HomeMy WebLinkAbout2009-03-24 Appointment03-24-09
12a
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
AIRPORT ZONING BOARD OF ADJUSTMENT
One vacancy -Unexpired + 5-yr Term
Ending December 31, 2011
The powers and duties of the Airport Zoning Board of Adjustment are:
1. To hear and decide appeals where it is alleged there is an error in any order, requirement,
decision, or determination made by an administrative official in the enforcement of the Airport
Zoning Chapter.
2. To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which
such board is required to pass under the Airport Zoning Chapter.
3. To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning
Chapter as will not be contrary to the public interest, where owing to special conditions a literal
enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship,
and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Board meets at the call of the Chairperson.
Applications must be received by 5:00 p.m., Wednesday, March 18, 2009. The City Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application
forms are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be
directed to Michael Tharp, Airport Operations Specialist at 356-5045.
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in-
law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step-
child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 0
Council Announcement Date: June 13, 2006; August 1, 2006; September 5, 2006;
September 19, 2006; November 14, 2006; December 12,
2006; January 9, 2007; February 20, 2007; March 20, 2007;
May 1, 2007; June 5, 2007; July 24, 2007; September 18,
2007; November 5, 2007; December 11, 2007; January 29,
2008; March 11, 2008; April 14, 2008; May 13, 2008; June
17, 2008; July 15, 2008; August 26, 2008; October 6, 2008;
November 18, 2008; January 6, 2009; February 24, 2009
Application Deadline: Wednesday, 5:OOp.m., March 18, 2009
Council Appointment Date: March 24, 2009
AIRPORT ZONING BOARD OF ADJUSTMENT
One Vacancy -Unexpired + 5-yr Term
Ending December 31, 2011
Carl Williams resigned
No applications as of Wednesday, 5:OOp.m., March 18, 2009
Denotes applicant completed the Confidential page of the application.
12b
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
AIRPORT ZONING COMMISSION
One vacancy -Six-yr Term
January 1, 2006 -December 31, 2011
Duties of the Airport Zoning Commission are:
1. To recommend amendments to the current Iowa City Airport Zoning regulations, including the
repeal thereof.
2. To recommend the adoption of new Airport Zoning regulations.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Board meets as required.
Applications must be received by 5:00 p.m., Wednesday, March 18, 2009. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application
forms are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Airport Zoning Commission should be directed to Michael Tharp,
Airport Operations Specialist at 356-5045.
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in-
law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step-
child, aunt, or uncle. (Resolution 85-354}
Males: 4
Females: 0
Council Announcement Date: September 20, 2005; November 1, 2005; December 13,
2005; January 23, 2006; February 28, 2006; March 21,
2006; April 18, 2006; June 13, 2006; August 1, 2006;
September 5, 2006; September 19, 2006; November 14,
2006; December 12, 2006; January 9, 2007; February 20,
2007; March 20, 2007; May 1, 2007; June 5, 2007; July 24,
2007; September 18, 2007; November 5, 2007; December
11, 2007; January 29, 2008; March 11, 2008; April 14, 2008;
May 13, 2008; June 17, 2008; July 15, 2008; August 26,
2008; October 6, 2008; November 18, 2008; January 6,
2009; February 24, 2009
Application Deadline: Wednesday, 5:OOp.m., March 18, 2009
Council Appointment Date: March 24, 2009
AIRPORT ZONING COMMISSION
One Vacancy -Six-year Term
January 1, 2006 -December 31, 2011
Term expires for Mark Anderson
No applications as of Wednesday, 5:OOp.m., March 18, 2009
~ Denotes applicant completed the Confidential page of the application.
12c
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
HISTORIC PRESERVATION COMMISSION
One Vacancy -Three-Year Term
March 29, 2009 -March 29, 2012
(1) College Green District Representative
Duties of the Historic Preservation Commission include: conducting studies for the identification and
designation of Historic Districts; reviewing and acting upon all applications for Certificate of
Appropriateness; cooperating with property owners and city agencies regarding remedy of dangerous
conditions; furthering the efforts of historic preservation in the City by making recommendations on
preservation issues, when appropriate, by encouraging the historical, architectural or cultural value, and by
encouraging persons and organizations to become involved in preservation activities.
