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HomeMy WebLinkAbout2009-08-18 AppointmentUtf-1 iS-Uy 17a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HISTORIC PRESERVATION COMMISSION One Vacancy -Unexpired Term Effective upon appointment, ending March 29, 2011 For a Northside 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, August 12, 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. 7/7/2009 Nistoi i~ P.reseiv~lio~ Commission Attendance Record 2009 Name Term Expires 1108 2113 3/12 4113 5114 5128 6111 Baldrid a 3/29/11 X O/E X X X X X Baker 3/29/09 X X X 0!E X X X Downin 3129/10 X X X X X X X Eubanks 3/29!11 X X X X X X X Hirschman 3/29/11 -- - X O/E X X -- -- -- -- Michaud 3/29/09 X X O/E X X O/E O/E Ponto 3I29I10 X X X X X X 0/E Swaim 3/29/09 X X X O/E O/E X 0/E Trimble 3/29/10 X X X X X X X Wa ner 3129109 X X X X X O/E X Key: X =Present O =Absent 0/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: 4 Females: 5 Council Announcement Date: July 6, 2009 Application Deadline: Wednesday, 5:00 p.m., August 12, 2009 Council Appointment Date: August 18, 2009 HISTORIC PRESERVATION COMMISSION One Vacancy -Unexpired Term Effective upon appointment -March 29, 2011 (1) Northside District Representative New District No applications as of Wednesday, 5:OOp.m., August 12, 2009 D Denotes applicant completed the Confidential page of the application. 17b NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HOUSING & COMMUNITY DEVELOPMENT COMMISSION Three Vacancies -Three Year Terms September 1, 2009 -September 1, 2012 Duties of the Housing and Community Development Commission include assessing and reviewing policies and planning documents related to the provision of housing, jobs, and services for low- and moderate-income residents; reviewing policies and programs of the Public Housing Authority and Community Development Division and make recommendations regarding the same to the City Council; reviewing and making recommendations to the City Council regarding the use of public funds to meet the needs of low- and moderate-income residents; housing policies and programs, and seeking public participation in assessing needs and identifying strategies to meet these needs; recommending to the City Council from time-to-time amendments, supplements, changes, and modifications to the Iowa City Housing Code. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. When possible, Council will appoint persons with expertise in construction and/or finance, a person receiving rental assistance, and a member of the Local Homeless Coordinating Board. The Housing and Community Development Commission will have monthly meetings. Applications must be received by 5:00 p.m., Wednesday, August 12, 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 Housing and Community Development Commission should be directed to Tracy Hightshoe, Community Development Planner at 356-5244. Housing 8~ Community Development Commission Attendance Record 2009 Term Name Ex fires 2/17 2/18 2/19 3/12 3/26 4/16 5/4 Steve Crane 09/01/09 X NM X X X X X , De France, Marc 09!01/09 O/E NM X O/E X O/E X Dou las, And 09/01/11 X NM O/E X X 0/E X Drum, Charlie 09/01/10 X NM X X X X X Holl Jane Hart 09/01/10 O/E NM X X X X X , Michael McKa 09/01/11 X NM X X X X X , McMurra ,Rebecca 09/01/11 O/E NM X X O/E X X Brian Richman 09/01/10 X NM X X X O/E X , Shaw, Michael 09/01/09 X NM X X X O/E X Key: X = Present O = Absent O/E = Absent/Excused NM = No Meeting -- -- = Not a Member 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: 2 Council Announcement Date: July 6, 2009 Application Deadline: Wednesday, 5:00 p.m., August 12, 2009 Council Appointment Date: August 18, 2009 HOUSING & COMMUNITY DEVELOPMENT COMMISSION Three Vacancies -Three-Year Terms September 1, 2009 -September 1, 2012 Term expires for Marcy DeFrance, Michael Shaw, Steve Crane Daniel Talton ~ 320 S Gilbert #1011 Jarrod M. Gatlin D 2109 Union Rd Andrew Chappell ~ 911 Rider St ~ Denotes applicant completed the Confidential page of the application. 1 CITY OF IOWA CITY _ r ..,:.®~r Adviso 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 BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. BOARD/~MMISSION/COM~,~jTEE NAME ~~ t~Jb~'y~ TERM j S~P~" Z~~ Z~/~ NAME ZIP ~~~~ aNo HOME ADDRESS ~ZC~ S- ~ ~`~~ } ~ ~O~` - Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes How long have you been a resident of Iowa City OCCUPATION . ~ 61`~~~1" rHONE NUMBER: HOME Z ~ ~-t. EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~~ ~6 _ ~~.. ,.,: ~, , ~ .~ .,~. ,r WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ,.-,: "` .:~ ,;1 r~ 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. 1^ EMPLOYER ~,~,E~ tY.~a~„w~- ~~ ~o~' ~- BUSINESS HCDC Application March 2008 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING? .~--~ -~ 6 ~ e y~.c~ ~ ~ ~~ ~ t ,fie vu ~ w d ~ ~L-t l/ ~ , , ' Se ~ ~- ~-~ ~C~~vc ~owcc ~~~ ~~ ~ ~ i C~ .~. ~'"~~ POTENTIAL CONFLICTS OF INTEREST _ ~ ,.,,~ `°",;; s~ Please identify any potential conflicts between membership on the advisory board and yoriXpersorial inte~sts, including financial interests and your duties to an employer. -- `-' ~ i C; -:: ~~~ s.,~ In particular, if you are applying to be a member of a board or commission which makes r,~comm~dations to the City Council about the allocation of City funds, please list any present affiliations you have vJ'i~h agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. ether types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7-. If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. 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. HCDC Application March 2008 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Name ~ r :~mh~. ,~ '` "''W"~'Q'~ -~c.ar~ CITY OF IOWA CITY Date Zu v I G ~( Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none . BUSINESS NAME BUSINESS ADDRESS ~1 a w t. __ "~ . ~, NOTE Signature Anew form must be completed if the above information changes or an ownership interest is acquired in an additional business. Address ~Z~ a, ~ ~ ~L'~~ ~:I-c-c.