HomeMy WebLinkAboutForbes, Missie (1st term 1/1/22-12/31/25) appt 11/16/21I Advisory Board/Commission Application Form
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It This application is a public document and as such can be reproduced and distributed for
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_ the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated.
Date of Application
5/17/2021
First Name
Missie
Last Name
Forbes
First Name ( Phonetic spelling )
Optional
Last Name ( Phonetic spelling )
Optional
Home Address*
1326 Lower Muscatine Rd
City*
Iowa Clty
State
IA
Zip Code
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3199362883
Email Address*
missieforbes.rnf@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Parks and Recreation Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?
38 years
Occupation:
Non -Profit management
Gender*
"This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
V Female
Experience and/or activities which you feel qualifyyou for this position:*
I am a lifelong resident of Iowa City who has utilized the facilities, parks and activities provided by this
department over the course of my lifetime --not only as a child but as a parent as well. Working primarily in the
Human Services non-profit sector, I am well -versed in operating within budget, the management of projects that
are beholden to budget constraints and understand how restrictive government funding can be. I am also
familiar, through my role as an Executive Director of 4Cs and as the President of the Free Lunch Program
Board of Directors, in working with boards to further the goals of the program the directors are meant to
support.
As a co-founder of Neighborhood NESTS, I have a desire to work with this commission to see how we might
strengthen our Parks and Recreation Department to provide supports to our most at -risk youth and families
and to create more cohesive, inclusive multi -generational spaces within our community.
What is your present knowledge of each advisory board you are interested in?*
The Parks and Rec Commission assists City staff with that division's fiscal responsibility, as well as guides the
department with its decision making within the department.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate familyties, during their tenure orfor one yearthereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
(Optional) Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
51
Country of Origin
United States
Sexual Orientation
heterosexual
Religion
Christian
Do you have a disability?
No
Ethnicity
caucasian
Race
Mite
Gender identity
female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
�15.5l� �OF-5
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.