This Commission meets the second Thursday of each month at 5:30 p.m and, if necessary, the fourth
Thursday of each month at 5:30 p.m. Iowa City appointed members of the boards and commissions must
be eligible electors of the City of Iowa City.
Applications must be received by 5:00 p.m., Wednesday, March 18, 2009. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Historic Preservation Commission should be directed to Christina
Kuecker, Associate Planner at 356-5243.
2/26/2009
Historic pr~servafitn Commission
Attendance Record
2009
e
N Term
Expires 1108 _~
am
Baldrid a 3/29/11 X
Baker
Downin
Eubanks 3/29/09
3/29!10
3/29/1'1 X
X
X
_
--
1
" '-
Hirschman 1
3/29/ -- --
Michaud
Ponto 3129/09
3/29/10 X __
X
Swaim 3/29/09 X
Trimble
Wagner 3/29110
3/29109 X
X
-
Key:
X =Present
O =Absent
O/E = AbsenUExcused
Historic Preservation Commission
Attendance Record
2008
Term 1110 2128 3113 M10 5/8 5122 6/12 7170 7/24 8114 6/28 9111 1019 1113 11113 12111
N8R18 Exprzes
X
O/E
X
_._
X
X
X
X
X
X
OlE
X
X
Baldrid a 3/29/11 -- -- -- -- -- -- X X O/E X X X O/E O!E
Baker 3/29/09 X X X O/E X X X X
Brennan 3129/08 X OIE 0/E ° -- --'-
X -- --
X --'-
X -- --
OlE -- --
X -- --
X -- --
0/E -- --
0/E
Downin 3129!10 X X X O/E X X 0/E 0/E
Eubanks 3129/11 O/E X X X X X X O/E X X X X X X X X
X
Michaud 3129109 X X X X O/E O/E X X X X X X X X O/E _
3/29/10 X X O/E X X X X X 0/E X O/E X 0/E X X X
Ponto 3/29/09 X O/E X O/E X O/E O/E X X X X OJE X X X O/E
Swaim OIE X O/E O/E OlE 0/E 0/E O/E O O -- -- -- -- •- --
Tich 3129/11 -- -- -- -- -- --
Toome 3/29/09 X OIE X X X X X -- -- -- --
X -- --
O/E -- --
X ° --
X -- --
X -- °
X -- -
X
Trimble 3/29/10 x O/E X X X X O/E X X X X X X X
Wa ner 3/29109 -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- ° X
Weitzel 3!29/08 O/E X X -- -- -- -- -- -- -- -- -- -- -- --
Key.
X =Present
O =Absent
O/E = AbsenUExcused
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: 4
Council Announcement Date: January 12, 2009; February 24, 2009
Application Deadline: Wednesday, 5:00 p.m., March 18, 2009
Council Appointment Date: March 24, 2009
HISTORIC PRESERVATION COMMISSION
One Vacancy -Three Year Term
March 29, 2009 -March 29, 2012
(1) College Green
Term expires for Pam Michaud
Pam Michaud D (Currently serving unexpired term)
109 S. Johnson St
Kevin Burford ~
528 E College St
Denotes applicant completed the Confidential page of the application.
City of Iowa City rl r i
Advisory Board/Commission/Committee ~;~= Vc~''~~
~®~~~
. _pplication Form -n-~-
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Advisory Board/Commission/Committee Name Historic Preservation Commission Term 3 years
Youth Advisory Commission (shall not be more than 18 years of age at the time of application)
Name of Iowa City High School or high school equivalent:
Signature of parent/guardian:
ME Pam Michaud
HOME ADDRESS 109 S. Johnson St.