~~' ~ ~V ~~ 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. HCDC Application March 2008 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 19, 2009 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $15,950 $26,600 $31,920 $42,550 $53,200 2 18,250 30,400 36,480 48,650 60,800 3 20,500 34,200 41,040 54,700 68,400 4 22,800 38,000 45,600 60,800 76,000 5 24,600 41,050 49,260 65,650 82,100 6 26,450 44,100 52,920 70,550 88,200 7 28,250 47,100 56,520 75,400 94,200 8 30,100 50,150 60,180 80,250 100,300 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, PLEASE INDICATE IF YOU ARE A MEMBER OF EITHER OF THE FOLLOWING CATEGORIES: _~, Lower Income (see table) ~ Receive Rental Housing '`r .`i`~ Assistance _,,,, `~° t„~J 'A i~3 Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint a person or persons with expertise in construction, fnance and/or a person receiving rental assistance. If you have expertise in construction or finance, please describe your experience and/or training. .~,t~ U'~~ ~tt- ~--~_ ~~c. v~ ~;~,~ o~ r ve~ti~-~~;1 I~w~~ ~ ~~ r ~~ HCDC Application March 2008 page 4 of 8 CITY OF IOWA CITY ~ r i ~~®a~r Adviso Board/Commission/Committee ~.`"'~,~'~~ ~ '~ Application Form cl- o IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. BOARD/COMMISSION/COMMITTEE NAME Housing and Community Development Commies TERM 9/2009 - 9/2012 NAME Jarrod M Gatlin HOME ADDRESS 2109 Union Rd. Iowa City, IA. 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? 25 years OCCUPATION Clerk III PHONE NUMBER: HOME (319) 936-4800 ZIP 52240 a No EMPLOYER University of Iowa Hospital and Clinics BUSINESS (319) 356-2632 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: As a youth, I lived with a parent that received housing assistance from the City of Iowa City. I have a first hand knowledge of what a positive contribution this service can be to the right candidates. 1 have also had several other family mem„~ers use these services in the Iowa City community with less desirable outcomes. I believe that 1 understand what makes~.~i qualified; candidate, when looking beyond the financial requirements that are necessary for eligibility. I've worked with low~intome a _ students that benefits from the services as well. •- ::; ~ u'..i ~..~ i . ~ .~- >~: w> _~ WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? This is the commission that will make recommendations to the city council in regards to use of funds, modifications and amendments for housing provisions for low income and moderate income residents. 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. HCDC Application March 2008 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD iOR STATE REASON FOR APPLYING)? I believe that as a board member I can accurately represent moderate income Iowa City residents. These people may not qualify for these particular programs, but they want to ensure that the funds go to the people that need and deserve them most. In certain instances, these funds have been granted to individuals that aren't deserving, and that there should be more regulation and monitoring of how these funds are used. A conservative approach to spending is essential to any local government. I believe I can represent the people of Iowa City that feel the same way. ±''e7 ..;._ ~: ~` :m,. ~%::. ~- ~,,t POTENTIAL CONFLICTS OF INTEREST .U.= 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 (see page 7!. If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? AYES aN0 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. HCDC Application March 2008 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Name Jarrod M Gatlin Housing and Community Development Commission ~~~~®rd7 .~- :~III~~~ -•~.a.__ CITY OF IOWA CITY Date 08/12/2009 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 7). List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings. Please indicate if there are none . BUSINESS NAME BUSINESS ADDRESS None None 0 ~. t,.. . ~vaa wso ' ~~ .~s.~ r,^~+s; f'• .. NOTE: Anew form must be completed if the above information changes or an ownership interest is acquired in an additional business ~ n Signature Address 2109 Union Rd' Iowa City, IA. 52240 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. HCDC Application March 2008 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 19, 2009 Household Size 30% Median Income (Poverty Level) 5096 Median Income 60% Median Income 8096 Median Income (low income) Median Income 1 $15,950 $26,600 $31,920 $42,550 $53,200 2 18,250 30,400 36,480 48,650 60,800 3 20,500 34,200 41,040 54,700 68,400 4 22,800 38,000 45,600 60,800 76,000 5 24,600 41,050 49,260 65,650 82,100 6 26,450 44,100 52,920 70,550 88,200 7 28,250 47,100 56,520 75,400 94,200 8 30,100 50,150 60,180 80, 250 100, 300 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, PLEASE INDICATE IF YOU ARE A MEMBER OF EITHER OF THE FOLLOWING CATEGORIES: Lower Income (see table) Receive Rental Housing Assistance Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint a person or persons with expertise in construction, finance and/or a person receiving rental assistance. If you have expertise in construction or finance, please describe your experience and/or training. HCDC Application March 2008 page 4 of 8 CITY OF IOWA CITY r =~, Advisory Board/Commission/Committee ~'.-,~~~~ Application Form cl- o IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. MISSION/COMMITTEE NAME ~a,str~Aµ~~w~w~yr`1~ D~Je[c~p,µe.~~ TERM Z~°~ - ?mil 2 NAME NNdrQw C,~Nat HOME ADDRESS ~ (~ Qi Q-~f \~. 1 o vro~ ZIP ~ Z?1~ ~ 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? ygVSl o~ [q~4 i-o pY~~~ OCCUPATION Laly.~~C.1r EMPLOYER ~o~.Soy~Cw,~-y~o-ry~ea/s ~C. PHONE NUMBER: HOME ~~ ~ • 35q .707 3 BUSINESS 3!-°!. '~ ~°~• ~o lob EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Z~irYe o~, ~S~ r'Qce~v~-C~.c~-Y~-2.r~e~vfea,.fC.4s,~ti1M.5~sP~ovt. _ ~0.~e-Se-rVe-~o,n~c~oS~'~eo11~~eVear~ pr~~Qs.Slor~~~ Corti-~M.J}~e.QS~iVI.f.~v~~y~ {~.,Q Towa~~-~ ~~ ass' ~ S+YQ-1.~ i c P [~,~q C~a~~, a~ z s 6A J ~ Y y t SwS~YVC~10y`$CdVU~~~~e, ~ SvPv~nn~Co~v"~ GYr~e~/a-~cCe~~N~,~n.~SsfoKyOwLd I avv~.~eQa1 CDVY~S~~ •o Sc~J'er'a~,l ~o~.NSQreovy~,~ ~oa~r~.-s a-K.d Ca~u,-n~T4Sfo~S WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~} ~,,kes ~Q~~ ~ ~m ~ City Cov~l re~Ax'~.~IV1~ Ci~'s lj~bli C ~.ovSir.q poLic~y o.