this application will constitute just cause for removal of an appointee. I If you fail to answer all the questions, Council will not consider your application. ¢~lbdcome~ll~.do~ April 2002 "'HAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ~ ~..~ c~.A~.[~-o) ~) ~ v~c..~ ~t I~ ~ So~ POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. mAffiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. /ou are uncertain whether a potential conflict of interest exists or have questions about Section 36~2.5 of the L;ode of Iowa, please contact the City Attorney's office at 356-5030. ~_~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~(~YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~( YES NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) If yo~ fail to answer all the questions, Council will not consi~der your application. (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income I $13,600 $22~700 $27~200 $36,300 $45,400 2 15,550 25,900 31~100 41,450 51,800 3 17,500 29~150 35,000 46~650 58~300 4 19~450 32,400 38,900 51,850 64,800 5 21~000 35,000 42,000 56,000 70,000 6 22,550 37,600 4~,!00 60,150 75,200 7 24~ 1 O0 40,200 48~200 64,300 80~400 8 25~650 42,750 51,300 68,450 85,500 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 ~om 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. ~2"~ Age Religion ~ Gender Disability ~-~6 c~ Ineome (see table) Race, color Sexual Orientation Nationaf~.o~n _~:: __ (PI plain bel ) '~ ~ :':" ~-~: · ~ " CITY OF IOWA CITY ADVISORY BOARD/COMMISSION /' °PLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications dudng the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR I-HE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY OURING THAT TIME. ~,DVISORY BOARD/COMMISSION NAME NAME ~.~s~ ~ · ~;~Jo~ HOME ADDRESS ~s your home address (listed above) within the ~orate limits of Iowa Ci~ ~es No ~ow long have you been a resident of Iowa Ci~? DCCUPATION ~;~ ~ ~nONE NUMBER' HOME ~XPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITS-.. WHAT IS YOUR PR~ENT KNOWLEDGE OF THIS ADVISORY BOARD? [I~srepres~ntatiOns On this appl'catiOn w'll cOnstitutO just cause for rOmOval Of an appO'ntee' II If you fail to answer all the questions, Council will not consider your application. V~' \T CONTRIBUTIONS DQ YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? A I' , ¼ / d' I POTENTIAL CONFLICTS OF INTEREST ~lease identify any potential conflicts between membership on the advisory board and your pemonal interests, ncluding financial interests and your duties to an employer. in particular, if you are applying to be a member of a board or commission which makes recommendations to the Sity Council about the allocatiOn of City funds, please list any present affiliations you have with agencies that apply !or funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of ~ffiliations must be examined on a case by case basis by the City Attorney's office. Y'ou should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a -nember of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is ~ttached. f ,.~u are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code }f Iowa, please contact the City Attorney's office at 356-5030. F YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? YES I~NO 30 YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES V/NO lit has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. .l: you fail to answer all the questions, Council will not consider your application. ~-clerk\bdcomapp( 1 )dcc Apdl 2002 (2) TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective January 31, 2002 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income 1 $13,600 $22,700 $27,200 $36,300 $45,400 2 15,550 25,900 31,100 41,450 51,800 3 17,500 29,150 35,000 46,650 58,300 4 19,450 32,400 38,900 51,850 64,800 5 21,000 35,000 42,000 56,000 70,000 6 22,550 37,600 45,100 60,150 75,200 7 24,100 40,200 48,200 I 64,300 80,400 8 25,650 42,750 51,300 68,450 85,500 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 Religion Gender Disability Income (see table) Race, color or ethnic group S al Ori ntati N tion ~rigi ~'~ exu e on a a n Oth (PI plai b lo ) er ease ex n e w ~.. Human Rights Attachment.doc April 2002 Marian Karr From: Dale Helling Sent: Monday, November 18, 2002 9:22 AM To: 'SHenningsen@appliedsystems.com' Cc: Marian Kart Subject: RE: Human Rights Commission Dear Ms. Henningsen, Thank you for your communication to the City Council. They will receive it this evening and will remove your name from further consideration. Your interest in Human Rights issues and the Human Rights Education Team is appreciated. Dale Helling Assistant City Manager cc City Clerk ..... Original Message ..... From: SHenningsen@appliedsystems.com [mailto:SHenningsen@appliedsystems.com] Sent: Friday, November 15, 2002 4:54 PM To: cou ncil@iowa-city.org Subject: Human Rights Commission Dear Council, I recently submitted an application for the Human Rights Commission. understand that this commitment involves the ability to visit City Hall during working hours, which may be a conflict for me at this time in my career. As a result, I would like to withdrawal my application for the current term. Instead, I plan to become involved in the Human Rights Education Team. Thank you for your time, Susan Henningsen Page 1 of 1 Marian Karr _~'/....