ZIP 52240
Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes
How long have you been a resident of Iowa City? 35 years
OCCUPATION landlord EMPLOYER self
PHONE NUMBER: HOME 339-1247
BUSINESS College Green Guest House
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU'FOR THIS POSITION:
In 1990, I bought 109 S. Johnson and recognised the historic significance of the 16 historic buildings on College
Green Park, half of which were owner occuppied. I initiated a petition to have my neighborhood designated a
historic district. I served a 3 year term on the Historic Preservation Commission in the late 1990's and from 2006 to
present 3-09. I renovated and restored two historic homes on College Green Park for my business.
~ ~.; 3S P - m .
~1AR - 5 2009
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
No
General Application
December 2008 Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I have served two terms on the HP Commission.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
I love the University of Iowa as a resource for this community and Iowa. Clty's responsive governance. In addition to
this diverse community of rural and urban backgrounds, I enjoy meeting faculty from around the world. Part of my
work is orienting internationals to in Iowa City community resources.
I was raised in architecturally rich Chicago, visited historic Galena, IL many times as a youth, and enjoyed the
architecture of many European cities and towns. I feel this background gives perspective to local development.
This winter, I researched about 18 properties for the Manville Heights Survey 2008-09.
have researched materials and techniques to be used in vmy own house restoration projects over 18 years.
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.
,articular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also knowthat Section 362.5 of the Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030.
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IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes U 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 may not consider your application.
General Application
December 2008 Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City ~~~ //' _/ -,
Board/Commission/Committee ~_S°f-~~ / ~- ~h°s ~ ~ ' ~~~ ~
~r
_~ _~
-~®~~~
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CITY OF IOWA CITY
Date ~ ~~~
Name p n~ ~ i ~ ~~~~
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 6).
List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission
applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's
stockholdings). Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
Cv ~ e Gee Gu c,s--~ .sue ~ .S`
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S ~ 57~
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`~ ~ C.~7lE'. ' S~
q-•
`1 Z: 3s' P ri.
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NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
i
Applicant Signature G~ i~~ Lam---~
~'~
Signature of parent/guardyian/(Youth Advisory Commission only):
Add ress ~~ ~ --S i/ v ~t ~ s o ~ -S ~ --~~~ y~
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
io answer all the questions, Council may not consider your application.
General Application
December 2008 Page 3 of 7
City of Iowa City ~ r
~.~ _ _
Advisory Board/Commission/Committee ~!'-~! +~~'~~
,~~,~-~
Application Form -~-~--
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Advisory Board/Commission/Committee Name Historic Preservation Commission Term 3/29/09-12
!i Youth Advisory Commission (shall not be more than 18 years of age at the time of appl~tion)
''~, Name of Iowa City High School or high school equivalent: ~n
Signature of parent/guardian: c} -~ ~'
NF"9E Kevin Burford
HOME ADDRESS 528 E. College Street, Iowa City, IA
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. m
Ci ~
~~
P
Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes
How long have you been a resident of Iowa City? 1950-1974 & 2002 to present
a
N
520
No
OCCUPATION Circulation Supervisor-Law Library EMPLOYER University of Iowa
PHONE NUMBER: HOME 319-341-9889
BUSINESS 319-335-9015
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I am a native Iowa Citian, and have therefore witnessed many local architectural changes in my lifetime. I worked in
the library of the State Historical Society in Iowa City for nearly four years and developed a special interest in Iowa
City's historic homes, buildings and neighborhoods. I have participated in salvages and activities with The Friends of
Historic Preservation and have been involved in the renovation of my own historically significant home as well as
that of my parents, both located in the College Green Historic District.
lisrepresentations on this application will constitute just cause for removal of an appointee. If you fail II
~o answer all the questions, Council may not consider your application.
General Application
December 2008 Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I have basic knowledge of the functioning of the Board, know some of its members, and have been present more
than once at its meetings as ahomeowner-petitioner.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
Having had personal experience renovating my own home, I'm very aware of the balance which must be struck
between historical authenticity and financial pragmatism and the need for use of more contemporary materials in
situations where historical authenticity is prohibitively expensive. My philosophy is that the historic Preservation
Commission should do all it can to promote and support historic preservation without being punitive to the
well-intentioned property owner. _
O ~;
?' ~ ~ ~
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c~ ~ ~ ~
~x
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 .rticular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030.