~ 2J(, .ey~~~~~o r Q-8. pvb~s~ vv~~ ~i-a1,s d I~o~~S p ~b L a c 1^.ear t ~s ar.,~ ~~~~a~~S p v 6 4t ~ 1 r~.P v~- o ~n ~s~~ rigs. 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 applicat' HCDC Application March 2008 Page 1 of 8 AU G 12 2009 City Clerk Iowa City, Iowa l~ P "~ WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? S' ~ `~` ~,~ ~ ~ ~r~v.~V~[R on. rs t~G~-~ ~NMfWI~S-~vts ear Codv`w~3~,~.s v~r J ~~ al~ew iIV~ ~- ~ o W o ~~L W ~-ti` w ~ ~ a (~ YeXS 2 C~ Y25vP a ~ C.4 r~.~rv~~~+n ~ e~Y"S o~.N d c~v~ cl~-~ ~tC.~c- v P o v~ a~ra. ~ vbs~e.~v.~rtQ wor1L ~Q,,~. wtQC~ ~ b-•~ ~ort.e. _ ~' a~ ,nn~ ~ e~ ~ ~~ e-KCR w ~ C-o go o,~~s o--1a~ (~, ~~ ~.,~otn,~ w i~~ qZd~ w..~ a k~.~ v-r~~~-~ m I~w~o•~ A.a~vz~e,ry ~ re.c-a,~t,>N~u~d.Jxy body.{ ~ ~nov~~ p ~ o~~. Z~ a1,ze ~~w~ ,M,e ~ v~r~~~c( ~~ ~rv~,- P o r~-a.~v,c~~ ~ ~~C.i ~,~~ ~ ~1 ~o~i c ~y.,p~r~ . ~-z ~~ , S b e-I,d~rQ ~ o-vv` s-~r>~~-N~ ~,vi c~k ~~-.r~vy- paM~- o,-v-ti wi~v~ '~ c~ }~,~ ~- iinn_Q n.ec.~so~1 ~a c-o -~r1~i v~-e- ~ F~n~ ~ w-. n~.~ s srav~ _ 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 (see page 7). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. T kwew o~ v~o P~~w~-aic~., ~oV~~-~c:~-S ~'row• Z c~v\~ aq~~ ro.~ pb~~v1 c~ cmv~~c~- CovV~s ~ Soon ~~~~ ~ov~,~'~-.~ c ~r~r~~-y e ~ }~~~ p~-rsa~l ~v~s~s. s ~-1.c~~#. i~ vw~ r~ 1,~ ~s ~. ~ ail do ~~ kv~~o~ a~ ~-I~~,~- 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. HCDC Application March 2008 Page 2 of 8 AUG 12 2009 Ciry Clerk Iowa City, Iowa 1 ~ ~~,~ ~~ r i "m~'` ~ • ww®~~~ BOARD, COMMISSION, & COMMITTEES -+t.ay_ BUSINESS LISTING CITY OF IOWA CITY Name of City I, Board/Co mission/C~o1mmittee PtbvSi~~Carn~-~,~nTvv~~y~e„/Q~I~-vr.~ Date °~'I12Ic'9 Name ~KC~,r~ ~a-Ap~~ Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none . ~ BUSINESS NAME ~ BUSINESS ADDRESS ~ A Iowa City, Iowa NOTE: Anew form must be completed it the above information changes or an ownership interest is ac fired in ition sines. / ' ,,3C ~"~ Signature - Address ~ ~ ~ ~ ~ O 1/f ~ 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. HCDC Application March 2008 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 19, 2009 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $15,950 $26,600 $31,920 $42,550 $53,200 2 18,250 30,400 36,480 48,650 60,800 3 20,500 34,200 41,040 54,700 68,400 4 22,800 38,000 45,600 60,800 76,000 5 24,600 41,050 49,260 65,650 82,100 6 26,450 44,100 52,920 70,550 88,200 7 28,250 47,100 56,520 75,400 94,200 8 30,100 50,150 60,180 80,250 100,300 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, PLEASE INDICATE IF YOU ARE A MEMBER OF EITHER OF THE FOLLOWING CATEGORIES: N° Lower Income (see table) Ne Receive Rental Housing Assistance Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint a person or persons. with expertise in construction, finance and/or a person receiving rental assistance. If you have expertise in construction or finance, please describe your experience and/or training. = Ina,-~ No SPe~~Q-~o~ea QX~2Yte~_e iV~ e-~t~hax ~-~Trv~{~.Ib+'~ar i-Tv~4~+~e~2, ~.t~~l~ HCDC Application March 2008 page 4 of 8 City Clerk Iowa City, Iowa l ~3oP~~ 17c NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: POLICE CITIZENS' REVIEW BOARD Two Vacancies -Four-year Terms September 1, 2009 -September 1, 2013 (1) Peace Officer (1) Eligible Elector Duties of the Police Citizens' Review Board include reviewing Police Department investigations into allegations of misconduct lodged against police officers, conducting further investigation of the complaint when the Board deems it necessary, and issuing a public report which explains why and the extent to which the complaint is sustained or not sustained; maintaining a central registry of complaints against sworn police officers and issuing annual reports regarding the disposition of the complaints to the City Council; reviewing police policies and practices from time-to-time and recommending changes to the City Council when the Board deems it appropriate. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. However, the City Council reserves the right to waive the residency requirement for good cause shown. The City Council also reserves the right, for good cause shown, to waive the requirement that the Board include one current or former "peace officer" as that term is defined by State law. "Peace officers", sometimes designated "law enforcement officers", include: a. Sheriffs and their regular deputies who are subject to mandated law enforcement training. b. Marshals and police officers of cities. c. Peace officer members of the department of public safety as defined in chapter 80. d. Parole officers acting pursuant to section 906.2. e. Probation officers acting pursuant to section 602.7202, subsection 4, and section 907.2. f. Special security officers employed by board of regents institutions as set forth in section 262.13. g. Conservation officers as authorized by section 456A. 13. h. Such employees of the department of transportation as are designated 'peace officers" by resolution of the department under section 321.477. i. Employees of an aviation authority designated as 'peace officers" by the authority under section 330A.8, subsection 16. j. Such persons as may be otherwise so designated bylaw. Applications must be received by 5:00 p.m., Wednesday, August 12, 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 Police Citizens' Review Board should be directed to Kellie Tuttle at 356- 5041. 