~ ,~ From: Dale Helling Sent: Monday, November 18, 2002 2:25 PM To: 'B&G Klein' Cc: Marian Kart Subject: RE: Human Rights Commission Information Dear Mr. Klein, Thank you for the additional information. Councilmembers will receive it at their work session at 6:30 this evening. Dale Helling Assistant City manager cc City Clerk ..... Original Message ..... From: B&G Klein [mailto:the3rdiowa@mchsi.com] Sent: Sunday, November 17, 2002 12:17 AM To: council~iowa-city.org Subject: Human Rights Commission Information To: Council Members Champion, Lehman, Kanner, O'Donnell, Pfab, Vanderhoef, Wilburn l recently submitted my application for the Human Rights Commission. 1 appreciate the limits to your time, but would like to add a little bit more information for you to consider in making your decisions about whom to place on the HRC. 1 am interested in serving in the capacity because of my belief in the strength of community. When someone in the community is injured by another, it is in the best interest of all for mediation to occur. While I understand the HRC is quasi-judicial and reports its findings to the city attorney, it is also a group that includes a cross section of people from Iowa City who are trying to serve in the community's interests. People who know me know I'm not, by nature, a "joiner". However, human rights is one arena that I have been involved for a number of years. While I lived in Texas, I facilitated diversity workshops and served at my college, Texas A&M University- Corpus Christi, in a mediation role, as weI1 as a counselor to young adults 1 was a member of a national organization called the National Coalition Building Institute (NCBI) which develops a corps of community leaders who are taught effective bridge- building skills to combat intergroup conflicts with over 140 chapters in the U.S. and abroad. My current role is as a researcher at ACT. In that capacity I work to develop career guidance materials and programs that can help all students. Philosophically, I believe that communities that embrace diversity thrive. My wife Betsy and I live in the house that Rick Graf once lived. Whether or not I am chosen to serve in this capacity, his legacy should be upheld. I'd like the opportunity to serve. If I can answer any specific questions you may have, please call me at home: 354-2600 or at work: 341-2313. Thank you in advance for your consideration, Garry Klein 628 2nd Ave. Iowa City, IA 52245 11/18/02 NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: PARKS AND RECREATION COMMISSION Three Vacancies - Four Year Terms January 1, 2003 - January 1, 2007 The duties of the members of the Parks and Recreation Commission are to recommend and review policies, rules, regulations, ordinances, and budgets relating to parks, playgrounds, recreation centers, and cultural functions of the City and make such reports to the City Council as the Commission deems in the public interest; to exercise broad responsibility for the development of parks, recreation centers, playgrounds, and cultural facilities to serve the City--including the creation and appointment of advisory groups to make studies. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Parks and Recreation Commission meets the second Wednesday of each month at 5:00 p.m. Applications must be received by 5:00 p.m., Wednesday, November 13, 2002. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at the Civic Center, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Parks and Recreation Commission should be directed to Terry Trueblood, Parks & Recreation Director at 356-5110. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 5 Females: 1 Council Announcement Date: October 8, 2002 Application Deadline: Wednesday, 5:00 p.m., November 13, 2002 Council Appointment Date: November 19, 2002 PARKS AND RECREATION COMMISSION Three Vacancies - Four Year Terms January l, 2003 -January 1, 2007 Term expires for Toni Cilek, Rex Pruess, Craig Gustaveson Kristine Winegarden [] 1763 Louis Place Dave Fleener [] 72 Goldfinch Circle Sarah Walz [] 1813 Morningside Dr Craig Gustaveson [] (Currently serving 4-yr term) 2603 E. Court Street Judith Klink [] 1101 Hadocke Street [] Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED ~CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME'~ ~..