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.)
'isrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2008 Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board/Commission/Committee Historic Preservation Commission
Name Kevin Burford
_- r
~~~~
~"m1~ ~
'"r'®'~~
-+~a.aL_
CITY OF IOWA CITY
Dat@3/17/2009
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 6).
List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission
applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's
stockholdings). Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
none
Q ~
~ ::~
c~ _ _ --°-
--~ c ~ c:o
m
~~
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature,
Signature of parent/guardian (Youth Advisory Commission only):
Address _528 E. College Street, Iowa City, IA
1isrepresentations on this application will constitute just cause for removal of an appointee. If you fail
co answer all the questions, Council may not consider your application.
General Application
December 2008 Page 3 of 7
12d
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
TELECOMMUNICATIONS COMMISSION
Two Vacancies -Three Year Terms
March 13, 2009 -March 13, 2012
The duties of the Telecommunications Commission include serving as a review board to resolve
disputes between any subscriber or potential subscriber and the cablevision company; reviewing and
auditing reports by the cablevision company to the City as required by the Cable Television Ordinance;
working with the public, the media, the City, and the cablevision company for the purpose of making
recommendations on various issues; engaging in other activities pursuant to the effective monitoring and
evaluation of the CATV system in the City.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa
City. The Telecommunications Commission meets the fourth Monday of each month at 5:30 p.m.
Applications must be received by 5:00 p.m., Wednesday, March 18, 2009. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Telecommunications Commission should be directed to Drew Shaffer,
Cable Television Administrator at 356-5046.
2/26/2009
TELECOMMUNICATIONS COMMISSION
12 MONTH ATTENDANCE RECORD
01/01/03 to CURRENT
l
b
i Saul Meikes Brett Castillo Terry Smith Jim Pusack
Meeting
Date er
y
m
K
Thrower _
6/2/03 x x x x x
7/28/03 x X X x - x
8/25/03 X X X X OTC
9/22/03 X X X X 0/C
10/27/03 x x x x o/c
11 /24/03 x x o/c x x
12/15/03 o/c o/e X x x
1 /2/04 x o/c X x x
1 /26/04 x x X x x
2/23/04 x o/c x o/c x __
3/22/04 x x x -- x x
4/ 26/04 x x x x O/C
5/24/04 x x O/C x x _
6/28/04 X X X O/C x
7/26/04 o/c X X x x
8/26/04 did not meet did not meet did not meet did not meet did not meet
9/27/04 X --- X X X X
10/25/04 X _ X
eet
t
Did Did not meet Did not meet Did not Did not meet
11/04 no
m meet
12/20/04 }{ X X X X
1 /24/05 X X X X X _
2/28/05 X X X X
Gar Ha en
3/8/05 X X X X X
3/25/05 X O X X X
4/25/05 x o/c X X X
5/23/05 X o x_ vacanc X
James
Ehrmann X x Bebe
Balantyne x
6/27/05 X x X X X
X Michael
Chritians _
7/25/05 O X X X X
__
9/26/05 0 X X 0 X
10/31 /05 X X o/c _ __ X_ X
11 /28/05 X X X X X ,
1 /23/06 o/c X X O X
2.27/06 X_ X X 0 X
3/27/06. o/c X X John
Weaterson X
X
4/24/06 X X X_ X X _
5/22/06 0 x x/o 0 X
6/26/06 0 X Vacant 0 X
Nick Parker
7/24/06 x x x X
8/24/06 X_ x M. Wietin o/c X
_
9/25/06 x x x 0/c X
10/23/06 x X x o/c X
10/30/06 x x x vacant X
11 /27/09 X x x X
12.18/06 X X X X
Brett
Gordon
1 /22/07 X X X X X
2/26/07 X_ X X X X
3/26/07 Vacant x o/c x X
4/23107 Vacant X_ X X X
Hoerschelm
an
521 /07 X X o/c X x
6/26/07 X X X X X
7/23/07 X X X X X
9/24/07 X X o/c o/c X
10/22/07 x x o/c o/c x
11 /26/07 X X X X X
12/18/07 X X o/c X X
1 /28/08 X x o/c x X
3/3/08 X X_ X X_ X
3/24/08 Bob Kem
x x o/c X X
4/28/08 X X X X X
6/3/08 X X X_ X X
6/23/08 X X X_ X 0/C
7/28/Og X X X X X
g/25/pg X X X o/c X
9123/08 X X X X X
10.27/08 X X X o/c X
11/24/08 Did not meet
12/15/08 X_ X X X X
1 /26/09 X X X ~ X o/c
2/243/09 X' x o/c o/c x ____
(X) =Present