7/7/2009 j ~ O O til zz~~~ O O ~ ~ ~ e~ V1 Vi H !D f9 '~ fD ~ ~ ~ ~~+ f9 Vi "7 f9 ~C ~ G~ t" ~, d b~ ~ O C ~ ~S A p A~ O ~ ~ ~ ~ UQ ~ ~ ~ ~ ~. ~ ~ ~+ ~ ~ r-+ ~ ~ r-~ ~ ~ \ N O ~O O ~O '-' ~-' ~ N b ~ ~ ~ ~ ~ W C W A ~/- 7 ~ y ~ yy ra ~ .A N ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ I ~ ~ ~ ~ ~ 0o ' y C~7 K d ~ ~ ~z d o~ ~~ 0 r n r~ ~, r~ 0 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: 1 Females: 2 Council Announcement Date: July 6, 2009 Application Deadline: Wednesday, 5:00 p.m., August 12, 2009 Council Appointment Date: August 18, 2009 '"* Appointments to the Board shall include one current or former "peace officer" as that term is defined by State law. The City Council reserves the right, for good cause shown, to waive the requirement that the Board include one current or former peace officer. ** The City Council also reserves the right to waive the residency requirement for good cause shown. POLICE CITIZENS' REVIEW BOARD One Vacancy -Four Year Term (Peace Officer) September 1, 2009 -September 1, 2013 Term expires for Greg Roth Greg Roth ^D (Currently serving 1St 4-yr term) 324 4th Ave Joseph Treloar ^D 741 Alpine Drive Chris Bryant ~ 3324 Lwr W. Branch Rd One Vacancy -Four Year Term September 1, 2009 -September 1, 2013 Term expires for Michael Larson Simeon Talley D Greg Roth (Currently serving 1St 4-yr term) 350 Cayman St Apt #6 324 4th Ave (Also qualifies for Peace Officer) Vershawn Ashanti Young ~ Joseph Treloar ^D (Also qualifies for Peace Officer) 263 West Side Drive 741 Alpine Drive Daniel Tallon ~ Chris Bryant ^D (Also qualifies for Peace Officer) 320 S Gilbert #1011 3324 Lwr W. Branc h Rd Christine Walters ~ 1033 E Washington St Stephen Vlastos ~ 1346 E Bloomington St D Denotes applicant completed the Confidential page of the application. City of Iowa City ~ ? i Adviso BoardlCommission/Committee ~ ~-'' ~`'~~ Application Form -"`-'s-- 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 forrI 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 (~P,~t„~~-/~ ~1~'~~~d~ v~~'~'~ Term ~bb4 " ~ l 3 Youth Advisory Commission (shall not be more than 18 years of age at the time~bf..application) Name of Iowa City High School or high school equivalent: ~ =~.; ixl Signature of parent/guardian: -~'- ` x., NAME HOME ADDRESS ~~7 7 ~~' ZIP .~~~ Is your home address (listed above) within the corporate limits of Iowa City? How long have you beenfa-, resident of Iowa City? err OCCUPATION ~i~~I/'{'( ~L~ PHONE NUMBER HOME ~/~ ~ ~~ r7~ BUSINESS ~ 'es ~ No ~~ U r5 . G1(riv~ 1 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~~ ~~~f~~2~~ ~~`~~~~ C«y~~> ~~~lz~~ ~,~~t~~~ L~~~ ~~~~ ~f~ ~ ~~~ ~~~~ ~~~~~~~~~~ ~~ 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? Url~~"yfYtu-~au~~"_IJ ~'~~ .e~~`~~ki~ryt e-F y~ .~v~. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ~~~ ~~f~~-~%~~ ~~~ ;~-~: ~F~ E/~~iirr~~ __~ "`~Vi ~' ~r>w ~~~l~I~ ~~~~ ~`. ~ ~ .AC'S .. ::~ 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 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 3565030. _ < A ~~~~ ~~~ r'S 4~,t~ ,~ 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 QNo (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 . ~~Z~ Board/Commission/Committee ___ Name 1`G~I/~ ~~~®~1 ::VIII +' p ~~ -~a.as_ 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 ~~ ~, , .__. ,a. -,~ -~- `: ~- ,> ~.~ c~ NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional~xisiness. n ~ Applicant Signature Signature of parent/ uardi Address Commission only): 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 ~ r i Advisory Board/CommissionlCommittee ~',~~"',~"~'~~ 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 RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name /~OtTCC~ ~Z7~.ZZt~c/S /z~')~"~'li/ pq~l7Term ~S NF~p~,~ 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: 'qME ~/'C~S e'/~.S/ 13 T"k'ELO~/~ HOME ADDRESS 7y/ ALl~.fir/~ O~~V~ , ,~o,~//~+ GZ">Y, Z~ ~ /~} ZIP 5`2 2 S/ ~ 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? IC" ~.c~~,e5 OCCUPATION ~2c~~~- ~©~~`PARoL~ o~~'~~c~ ~ T~ EMPLOYER~>~r~~ ~~~orcrA~ nts>,~~ci ,~-c~S. PHONE NUMBER: HOME C3~1,) ~3 t//- 80 8 d BUSINESS- ~~~~ 5"~ 2 ~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: M... .. ~ ~~ . ~~~ .~J .. r :~ - W' 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? ~ F/A /~ ,ri9~l1'c ri! ? ~LC,p r1;'s~'CF k/ZfN ~'/t ~ 0k/ Z r~/F~1~tJFo~Q M A fl'pit/ A BoVJr 7'"/~E'~fOARDQUr~I,4d~i/E!/C/Z Cor/~ACT~/7 >f>~ r~oA2Q oil ~~L C.p l WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? C PG c~As~' s ~~ A TJ"A-C Hc6"~ G ~'n'~'/Z ~ ~; ~.+:,~ __ t ~ ~~. `,? .•.. :~ .. fi l.It 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 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. njo sC,Jr~~~l cO~JfL~ c~rs or" z'~/T~% ~5% 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 ~ .:III ~"~ BOARD, COMMISSION AND COMMITTEES ~'~~''~ BUSINESS LISTING -~.~ CITY OF IOWA CITY Name of City Board/Commission/Committee ~Q~ ~'c'C C »"~ 7 r.J /~Fl/~'Ea/ g®.4~ Date ~ 7 - 2 9-v,~ Name ~o ~ T ~'L 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 _ + ... ~1 S ~ I~_., Y •. NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional bless. Applicant Signature ~ Signature of parent/gu Address outh Advisory Commission only): 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 Joseph B. Treloar 741 Alpine Dr., Iowa City, Iowa 52245 (319) 341-8080. (319) 430-9983. joe.treloar(c~iowa.gov Professional Goals and Interests: I desire to advance the excellence of probation and parole in Iowa, promoting the good of our communities by making them safer, and offering new opportunities for offenders to achieve a more productive life. To achieve this goal, I am committed to serving to improve the criminal justice system in whatever capacity I am able. Education: Master of Organizational Leadership, St. Ambrose University, Davenport, Iowa, Bachelor of Arts in Criminal Justice and Philosophy, Morningside College, Sioux City, Iowa. Professional Certifications: Certified Law Enforcement Officer, 49th Basic LL.E.A. L.E.I.N. (Law Enforcement Intelligence Network) Certified, Iowa. Career History: Currently Residential Counselor, P.P.O. II, Hope House, Coralville, Iowa, 2001 to present. Field Probation Officer, P.P.O. II, John R. Stratton Center, Coralville, Iowa, 1999-2001. Chief of Police, Dysart, Iowa. 1990-1995. Police Officer, Perry, Iowa, 1987-1990 Loss Prevention Manger, Foley's Department Stores Inc., Dallas, Texas, 1986-1987 Private Investigations, Pinkerton's Investigations, Dallas, Texas, 1985-1986 Woodbury County Jail, Sergeant, Sioux City, Iowa, 1981 Police Officer, Centerville, Iowa, 1979-1981 ~ .-~ Campus Police Officer, Iowa State University, Ames, Iowa, 1976-1979 ~~~ Independent Businessman, Treloar Trenching, Ogden, Iowa, 1974-1977 '~ -,- - ...%: Awards and Honors: Socratic Prize, Morningside College. "~ ..