%_ O.t"~ ~L["~.J~O~t ~li'~ERM [J0~'4 I ~O'"/ NAME ~'~l"i~.'t'k,~ ,o, rae_n HOME ADDRESS 1'TBS) ~(.)[~ ~:)t(3~C ~ Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes ~ No How long have you been a resident of Iowa Ci~? ~O~¢~ (~G~ e~ 'CCUPATION~ EMPLOYER ~A ~&iC~ ~~ PHONE NUMBER: HOME ~- ~q'~q3~ BUSINESS ~R'~'05~ ~.~5~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? '-~_'XJ ~;;3.t,"r"~ ~T ......... 1 -- - ~ ~ · -~ I .... I M isrepresontations on this application will constituto just causo for romoval of an appointee. ~ If gou fail to answor all tho quostions~ Council will not consider ~our application. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)7 ~ POTBNT,AL Ce.FL,eTS OF,.TBREST PIoaso identi~ an~ potontial conflicts botwoon memb*rship on tho adviso~ board and gout porsonal interests, includin~ financial intorests and gout duties to an omplo~er. In particular, if gou aro applgin~ to bo a momb~r of a board or commission which makos rocommondations to tho Citg Council about tho allocation of Cit~ funds, ploaso list ang prosont affiliations gou havo with a~oncies that a~plg for fundin~ from tho Citg. ~Affiliation~ includos b~in~ a board member or omplogoo of tho Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain impo~ant 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. ' you are unce~ain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION7 YES ~ NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) IIMisrepresentations on this application will constitute just cause for removal of an appointee. I I If you fail to answer all the questions, Council will not consider your application. cleck\alll~com app{ 1 },d ¢~ April 2002 (2) crrY OF IOWA CITY ADVISORY BOARD/COMMISSION /~PPLICATION FORM ,- - - Individuals serving on Boards/Commissions play an important role in advising the Council ort~ffers ~---f interest to our community and its future. Applicants must reside in Iowa City. -~' -- After a vacancy has been announced, the Council reviews all applications during the work session. ~;~e appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Retum the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. NAME '--~,~ ?~ HOME ADDRESS 7,7 ~/~,4~,-~ C,',-~ is your home address (listed above) within the corporate limits of iowa City? /~ Yes No How long have you been a resident of Iowa City? /,~' OCCUPATION ~ EMPLOYER~,vx,.~ C,~.,, ~.-~, ~ .)NE NUMBER: HOME ~j/~- ~ ~'-/- /L/_%'~'-1 BUSINESS ~/¢~ ~?- EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THiS POSITION: X WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? 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. cclerk\bdcomepp(1) doc April 2002 W' ~AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply far funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. i. ~u are uncertain whether a potential conflict of interest exists or have questions about Section :~62.5 of the Code pie tact th City Atto y s offic 356 5030 of Iowa, ase con e rne ' e at - . -- CD IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? y~' YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES ~ NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. f you fail to answer all the questions, Council will not consider your application. cclerk\bdcomapp(1 ) doc April 2002 (2) CITY OF IOWA CITY ADVISORY BOARD/COMMISSION PPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the CounciF~fi-matte~ o~,erest to our community and its future. Applicants must reside in iowa City. After a vacancy has been announced, the Council reviews all applications during th~;~Yk ~sion. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volun6~rs. --4 PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME li~r'~f~' / /~g't'~.'/'/~'/ C/'~/~/~/,~<~ 1~/~ TERM ~/~t~ NAME ,~'q/~X~/~ ~/'~//~g~ HOME ADDRESS /~/6~ ~'A//~V~$/~)£ Is your home address (listed above) within the corporate limits of Iowa City? ~/' Yes __ No How long have you been a resident of Iowa City? ~I'X . CUPAT ON EMPLOYER PHONE NUMBER: HOME ~//~-~ BUSINESS EXPERIENCE OR ACTIVITIES THAT YOU FEEL QUALIFY YOU FOR THIS POSITION: I am a graduate student in environmental planning and have a particular interest in planning parks, open space, and recreation trails. I am a volunteer with Friends of Hickory Hill Park and organized the Hickory Hill Park Community Conservation Symposium this past September. I secured $3100 in outside funding to support the symposium, including $2000 from the National Park Service's Rivere, Trails, and