(O) =Absent
(O/C) = Absent/Called (Excused)
Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in- law,
father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 0
Council Announcement Date: January 12, 2009; February 24, 2009
Application Deadline: Wednesday, 5:00 p.m., March 18, 2009
Council Appointment Date: March 24, 2009
TELECOMMUNICATIONS COMMISSION
Two Vacancies -Three-year Terms
March 13, 2009 -March 13, 2012
Term expires for Brett Gordon, Saul Mekies
Saul Mekies D (Currently serving 2"d 3-yr term)
2151 Abbey Ln
Laura Bergus ~
2231 California Ave
Brett Gordon D (Currently serving unexpired term)
224 N. Dubuque St
Denotes applicant completed the Confidential page of the application.
City of Iowa City ~ r 1
~_ _
~'
Advisory Board/Commission/Committee ~; =-°' ''~~
Application Form ~-~--
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews atl applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Advisory Board/Commission/Committee Name Telecommunications Commission Term 3/,.09 to 3/12
Youth Advisory Commission (shall not be more than 18 years of age at the time of application)
Name of Iowa City High School or high school equivalent:
Signature of parent/guardian:
NAME Saul Mekies
HOME ADDRESS 2151 Abbey Lane, T~wa c'.i t~, TA ZIP 52246
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? ~ a ~,Pa,-G
OCCUPATION Professor, Economics EMPLOYER Kirkwood Community College
PHONE NUMBER: HOME 351-6809
BUSINESS 887-3617
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I have a background in the economics of utilities, including. telecommunications
I have previously served on the Commission, and acquired knowledge and experience
I have never missed a meeting and take my appointment seriously. I have put in many
hours of my time to be an effective contributor to the commission and represent the Ci
and the consumers to the best of my ability.
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail ~'
to answer all the questions, Council may not consider your application.
,.
~ ~.~ ~n1
General Application FEB 2 5 2009
December 2008 Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I have previously served on the Commission
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
It takes a lot of time to come up to speed and understand the vast array of information
before the commission. That means not only understanding the role of Mediacom, but also
the role of the local channels. It is also important to understand the technical issues
as well as the budgetary issues. I feel I am prepared for the task.
My background in economics (utilities, regulation)will be helpful.
I never miss a meeting and I am diligent at being prepared for the meetings, including
reading the material before hand, and doing some research on my own.
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.
,n particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also knowthat Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have, questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030.
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 individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
~~,
General Application ,2o Pal
3=
December 2008 Page 2 of 7 FEB 2 5 20~J9
._
:,a
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board/Commission/Committee Telecommunications Commission
Name Saul Mekies
r
_,~
~~~ ~~~
wr,®~w~
-~.a~
CITY OF IOWA CITY
Date
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 6).
List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission
applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's
stockholdings). Please indicate if there are none.
~ BUSINESS NAME ~ BUSINESS ADDRESS ~
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature,
Signature of parent/guardian (Youth Advisory Commission only):
Address 2151 Abbey Lane, Iowa City, IA 52246
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application. N.,-.-- -
;.