~ Community Service and Interests: Former member of Board of Directors for the Emergency Housing Project, Iowa City St. Mark's United Methodist Church: Member of Staff Parish Relations Committee (former), Member of Board of Trustees (former) ,Youth Sunday School Teacher, Confirmation Assistant Teacher, Youth Mission Trip Chaperone, Men's Reading Group, Audio-Visual Leader. Boy Scouts of America: Life Scout, Assistant Scoutmaster, Troop Treasurer, Scoutmaster. Iowa City Noon Kiwanis: Past President. Masonic Lodge of Iowa r::`~.i .~. 'a '.~ WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPYLING)? I started my police career as a part-time officer in my home town of under 2,000 people. These were people who knew me and my family for generations before I was born. From the start, I realized that my job was not only to enforce the law, but to enforce it is such a way as to be of maximum benefit to our community. Being a police officer in the 1970's was not glorified in the media as it is today. Television shows such as COPS and the like did not exist and being a cop was by no means prestigious. Being a police officer was a service position. If a police officer was not fair, impartial and friendly, they did not have the respect of the community and were crippled in their ability to perform their duties. Instead of talking with them, people would avoid them. An officer who did have the respect of their community also had the community working with them to enforce the law and ensure public safety. Our sheriff once told me that he solved more crimes over a cup of coffee than any other way. What he meant was, if the public trusted and respected you, they would do whatever they could to help you. In the final analysis, people want safety, security and freedom. Community Policing is nothing more than bringing this small town familiarity and respect for law enforcement to bigger cities. It is the core of what I believe effective law enforcement is all about. In my personal life I have enjoy studying differing religions and cultures. My studies are not only academic, but have involved spending time with people of differing religions and cultures. This is largely driven by my passion for justice. Religions and cultures bring different nuances of what justice is to the table. In my profession I work with very diverse populations. Open- mindedness is the key to success in my business. Since Iowa City is without a doubt the most diverse city in Iowa, having an understanding of differing cultural and religious views of justice will be very beneficial when pursuing just ends. My experience and training in investigations, both as a police officer and in the private sector, have given me the ability to conduct fair and impartial investigations. In my current position I make sentencing recommendations to the court when offenders violate the conditions of their probation. These recommendations are made after a thorough investigation into the circumstances of the case, the history of the behavior of the offender and the impact of the recommendation on public safety. Though we work closely with the County Attorney's Office, my recommendations are impartial and are sometimes very different from theirs. I believe my input on police actions, policies and practices may help to insure that police officers perform their duties in such a way as to maximize the safety of the public and the officers Both the public and the police benefit when the police are perceived as being trustworthy, caring d '`t`~i vigilant. To achieve this, it is necessary to have both and understanding of the letter of xhe law and the spirit of the law. My experience, education and training have prepared me to ~~i~:rve the ~~` city well in this capacity. ~ F" -"' ~= .-~ '", . . City of Iowa City - r i ~..=.®~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 F.OR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name ~('At C~i ~i~~it/j' AEt/1~'tilJ ~C)o~~~ Term ~ 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 HOME ADDRESS r;, o ~,:, +C' -~ .. ZIP S^~ ~~ Is your home address (listed above) within the corporate limits of Iowa City? Yes ~ No How long have you bJleen a resi/dent of Iow.a~City? ~~2~~.5" OCCUPATION ~.f,~ .hJ~ m'~/~o~.~~ EMPLOYER /I~~ PHONE NUMBER: HOME ~,~~',~~ J6 ~',S BUSINESS J„ l_3 ~xo ~~,~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: .1 h~ rec. 7 ~' ~S d'~ ~xie.vc C. u,~ ti. pi4T,~/~ii,~~v~ i~J,SZ~tcc7crcJ ~'~~'~~i'l~i~f M.~1s~~'~P~AI ~! /J r , ~ / 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? / ~((~-~ .LIE`~S6/yti~'/ f~2~`49.~. I ~ - -_ WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ~, ,~Gc'i,S'i.,,itlf /Qe'~ ~~ :~7 , ~t t POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on interests,including financial interests and your duties to an employer r• ytP .~ ~~ ::~ the advisory board and your personal 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 ~ 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 ~ .:III ~"- BOARD, COMMISSION AND COMMITTEES ~~~"'~ BUSINESS LISTING -~•~c.a~ CITY OF IOWA CITY Name of City " , ,~ Board/Commission/Committee ~/~~c (--s~J~~.d-~.s~ .f~~.r.~.d.~r> Ja Date ~~~/E~Wd~ Name. N, Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 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 m ,~• .~=; °~ r~ -~.. ~--~, ~ ~,` ~ :~ NOTE: A new form must~~~bg.~~pleted if the above information hanges or an ownership interestis acquired in an addition use ~'~ ~j~ Applicant Signature- Signature of parent/gu Address ~.3?_~ .