Conservation Assistance Program. I have met several times with Terry Trueblood about park issues and have also toured the park with Terry Robinson. I continue to work with FHHP to organize volunteer activities including bird toure and vegetation programs. As part of my graduate program I am working on a field project with the Cedar Rapids Parks and Recreation Commission. This project includes a cost and maintenance evaluation for landscaping along the riverfront in downtown Cedar Rapids. While I Was growing up, my parents ren the Parks and Rec. Department for the city of Prairie du Chien, Wisconsin. Dudng my high school and college days I worked for the PdC Recreation Program every summer as a lifeguard and water safety instructor. I have experience in fundraising, grant writing, organizing events, and working with volunteers. I am a user of Iowa City's parks and trails and think they are a great asset to the community! WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD I have followed issues with the parks and rec. department in the newspapere, read the minutes for the past two yeare, and have attended a meeting. I know that a major function of the board is setting the budget and working with the parks director. I underetand that the budget for the department is stretched thin and that finding funds for all the projects and special interests in the community is a real challenge. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE YOUR REASON FOR APPLYING)? My personal interest is to raise public awareness of the value of parks by working with neighborhood and volunteer groups. Volunteem and local organizations have the potential to alleviate some budget pressures, and volunteering creates a feeling of ownership and responsibility for parks among citizens. I enjoy working with people and I think I would bring enthusiasm and creativity to the board. I could help identify grants and funding opportunities outside of city and state funds that could augment the budget. Though I do not own a dog, I know that there is strong desire for a dog park in Iowa City, and I would love to work with citizens and the commission to find a creative way to work on this issue. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? /YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES V/NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. ~ I If you fail to answer all the questions, Council will not consider your application. ~ clerk\allbdcomapp(1).doc -~ -- "'- ~p~ 2002 (2) CB ! OF IOWA CITY ADVISORY BOARD/COMMISSION / PPLICATION FORM Individuals serving on Boards/Commissions play an important ro{e in advising the Council on matters of interest to community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointm~ is made at the nex~ formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa Cit Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FO, THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATIOh WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANC'~ DURING THAT TIME. ADV SORY BOARD/OOMM SS,ON NAME '~1'~- ~' '~,~--~- TERM Is your home address (listed above) within the corporate limits of Iowa City? ..y Yes __ No How long have you been a resident of Iowa City? '~ OCCUPATIONT'~'~,., ~l~J~-~. ~co~o¢o_ ' EMPLOYER '~u~"P,~'~ ~'~C~-~ * DNE NUMBER: HOME ..~.'.'.'.'.'.'.'.~['~ ~5~-t/ BUSINESS '~-/'- ~'~ / EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITi~: . KNOWLEDGE OF THIS ~VISORY BOARD? (~ ~HAT YOUR PRESENT 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. v" ~AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? /"~,/ ?~""~-~,f"~'~--,~,~, ~ ~ ~~ ~ ~*~ POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. .3u are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? NO c~ DO YOU CURRFNTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES NO (It has been Council policy not to permit an individual to serve on two Bo@r0s or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. cd erk~bdcomapp( I ) doc April 2002 (2) CITY OF IOWA CITY ADVISORY BOARD/COMMISSION °PLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Coundl on matters of interest to our community and ils future. Applicants must reside in Iowa City. After a vacancy has been announced, the Coundl reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME ~'.,4--~2~$ ~ P~e-z/?.~-~,4,-,,")p~ ~,,e~,,$~'/,~A/ TERM NAME C~T(,,p/7/¢ ]<-~x.,-/~- HOME ADDRESS//4' Is your home address (listed above) within the corporate limits of Iowa City?. ~" Yes No How long have you been a resident of Iowa City?. ~;~.5~' ~,~' OCCUPATION/7~--7?~ po~3~,c <~:.g.~,,~ /-'E-~z_.j~YER--~X- P~ONE NUMBER: HOME 3/'~f-3,,z-I~.- BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~ I M isrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer afl the quostions, Council will not consiOor your application. cclerk',bdcomapp( 1 ).doc April 2002 (1) V" 'AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. I,..~u are uncertain whether a potential conflict of interest exists or have questions about Section 3~6~2.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. -- IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~' YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES ~ NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. f you fail to answer all the questions, Council will not consider your application. ccle~k~lcomapp(1 ) doc Apdl 2002 (2) Application from Judith Klink for Parks and Recreation Commission November 12, 2002 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION I previously served one full term on the Parks and Recreation Commission from 1994 to 1998, and a partial term for a few months at the start of 1999. (This term was cut short because my husband and I left town for a year at that time due to his business and my retirement from the public school system after a 25 year career teaching English, 20 of those at West High School in Iowa City.) My previous experiences on the Commission were connected with the usual ones of interest in the Recreation Center programs, and Parks and Cemetery management and development. I also worked on subcommittees developing the Neighborhood Open Spaces Plan and suggesting Butler House utilization. Other areas of activity for the Commission at that time concerned the Oakland Cemetery expansion and the building of the Scanlon Gymnasium. I am an enthusiastic user of the current trail system as a recreational bicyclist and walker. In Iowa City I make frequent use of the opportunities for hiking and walking available in Ryerson's Woods, Hickory Hill Park, and Willow Creek Park as well as on neighborhood sidewalks. In the past I have taken courses in Iowa City and elsewhere in ceramics, watercolor painting, aerobics, Feldenkrais, Pilates and strength training. I am an avid tennis player; I love to swim. Thus I enthusiastically support the wonderful programs available through our Recreation Center. In recent years I have continued in public service by being one of the spokespersons for the Weeber/Harlocke Neighborhood Association, participation in the Neighborhood Council, and I recently joined the board of Johnson County Heritage Trust. I continue to~e committed to the concept of providing open spaces in residential ~ deve opments for eco ogica reasons and to promote a h gher qu~.'~ of life in areas of concentrated development. ~,~ ~ '-- WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I understand that the board advises the City Council on matters pertaining to Parks and Recreation; that it is not a policy making group, but an advisory one, and functions as a sounding board and a possible source of ideas and suggestions. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD?: I would hope my experience in the teaching profession would be of service to the Commission, and that I might help promote greater cooperation and communication between the city and the school district. I think my past experience serving on the Commission might be helpful in providing some kind of continuity with its current concerns. My special interest in preserving open spaces and advocating for trails as great recreational activity should be relevant to ongoing topics the Commission undertakes. I recognize, however, that budget constraints at the local, state and national levels are making such goals more difficult than ever to obtain. This awareness makes me somewhat less than totally enthusiastic about rejoining the Commission! If appointed I will, however, try to be realistic and collaborative. There may be ways in which the concerns of Johnson County Heritage Trust and the Parks and Recreation Commission overlap and can support one another. '~_ Marian Karr From: Dale Helling Sent: Monday, November 18, 2002 2:58 PM To: 'Jim' Cc: Marian Karr Subject: RE: Parks and Rec Board Nominee Recommendation Dear Jim, Thank you for your note to the City Council. Councilmembers will receive it at their work session at 6:30 pm this evening. Dale Helling Assistant City Manager cc City Clerk ..... Original Message ..... From: Jim [mailto:jim@prairielights.com] Sent: Monday, November 18, 2002 2:56 PM To: council@iowa-city.erg Subject: Parks and Rec Board Nominee Recommendation Dear Council Member I am writing to recommend Sarah Walz for a position on the Iowa City Parks Board. I worked with her when she was Marketing Director at the University of Press. She was and is extremely competent and hard