General Application FEB 2 5 2099
December 2008 Page 3 of 7 ~ ~3o P~
1
City of Iowa City i r 1
~_.:.®~
Advisory Board/Commission/Committee ~ ~"'~'~~
~w~~~
..pplication Form -~-~--
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Cterk, 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 RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Advisory Board/Commission/Committee Name Telecommunications Commission Term Starting 3/09
Youth Advisory Commission (shall not be more than 18 years of age at the time of application)
Name of Iowa City High School or high school equivalent:
' P
Signature of parent/guardian: ~~AR - 5 2009
M''`ME Laura Bergus
HOME ADDRESS 2231 California Ave.
ZIP 52240
Is your home address (listed above) within the corporate limits of Iowa City?
How long have you been a resident of Iowa City? Since 1981
OCCUPATION Student, U of I College of Law EMPLOYER --
PHONE NUMBER: HOME (319) 541-9677 BUSINESS
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I was director of the City of North Liberty's telecommunications dept. from 1998 to 2008 and was staff liaison to the
telecom. commission. I was in charge of cable franchise oversight with two providers. I negotiated an amendment to
North Liberty's Mediacom franchise in 2001 and a new cable franchise with a telephone cooperative (South Slope)
in 2003-2004. Having lived in Iowa City my whole life, I am familiar with all of the local access channels and how
they operate. I have experience producing video for local access channels in Iowa City, Coralville and North Liberty.
Over the past decade I have served as an advisor to several Iowa communities that have started new access
channels, including Coralville, Carroll, Wellman and Anamosa/Monticello. I worked with the Iowa League of cities in
amending and opposing the statewide video franchising legislation that was adopted iri 2007.
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
Yes ~ No
General Application
December 2008 Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I know that they oversee enforcement of the cable N franchise with Mediacom. I believe they also oversee
operations of City Channel and InfoVision and have some advisory role to some of the other access channels.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
In my years working with PEG access, I developed a reputation for producing high-quality, locally-relevant
community programming on a minimal budget. I would expect the same from Iowa City's access channels and could
help hold them accountable to the citizens to this end. I also have a good working relationship with many Mediacom
staff, am familiar with local, state and federal law governing cable television, and am comfortable assisting in
enforcement of these laws. I am familiar with the text of Iowa City's cable franchise agreement.
I am a proud resident of Iowa City and am glad to be raising my family here. While f am currently a law student, I am
interested in using my expertise in cable franchise oversight and PEG access to help the City further its
telecommunications goals. Having been on the staff side of this equation, I greatly look forward to serving as a
citizen.
a,~ yip ,~T
MAR - 5 2009
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.
articular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030.
None
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 may not consider your application.
General Application
December 2008 Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board/Commission/Committedelecommunications Commission
~ r i
~~~~~
~ ~~~~~ ~
-•~a.at~
CITY OF IOWA CITY
Dat@3/05/2009
Nam~aura Bergus
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 6).
List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission
applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's
stockholdings). Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
None
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
i
r~.
Applicant Signature ' ' ' ` ~~
Signature of parent/guardian (Youth Advisory Commission only):
Address 2231 California Ave.
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2008 Page 3 of 7
City of Iowa City i r 1
~~.®~x
Advisory Board /Commission/Committee ~: -="'"~~'`'~~
,~~~~~
Hpplication Form ~-~--
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Advisory Board/Commission/Committee Name _Telecommunictions Commission Term _2009-12_
Youth Advisory Commission (shall not be more than 18 years of age at the time of application)
Name of Iowa City High School or high school equivalent:
Signature of parent/guardian:
AME Brett Gordon
HOME ADDRESS _224 N. Dubuque St
ZIP 52245
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? Since 1959
OCCUPATION Therapist/ Telecomunications Specilist KWKB/KUBU/WAZU_ EMPLOYER: KWKB-DTV
PHONE NUMBER: HOME 319-337.4545 BUSINESS 319-248-5050
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
-~'
Prior Public Service ~, ~~°~-
BA/UIGommunications Studies : ~~ r~.
_ tit .
C.3 ?'= 9
:~'` ..
~' v,
o•
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 200 8 Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
Sitting Member
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
Offer Constructive Guidance for Community Media
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CTS
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests,including financial interests and your duties to an employer.
particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030.