~.a~ n (YQutfyAdvisory Commya'sion only): 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 1 City of Iowa City ? Advisory Board/Commission/Committee ~' ~"'~`'~~ ,,,,,,®,~v'-,~ ,application Form ~`-"-- CITY OF IO~NA CITY Individuals serving on BoardslCommissionslCommittees 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 a!i applications during the work session. The appointment is made at the next formal Council meeting. Appointees serrre 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 BoardlCommissionlCommittee Name Police Citizen's Review Board Term 2009-2_010 Youth Advisory Commission (shall not be more than 18 years of age at the time o~piic~tion), Name of Iowa City High School or high school equivalent: '' -"~ ~' 4 a Signature of parent/guardian: -~ ~-~'3 ~ ,: qME Simeon Talley HOME ADDRESS 350 Cayman St. Apt. #6 _ Zlp 52245 Is your home address (listed above} within the corporate limits of Iowa City? 0 Yes ~ No How long have you been a resident of Iowa City? 6 months OCCUPATION STudent EMPLOYER PHONE NUMBER: HOME 202-657-9102 BUSINESS EXPERIENCE ANDlOR ACTIVITIES WFi{CH YOU FEEL QUALIFY YOU FOR THIS POSITION: Most of my experience relates to partisan political activities. Yet I do have the desire to contribute to the Iowa City community in a more meaningful and local way. 2006 -Chet Culver Gubernatorial Campaign 2007 -Staff, YES Committee for SILO (School Infrasctructure Local Option) Sales Tax 2007 - Obama for America Field Staff, Iowa City, IA 2008 - Obama for America, Deputy Director for the African American Vote, Chicago, IL 2008 - Obama-Biden Transition Team, Staff Assistant Intergovernmental Affairs/Office of Public Liaison Misrepresentations on this application wifl constitute just cause for removal of an appointee. If you fail to answer all the questions, Councii may not consider your application. General Application December 2008 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? A friend encouraged me to apply. My understanding is that this board works with the council and the policy to resolve disputes as they relate to the police and make recommendations on how to improve relations between the policy and .he community. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? believe that I'll offer a thoughtful and well reasoned approached to matters that come before the committee. I think that I have a unique perspective being a student, being a person of color and also as someone who has chosen to live in Iowa City from another state. My previous work on political campaigns has afforded me the opportunity to meet and organize people from diverse and various backgrounds coming together for a common cause. POTENTIAL CONFLIGTS 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. "Affil{iation" 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 u~Ccertai~whether a potenfrai conflict of interest exists or have questions about Section 362.5 of theCode of~'flwa,~ ase contact the City Attorney's office at 356-5030. ~=. ~. f ..~ ~_ :~~ ,~ .~, _ - _ .° ~. [F YOU AR~r~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 far removal of an appointee. l# you fail to answer all the questions, Counci! may not consider your application. General Application December 2008 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/CommissionlCommitte~olice Citizen's Review Board Nam~imeon Ta _~ r -~- 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 ~ -; c ""-- NOTE: A new form must be completed if the above information changes or an~~ner`s~Tiip Testis acquired in an additional businef s. ~J ~ ~' ~' / 1 ~/ ~ Applicant Signature Signature of paren#lguardian (Youth Advisory Con(irnission only): Address 350 Cayman St Apt #6 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 ~ r 1 ..1.1 Adviso 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 BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name PCRB--Police Citizens Review Board Term Begin 9/01/09 Youth Advisory Commission (shall not be more than 18 years of age at the time o~applica~Jon) Name of Iowa City High School or high school equivalent: . . , ~ ~ . Signature of parent/guardian: t~~AME Dr. Vershawn Ashanti Young -'-'- O ~ ; HOME ADDRESS 263 West Side Drive,_lowa City, IA 52246 ZIP'' S224~ 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? Six Years, 3 months OCCUPATION Professor EMPLOYER University of Iowa PHONE NUMBER: HOME 319-354-4308 BUSINESS 319-335-0186 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I have a number of experiences that will transfer into my role as a member of this the PCRB. I have worked as a minister, high school teacher, elementary principal, and college professor. All of these roles involved working with groups, serving the interest of constituencies and clients, resolving and mediating conflicts, engaging in tough and difficult conversations/dialogue, building trust and confidence among various/competing groups. In these activities, I have striven to achieve objectivity, envoking empathy when necessary, but always with a mind to pursue the best interest of all involved. In addition, as a monthly writer for the Iowa City Press Citizen, I often keep my eye on issues of social justice both on the local and national scene. These experiences and activities illustrate both the interest and expertise to deal effectively with others and engage concerns of Iowa City citizens for common good. 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 15 YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I fully understand that the PCRB is a review and recommendation making body. It reviews complaints, police policies, and may advise modifications. The success of PCRB is noted by the recent amendment to the City Charter (which ~ssed by 72%) to make the PCRB a permanent City board and to give it subpoena power. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I will make a considerable contribution to this board for several reasons: (1) I am the son of a police detective in Chicago. I know some of the hard decisions that go into the role of law enforcement; I also know from accounts that some policies and precedures can improve some of those hard decisions; (2) I have personal experience as someone who has been the recipient of police behavior that could lead to complaint. Although my cases have been comparatively mild in light of other cases that ended in physical harm or even death, they were enlightening episodes nonetheless. In a recent high profile arrest of Professor Henry Gates, Jr., of Harvard University, the president of the United States linked that arrest with the ongoing experience of some people in the nation. Iowa City is improving in this regard, and as someone interested, knowledgeable and experienced in various facets of law, politics, human behavior, and interpersonal interactions, I can contribute to that continuing improvement; and (3) my ability to communicate orally and in written form, I can contribute by participating in healthy dialogue and deliberations, along with equally interested and qualified citizens. _, J ~_.., J ~ «... .. i rtamr POTENTIAL CONFLICTS OF INTEREST - ;~_ ~~~- Please identify any potential conflicts between membership on the advisory board a~c7~=your perse~a{ 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 recor~nendons tothe amity Council about the allocation of City funds, please list any present affiliations you have with a~nciesthat 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. 