working. She also is sincerely committed to the parks of Iowa City and would make a perfect board member. She is open minded, fair, intelligent and resourceful. Resourceful! If you have any questions concerning Ms Walz, do not hesitate to contact me. Sincerely Jim Harris Prairie Lights Bookstore 15 South Dubuque Street Iowa City Iowa 337 2681 NOTICE THE CiTY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMITTEE: PUBLIC ART ADVISORY COMMITTEE Two Vacancies - Three Year Terms January 1, 2003 - January 1, 2006 Duties of the Public Art Ad~viSory Committee include developing by-laws and procedures for the Iowa City Public Art Program; administering the Public Art Program by determining the placement of public art, the type of art to be used in a specific project, and the artist to be engaged; overseeing the acceptance of gifts of art; overseeing the maintenance and disposition of public art; and overseeing expenditures of the Public Art Program budget. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Public Art Advisory Committee meets the first Thursday of each month at 3:30 p.m. Applications must be received by 5:00 p.m., Wednesday, November 13, 2002. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at the Civic Center, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Public Art Advisory Committee should be directed to Karin Franklin, Planning & Community Development Director at 356-5232. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 2 Females: 3 Council Announcement Date: October 8, 2002 Application Deadline: Wednesday, 5:00 p.m., November 13, 2002 Council Appointment Date: November 19, 2002 PUBLIC ART ADVISORY COMMITrEE Two Vacancies - Three Year Terms January 1, 2003 - January 1, 2006 Term expires for Sandra Hudson, Charles Felling Charles Felling [] (Currently serving unexpired term) 825 South Seventh Ave James Morgan Hemsley [] 445 Highway 1 West, Apt 23 r-~lDenotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION A, PPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION N~A.ME ,~ ~ /;O, ~LV""/- ~JP,3o.,~. do~,~;,/-~ERMJ~.. Is your home address (listed above) within the corporate limits of Iowa City? ~' Yes ~C-) How long have you been a resident of Iowa City? /-f/~"~ ~/ e'o.~- ~ ~:~': ~ :-~ -T~ OCCUPATION ~ ~ ~ EMPLOYER t ~NENUMBER: HOME'~I~-~ b~?¢ .BUSINESS ::~;,- EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~ ~{'E ~ I Misrepresentations on this application will constitute just cause for removal of an appointee. ~1 /I If you fail to answer all the questions, Council will not consider your application. cderk\lXlcomapp( 1 )doc April 2002 (1) WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR ~ ' tj '~ I POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. }u are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356~5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? /'%/YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES /~/' NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) IMisrepresentations 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. I' cclerk\bdcomapp( 1 ) doc April 2002 (2) CITY OF IOWA CITY -- ~',:~ ADVISORY BOARD/COMMISSION = ,PPLICATION FORM - Individuals serving on Boards/Commissions play an important role in advising the Council 9~, matte~.~ of interest to our community and its future. Applicants must reside in Iowa City. ~ After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE ~ST PAGE MARKED 'CONFIDENTIAL" THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Is your home address {listed above) within the corporate limits of Iowa City? X Yes __ No How long have you been a resident of Iowa City? O CUPAT,ON EMPLOYER AcT .'HONE NUMBER: HOME (~?o~) SSI- ~'(..~ BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~a~'~ I~H coll~ WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISOBY BOARD? ~;S ~ ~S ~'N~ ~ Misrepresentations on this application will constitute just cause for removal of an appointee. I I If you fail to answer all the questions, Council will not consider your application. clerk\ai~bdcornappl 1 }.doc April 2002 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. ~Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.6 is attached. If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the ~ode of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~'YES NO SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES ,~ NO DO YOU CURRENTLY (it has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) I M isrepresentations 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. ,erk\allbd~om app(1 ),doc April 2002 (2) NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: SENIOR CENTER COMMISSION Two Vacancies - Three Year Terms January 1, 2003 - December 31,2005 The duties of members of the Senior Center Commission are to: 1. Serve in an advisory role to the City Council with regard to needs of the Senior Center. 