FCC Agent for New Bohemia Group, INC
2007 NCE Application attached
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes X No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes X No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2008 Page 2 of 7
~ r i
~1.=.®~
BOARD, COMMISSION AND COMMITTEES ~.~`~~ ,~`~*~
BUSINESS LISTING .,,~~
CITY OF IOWA CITY
Name of City
Board/Commission/Committee ~ C ~ ~ Date ~ Z ~~~~
Name ~'~ ~ e-, ~-r-~.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 6).
List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission
applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's
stockholdings). Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
t~ -~' ""
~~ N
m
v +,~
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature ~ `
Signature of parent/guardian (Youth Advisory Commission only):
Address
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2008 Page 3 of 7
Page 1 of 1
~~
Marian Karr
From: Regenia Bailey [bailey@avalon.net]
Sent: Thursday, March 19, 2009 7:23 PM
To: Marian Karr
Subject: FW: Telecommunications Commission
Council correspondence
From: Saul Mekies [mailto:smekies@kirkwood.edu]
Sent: Tuesday, March 17, 2009 5:05 PM
To: 'regenia-bailey@iowa-city.org'
Subject: Telecommunications Commission
The Honorable Regenia Bailey, Mayor
Hi Reginia,
I am interested in being reappointed to the Telecommunications Commission for the 2009-2012 term. My
previous service has enabled me to contribute more effectively to the Commission. I take my responsibility
seriously. I have perfect attendance at the meetings. I am a professor of economics at Kirkwood Community
College. I am also the only one of the three candidates to have applied on time, before the deadline was
extended.
If you have any question, please contact me. Thanks for your consideration.
Saul
Saul Mekies
Prof., Economics
Tel.: 319-887-3617
E-mail: smekies kirkwood.edu
3/20/2009
Page 1 of 1
-~ ~~ ~
Marian Karr
From: Laura Bergus [laura.bergus@gmail.com]
Sent: Monday, March 23, 2009 8:05 AM
To: Council
Subject: Telecommunications Commission Appointment
Dear Mayor and Councilors,
In your agenda packet for Tuesday's meeting is my application to serve on the Telecommunications
Commission. I have ten years of experience administering cable franchise agreements as director of the
Telecommunications Department for the City of North Liberty (1998 to 2008). I worked directly with
representatives from Mediacom and South Slope Cooperative Telephone (North Liberty's franchised
cable providers) to oversee enforcement of the agreements, negotiate amendments and, most
importantly, to resolve subscriber complaints.
I am a lifelong Iowa City resident and have been very much looking forward to the opportunity to serve
the City in a volunteer capacity. Please feel free to contact me with any questions you may have about
my background or qualifications. Thank you for your consideration for appointment to the
Telecommunications Commission.
Sincerely,
Laura Bergus
(319) 541-9677
laura.ber~~is. cr ~malcom
3/23/2009
12e
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
YOUTH ADVISORY COMMISSION
Two Vacancies
One Unexpired Term
Effective upon appointment -December 31, 2009
One (1) person - At Large
One Two-Year Term
January 1, 2009 -December 31, 2010
One (1) person -Tate High
The mission of the youth Advisory Commission is to promote understanding and awareness of Iowa
City among Iowa City youth, allow a select group of youth to help make decisions concerning them and
their peers, enable youth members to utilize and expand on their leadership abilities, to serve as a
mechanism for communication between youth and adults in Iowa City and create a bridge whereon youth
and adults can develop partnerships.
Membership shall consist of seven [7] members appointed by the City Council currently enrolled in an
Iowa City high school or high school equivalent. Four members shall represent City, Regina, Tate, and
West high schools. The three remaining members shall be at large. All ages shall be calculated on the
date of the filing of applications, and shall not be more than 18 years of age at the time of application. All
members shall be residents of Iowa City.
Applications must be received by 5:00 p.m., Wednesday, March 18, 2009. The City of fovea City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.orq.
Questions about the Iowa City Youth Advisory Commission should be directed to Marian Karr, City
Clerk at 356-5041.