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/Committe~CRB--Police Citizens Review Board Namur. Vershawn Ashanti You ~~~.®a't ~-' "'Wj°a~~Il -+t.as._ CITY OF IOWA CITY Dat®7/23/2009 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 spouseldomestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sale proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME ~ BUSINESS ADDRESS ~ There are none. . ~.. _. ; ~. ~w f i~~, ~ C ,~~ ~ N NOTE: A new form must be acquired in an additionalrbt Applicant Signature :~~ Signature of parent/ ardia outh Advisory C~ Address 263 West Side Dr' ,Iowa Cit , IA 52246 above ~orm~n changes or an ownership interestis only): 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: the3rdiowa@mchsi.com Sent: Friday, July 31, 2009 8:41 AM To: Council Subject: Letter of Support Mayor Bailey and Council members, I am writing to support the application of Dr. Vershawn Young for the Police Citizens Review Board. Dr. Young has lent a powerful voice to the community both as an educator and a contributor to community discourse. With recent events around racial tensions and police interactions with the public, Dr. Young's presence on this board would be seen as a positive affirmation. Garry Klein 628 2nd Ave Iowa City, IA 52245 7/31 /2009 Page 1 of 1 Marian Karr From: Venantie Nduhirahe [vnduhirahe@yahoo.com] Sent: Sunday, August 02, 2009 4:34 PM To: Council Subject: Re: Vershawn Young Mr Young will be an asset in the Police Citizen Review Board. Venantie 8/3/2009 Page 1 of 1 Marian Karr From: Icm-elca@uiowa.edu Sent: Monday, August 03, 2009 1:38 PM To: Council Subject: Vershawn Young-Police Citizens Review Board To Whom it May Concern: This message is in support of Vershawn Young as a potential appointee to the Police Citizens Review Board. I attended the public forum at the Iowa City Library on July 29 which was led by Prof. Young in response to the shooting incident involving John Deng. Mr. Young did an excellent job of addressing the issues at hand and mediating public comments, some of which were quite emotional. I think he would be an excellent addition to the Review Board. Sincerely, The Rev. Robert Dotzel, Campus Pastor Lutheran Campus Ministry - ELCA Believing Boldly in God's Grace 109 E. Market St. Iowa City, IA 52245 319-338-7868 www.uiowa. edu/~lcmelc a 8/3/2009 Marian Karr From: Idleah2000@yahoo.com :nt: Wednesday, August 05, 2009 11:36 AM ~ o; Council Subject: I support Vershawn Hello, I recently received an email about the possible candidacy of Vershawn Young. He seems like a very good candidate for city council and I would support him. My name is LaSharon Duckett Sent from my Verizon Wireless BlackBerry 1 City of Iowa City _ - r 1 Advisory Board/CommissionlCommittee ~,~~"';~'~~ 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 RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name 6 ' `-~ ee`~~~ ~~" Term i Youth Advisory Commission (shall not be more than 18 years of age at the time of:~applicati~n) Name of Iowa City High School or high school equivalent: Signature of parent/guardian: ~t HOME ADDRESS ~z~ ~- G ~~ 1~e-t~ ~ IC~~ L Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? ~ ~--~ OCCUPATION ~ r ~b`, ~~ ~ ~~x-~~~t~- PHONE NUMBER: HOME 63 Z 1 ~,~1'-4- '~~ v.:;-~~ u ~-~,; r' ~::_ ~ --~ , 9..a.1 _y ,~ .. ZIPS ~~ Yes ~ No EMPLOYER t~.w l~ 1~~,;~1 fx„~r~ Vol~y°'"` BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: r ~ ~-`- N~r+ ~CY~~I.~SC'J~ ~ r?~CJ{S~ 4~('~'~(~> C1,/L~ d~tl.J V~-~ ~4-C.-~ ~ ~ .c-~ l.y ~"~'~- ~ c.-~ ~ 1. f? ~\ ~ ~ ~ U ~ a 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? n (,~ rcX C v t `~ lit-S' ~' ~'`. c~c~° u~Y- ~.~5-~,..-e c r'I C'G y~ 1 G~ •jc ~,+ ~~~ ~ ° ~~ WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ~~ ~~ ~~4 C,ce ~'av;~ ~-rc~.. ~ s ~ C~-.~ 0 ~~ S S C~, Z /~~GYf^!- ~~.. y e ~~ e di r ~~ J ~Ct;t,•~- ~~-~e ~,,, ,~k Gc ~~ ~~~ z~l ~- f s T ~ `• 1. tt ~~ V( Vn ' U t U,cti~ ~b ~ r< c~c~j . ~,a~ ~ ~ y~i"~o POTENTIAL CONFLICTS OF INTEREST o' 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 certainmporta[t'texceptions, a member of a city Board or Commission from having an interest in a city contract. A copy. ofSec'tion 362.5 is attached (see page 6). - _~ ~~~ If you are uncertain whether a potential conflict of interest exists or have questions about Section ~i~.5 of tnecoae of Iowa, please contact me ~.uy r~u~i ~~cy ~ ~~~~~~ a~ ~~~-~~~~• ~ ~ ~ ~ ,.~; _T yt.. ~.~,., 'f„` .. ~~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD O 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 ~ ~~-~ Name ~~~~ ~~ ~~~®~f ~'~ wY, ~ "Ri~ -~a.as__ CITY OF IOWA CITY Date c ~u\ OG 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 alt 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 ._ V3 ',_ ,~, "'7 ~.\ i,~ ,:% .... 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 ~ Zd ~- ~ ~~ L- ~ `~ b ~. ~~ZZ~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 2008 Page 3 of 7 City of Iowa City ' r ~~®~r dviso Board/Commission/Committee ~.~~"',~`'~~ A ry _,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 Police Citizens Review Board Term 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: "4ME Christine Walters ,_.,, r . *y '" ~ ~- i Y `'`~~ arce:>~ua _ _ HOME ADDRESS 1033E Washington St Iowa City, IA 52240 ~Ip. 5224fl ;-.+ - rT; Is your home address (listed above) within the corporate limits of Iowa City? ~ Yew ~;; ~lo ~;.,~ .~- .. t How long have you been a resident of Iowa City? 6o Years OCCUPATION Librarian EMPLOYER University of Iowa PHONE NUMBER: HOME 319 466-1134 BUSINESS 335-5919 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I have attended the Police Citizen's Academy so I am somewhat famuliar with law enforcement and I have an interest in being a good citizen who takes an interest in civic affairs. 