2. Make recommendations with regard to policies and programs at the Senior Center. 3. Join staff and other interested persons in seeking adequate financial resources for operation of the Senior Center. 4. Encourage full participation by senior citizens in the programs of the Senior Center. 5. Ensure that the Senior Center is effectively integrated into the community and cooperates with organizations with common goals in meeting the needs of senior citizens. 6. Serves in an advocacy role with regard to the needs of senior citizens in Iowa City. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Senior Center Commission meets the third Tuesday of each month at 3:00 p,m. Applications must be received by 5:00 p,m., Wednesday, November 13, 2002, The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at the Civic Center, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Senior Center Commission should be directed to Linda Kopping, Senior Center Coordinator at 356-5225. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 3 Council Announcement Date: October 8, 2002 Application Deadline: Wednesday, 5:00 p.m., November 13, 2002 Council Appointment Date: November 19, 2002 SENIOR CENTER COMMISSION Two vacancies - Three Year Terms January 1, 2003 - December 31, 2005 Term expires for Lori Benz, Charity Rowley Lori Benz [] (Currently serving 3-yr term) 2012 Dunlap Ct Charity Rowley [] (Currently serving 3-yr term) 519 Park Road [] Denotes applicant completed the Confidential page of the application. CITY' OF IOWA CITY ADVISORY BOARD/COMMISSION /xPPLICATION FORM ndividua s serv ng on Boards/Comm ss OhS p ay an mportant roe in advising the Coup. cil ~n matters of interest to our community and ts future. Appl cants must res de n Iowa C ry. After a vacancy has been announced, the Council reviews all applications dunng trleWork,se~s~onb,'Gt¢ appo ntment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL," THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ^Dv,soRY BOAR /COMM,SS,ON NAME TERM NAME ~:3r'l' ~/~X.....HOME ADDRESS ~Z..~lZ ~ ~ . Is your home address (listed above) within the corporate limits of Iowa City? g Yes __ No How long have you been a resident of Iowa City? ,,~'~t~, ~. OCCUPATION ¢/~f'lt,t~ t'~z~[g~i~,t{~'-(:c'o~Jc~r' EMPLOYER~I,;V',, f .)NE NUMBER: HOME ~c~.-]g,.~'",.~ BUSINESS ..~3fS~'"'O~SLl-t' EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:C'~ITr~.~ PRESENT NOWLEg ¥ I M isrepresentations 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. cclerk\bdcomapp(1) doc April 2002 (~) W'HAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR · U ~i - o - , Please identify any potential conflicts baleen membership on the adviso~ board and~?~ - ~, including financial interests and your duties to an employer. In padicular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allo~tion of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or'employee of the agency. Other types of affiliations must be examined on a case by case basis by the City A~orney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with ~dain impodant 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. ~u are un~dain whether a potential conflict of interest exists or have questions about ~on ~2.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? "//'YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES ~'/NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. cclerklbdcornapp( 1 ) doc Apl'il 2002 (2) CITY OF IOWA CITY ADVISORY BOARD/COMMISSION / PPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applicetions during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Is your home address (listed above) within the corporate limits of Iowa City? I//Yes . No How long have you been a resident of Iowa City? ~.~'~ ~' //¢¥/~ ' / OCCUPATION r~ ~ EMPLOYER ~ .)NE NUMBER: HOME :~)Z~ - .._~-/- 7~i/3-- BUSINESS THIS POSIT~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? p¢%/L,r ~ /~Z ~ II 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. cclerk\bdcomapp(l ) doc April 2002 (1) V" ~AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR / ? / POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. in particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached. I ~u are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. "'L~ ~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? /.'/YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) f you fail to answer all the questions, Council will not consider your application. I' cclerk\bdcomapp( 1 ) doc Apd[ 2002 (2)