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Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in-
law, brother, sister, brother- in-law, sister- in- law, step-father, step-mother, step-
child, aunt, or uncle. (Resolution 85-354)
Males: 2
Females: 3
Council Announcement Date: February 10, 2009
Application Deadline: Wednesday, 5:00 p.m., March 18, 2009
Council Appointment Date: March, 24, 2009
(Recommendations to be made by Council liaison)
YOUTH ADVISORY COMMISSION
One Vacancy -Two Year Term
January 1, 2009 -December 31, 2010
One (1) person -Tate High
One Vacancy -Unexpired Term
Effective upon appointment, ending December 31, 2009
One (1) person - At Large
Danielle Malatek resigned
One (1) Tate High
No applications as of Wednesday, 5:00 p.m., March 18, 2009
One (1) At Large
Jerry Gao D
29 Coll Court
D Denotes applicant completed the Confidential page of the application.
i
City ofi Iowa City r
~...®~
Advisory Board/Commission/Committee ~:~~"',1'`'~~
. pplication Form "`-"-
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Advisory Board/Commission/Committee Name Youth Advisory Commission Term 2009
Youth Advisory Commission (shall not be more than 18 years of a eat the time of application)
Name of Iowa City High School or high school equivalent: W25'~ ~~~ ~ ~-~o° t
Signature of parent/guardian: _T~-- C~°/
~~4ME Jerry Gao
HOME ADDRESS 29_coll court ZIP ~22L~b
Is your home address (listed above) within the corporate limits of Iowa City? Q Yes ~ No
How long have you been a resident of Iowa City? Since July 2003
OCCUPATION Student
EMPLOYER West High School
PHONE NUMBER: HOME 319-466-9411 BUSINESS 319-688-1050
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS PC~ITIOI
West High Student Senate (2006-present) ~' W
- -_
National Youth Leadership Forum ~ ~` -- ~-
Community Youth Leadership Program "~ ~'
~'~' co
Volunteering: UIHC (60 hours), Iowa City Public Library (150 hours) ~ -aa
Band (2003-present) O
West High Mu Alpha Theta (2006-present) ~ ~
West High Academic Decathlon (2008-present) ,~,~
~I Swimming/Tennis (2006-present)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2008 Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
The Youth Advisory Commission is comprised of seven members. The goal of the commission is to promote
communication between youth and adults and an awareness of Iowa City. The commission also increases
dership abilities for its members by allowing them to make decisions that affect not only them, but other youth as
well.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
As a member of West High Student Senate for the past few years, and as a member of the Community Youth
Leadership Program, I have noticed that many youth are apathetic of what goes on around them. I feel that much
can be done in order to increase teenagers' awareness of Iowa City. Current youth are often isolated from the world
around them, unwilling to engage in discussion with older adults or to appreciate what Iowa City has to offer. If I am
a member of this commission, I think that I would be able to help increase enthusiasm and understanding of Iowa
City, and help youth become more involved with other adults. Also, as a responsible student, my decision-making
skills would be well-suited as a liaison between the general youth population and the City Cowlcil.
.y ~ ,~
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POTENTIAL GUNFLIGI 5 UF- IN I tKtS I
q -~-
v
Please identify any potential conflicts between membership on the advisory board and your personal
interests including financial interests and your duties to an employer.
particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also knowthat Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030.
None
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 may not consider your application.
General Application
December 2008 Page 2 of 7
~ r
BOARD, COMMISSION AND COMMITTEES ~,, ,~ ~
BUSINESS LISTING ...~,,~._
CITY OF IOWA CITY
Name of City
Board/Commission/Committee Youth Advisory Commission Date /(l~j ~ ~ ~1
Name Jerry Gao
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 6).
List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission
applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's
stockholdings). Please indicate if-there are none.
BUSINESS NAME BUSINESS ADDRESS
Yb ~
~...>
O
~ ~, "'f"1
t~ -r _,..
r-
rv
-.a
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature
Signature of parent/guarc~ian (Youth Advisory Commission only):
Address 29 Coll Court
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2008 Page 3 of 7