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? I have looked at the mission description and read the meeting minutes. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE RFA~(~N F(~R APPLYING)? I haven't served on any local committees and I think I have the time to spend working on this committee. . _„7 ,:.. ~,+~ ~Y r.'YaJY ~~ .«.-~ i ~~ ~- Q F~ v 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 knowthatSection 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. I work as a substitute librarian at the Iowa City Public Library. 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 ~- `~~~~~'~ ~ *~ war®'~~ BUSINESS LISTING -•n.a~_ CITY OF IOWA CITY Name of City Board/Commission/CommitteePolice Citizens Review Board Dat@8/05/2009 NameChristine Walters 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 'a ~. ~.~ . ~ ..~~. ~~,. .. ._ fa y ~~T NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. U' M~1 W ' VIJI~.rb Applicant Signature , Signature of parent/guardian (Youth Advisory Commission only): Address 1033E Washington St Iowa City, IA 52240 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 , ~ 1 ~r _ _ Advisory Board/Commission/Committee ~;~~'~ ~''~~ 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 FORA Y VACANCY DURING THAT TIME. ~ ~j ~` ~ ~ Advisory Board/Commission/Committee Name erm ~ ~- Youth Advisory Commission (shall not be more than 18 y rs of ag at th im of 'cati n) Name of Iowa City High School or high school equivalent: ,. ,~ Signature of parent/gu rdian: ` ;-~, s~ NAME ~ ~ ;.t ~~~ - ~,, Adm. _. ~. _ `'i HOME ADDRESS h ~ ZI~j'--~, Is your home address (listed above) within the corporate limit,.. of Iowa City? Yes ~~ ijln How long have you be a resident f ow City? _ OCCUPATION v~ ! EMPLOYER PHONE NUMBE :HOME BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~z~ ~°~~`~~dµQ~w I~ a ~~^ ~ fqJ ~~~w~ ,~ ~~~ 1~-c~~~w~J1lfacesinn~,1l~r~ rli~/w~'1 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? irk i- ~~~ V WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD- (OR STATE REASON FOR APPLYING)? ~ ~~~~~ ~~~~d~ ~~ ~~, ~ _ ~- ~~l ~~rK n~~ c~ POTENTIAL CONFLICTS OF INTEREST ~ -%- ~ ~.~,,. Please identify any potential conflicts between membership on the advisory board'; ~~d ~/o`ur ~'~sonal interests,including financial interests and your duties to an employer. =` i~~;~ c.~ particular, if you are applying to be a member of a board or commission which makes re~i~nmendations tothe ~~cy Council about the allocation of City funds, please list any present affiliations you hake with.cagenciesthat 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 Citv Attornev's office at 356-5030_ S. ~L2w~ 1(~ ', ~, 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/Commi Name _,! r ~ ~! ~"m~ ,~ "~®'~~ -•t.as~ CITY OF IOWA CITY Section 362.5 of the Cade 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 ,, :, ~;, - , ~ _. 4.. .~. `, ~.. ,: .v :~ -- NOTE: A new form must be acquired in an additional Applicant Signature ~- Signature Qfpar~nt/gua Address ~ ~~~/~ pleted if the above information changes or an ownership interestis Commission oily): 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: Peter Small [psdfliowa@yahoo.com] Sent: Saturday, August 15, 2009 2:18 PM To: Council Subject: I support Vershawn Young's application for the Police Citizen's Review Board Dear City Council Members, This is to let you know that I support Vershawn Young's application to serve as a member of the Police Citizen's Review Board. I attended the meeting he organized at the end of July in response to the shooting of John Deng. Mr. Young strikes me as afair-minded individual who would bring a valuable perspective to the review board. Thank you for considering my views. Sincerely, Peter Small Iowa City resident 8/ 17/2009 Page 1 of 1 ~1 L Marian Karr From: Michael Larson [mslarso@yahoo.com] Sent: Tuesday, August 18, 2009 2:20 PM To: Council Subject: PCRB: One vacancy -Four Year Term (Peace Officer) Greetings, Please accept this email as my support for re-appointing Greg Roth as Peace Officer representative on the Police Citizens Review Board (PCRB). Greg represents the Board extremely well and brings a wealth of knowledge and experience to our discussions as a retired ICPD Officer. There are certainly other qualified applicants for Peace Officer representative, however the intimate knowledge Greg brings to the Board is invaluable. Please contact me should you have further questions. Regards, Mike Larson Chairman, PCRB 8/18/2009 i~a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: YOUTH ADVISORY COMMISSION Two Vacancies -Unexpired (+) Two-year Terms Effective Upon Appointment, ending December 31, 2011 Two (2) persons - At-Large 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, August 12, 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.orq. Questions about the Iowa City Youth Advisory Commission should be directed to Marian Karr, City Clerk at 356-5041. ~ZQOX ii ~m„ u a 0 o DDS ~ N y ~ ~D lD ~ rt '~ '~=m ~~x ~ ca c ~ O N ~D A ~- 0 -~ c 3 ~ ~ `. m ~ ~ -` ~ C ~ ~i ~- ~ `- ~ ~ ~ c~ ~ ~- ~ v ~ G) Z m N w 0 (O N w 0 CO N w ~ O N w ~ O N w j O N <~ o CO N w 0 Cfl N w 0 O X :o ~ z ~ ~ ~ z z z z m ~ ~ ~ X x x x ~, z z z z z Z Z Z Z Z N X x x x x )C >C X m X x x x x x x x w X ~ X X m X m w x x x m x x ~ x x x x x ~ m y X ~ X X m ~ x N X ~ X m x X v+ X ~ X >C >C ~ X 'N x ~ x X m ~ X V ~ O _ mD 3 ~ v~ ~* D z O v o m~ o, o ~ C7 ~ ~ m0 ~~ 0 v~ 0 Z 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: 2 Council Announcement Date: July 6, 2009 Application Deadline: Wednesday, S:OOp.m., August 12, 2009 Council Appointment Date: August 18, 2009 (Recommendations to be made by Council liaison) YOUTH ADVISORY COMMISSION Two Vacancies -Unexpired Term + Two-yr term Effective upon appointment -December 31, 2011 Two (2) persons - At-Large (Michelle Han, Patrick Diamitani resigned) No applications as of Wednesday, S:OOp.m., August 12, 2009 D Denotes applicant completed the Confidential page of the application.