HomeMy WebLinkAboutPacketr Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
8/30/2022
First Name*
Ines
Last Name*
Beltre
First Name ( Phonetic spelling )
Optional
Last Name ( Phonetic spelling )
Optional
Home Address*
984 Westside Drive
City*
Iowa City
State
IA
Zip Code*
52246
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
787-426-1037
Email Address*
beltrei@yahoo.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
around 2.5 years (6 years in
Iowa)
Occupation: *
Employment Manager (HR)
Gender*
*This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position: *
Currently part of the Diversity and Inclusion Committee for Johnson County. Also part of LULAC in Iowa City. I
try to be on every activity regarding human rights, diversity and inclusion as well as keep up to date with news
and changes, participate in symposiums and conferences.
What is your present knowledge of each advisory board you are interested in?*
it currently has 8 members, the Chair is Jason Glass. I read the minutes to keep tracking what the commission is
doing for our community.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
35
Country of Origin
Dominican Republic
Sexual Orientation
Religion
Do you have a disability?
Yes
Ethnicity
Race
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*
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.
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
6/28/2022
First Name*
Darla
Last Name*
Burr
First Name ( Phonetic spelling )
Optional
Last Name ( Phonetic spelling )
Optional
Home Address*
784 Mission Point Rd
City*
Iowa City
State
IA
Zip Code*
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
707-290-1984
Email Address*
Darlaburr20l4@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
One week
Occupation:
Transitioning teacher
Gender*
*This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position:
Teacher in a title 1 school for 4 years in CA with extensive experience advocating for students and their families.
Living with a chronic illness since birth and I help run several support groups, as well as an ambassador for the
Oley Foundation.
What is your present knowledge of each advisory board you are interested in?*
Human rights are a passion of mine and I would love to be a part of a commission that helps ensure human and
civil rights are not violated. To be a part of community and educational programs for human rights.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
35
Country of Origin
United States
Sexual Orientation
Female
Religion
Do you have a disability?
Ethnicity
Race
Gender identity
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
r
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will
not consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
10/27/2022
First Name*
Christie
Last Name*
Cellman
First Name ( Phonetic spelling )
Optional
Last Name ( Phonetic spelling )
Optional
Home Address*
128 Arabian Ct
City*
Iowa City
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3199306177
Email Address*
christie-cellman@uiowa.edu
Boards & Commissions
Select a Board or Commission you are interested in:*
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
Iowa City
Occupation: *
Graduate Research Assistant and DEI Director at the Daily
Iowan
Gender*
*This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position: *
I am a current MSW candidate, a graduate research assistant at the Law, Health Policy, & Disability Center, the
DEI Director at the Daily Iowan, and I am heavily involved in the community - giving several public speeches and
rallying for the greater good. Public speeches include a voter inauguration ceremony in 2018 call hosted by the
NAACP, and two public speeches regarding the overturning of roe versus wade this year - one in Iowa city and
one at the capital and Des Moines.
What is your present knowledge of each advisory board you are interested in?*
Disseminating information to educate the public on illegal discrimination and civil rights and making
recommendations to City Council.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
35
Country of Origin
United States
Sexual Orientation
Pan
Religion
Atheist
Do you have a disability?
Yes
Ethnicity
Race
White
Gender identity
Non -binary
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will
not consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
8/28/2022
First Name*
T.J.
Last Name*
Dedeaux-Norris
First Name ( Phonetic spelling )
Optional
Dee Dough
Last Name ( Phonetic spelling )
Optional
Home Address*
332 S Linn St 418
City *
Iowa City
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
8184005236
Email Address*
tj-dedeaux-norris@uiowa.edu
Boards & Commissions
Select a Board or Commission you are interested in:
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
6 years
Occupation: *
Associate Professor/ Artist
Gender*
'This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position: *
T.J. Dedeaux-Norris is a mixed -media artist who employs painting, fiber, performance, video, and music to
explore the somatic impacts of racial, gender, and class socialization. In form and content, their work poses a
philosophical inquiry into the distinction between Self and Other, with the body as a social microcosm of distinct
yet discursive dynamics to observe and question. Everything is both permeable and fractile.
Dedeaux-Norris completed their BA at University of California at Los Angeles and their MFA at Yale University.
Their work has been presented internationally at the Contemporary Arts Museum Houston, Mission Creek
Festival, Nasher Museum of Art, Performa, Prospect New Orleans, Rotterdam Film Festival, The Studio
Museum in Harlem, Sundance Film Festival, and The Walker Art Center - among other institutions. Dedeaux-
Norris has participated in residencies at Grant Wood Colony, MacDowell, Skowhegan, and Yaddo. They are a
2019-2020 Pollock -Krasner Foundation grantee, a 2022 Iowa Artist Fellow, and a tenured Associate Professor at
University of Iowa.
What is your present knowledge of each advisory board you are interested in?*
I am newly acquainting myself with the HRC and feel that within my art practice and teaching pedagogy that I
embody and already practice the ideologies and concerns of the commission. Having lived in Cedar Rapids/Iowa
City for the past 6 years, I believe I've gotten great lived experience in understanding the needs and gaps of
needed programming and advocacy. I'm also an eager learner.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
43
Country of Origin
Guam, USA
Sexual Orientation
NA
Religion
Do you have a disability?
Ethnicity
Black American
Race
multi raced (black/white/native/creole)
Gender identity
Fluid she/they pronouns
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will
not consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
6/29/2022
First Name*
Denise
Last Name*
Hagerla
First Name ( Phonetic spelling )
Optional
Last Name ( Phonetic spelling )
Optional
Hey-girl-uh
Home Address*
174 Shrader Rd
City *
Iowa City
State
IA
Zip Code*
52245-4920
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
7732181287
Email Address*
didihag@yahoo.com
Boards & Commissions
Select a Board or Commission you are interested in:
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
7 months
Occupation:
Clinical Social Worker
Gender*
'This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position:
I've spent much of my 20+ years as a social worker serving marginalized populations and providing education
and support to other professionals working with the LGBTQIA+ community. I am always seeking opportunity to
create, live, and work in community that strives to uphold the values of diversity, equity, and inclusion. This is a
big impetus for my recent move to Iowa City.
What is your present knowledge of each advisory board you are interested in?*
I've been watching the educational initiatives of the Human Rights Commission over the past several months
and have been impressed with the level of community engagement and the breadth and scope of ways in which
this committee reaches out to community for education and impact. I also have watched several hours of the
committee meetings to witness the content and purpose of these meetings.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
50
Country of Origin
United States
Sexual Orientation
Lesbian/Queer
Religion
UUS
Do you have a disability?
No
Ethnicity
N/A
Race
White
Gender identity
Gender non -conforming
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will
not consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
7/22/2022
First Name*
Ryan
Last Name*
Hall
First Name ( Phonetic spelling )
Optional
3192486400
Last Name ( Phonetic spelling )
Optional
Home Address*
18 Kenneth Dr
City *
Iowa City
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3158706939
Email Address*
rhall@newpi.coop
Boards & Commissions
Select a Board or Commission you are interested in:
Human Rights Commission
Select a Board or Commission you are interested in:*
Historic Preservation Commission (HPC)
Historic Preservation Commission Category*
At -Large
Preference on first choice
If multiple boards are being applied for.
Human Rights Commission
How long have you been a resident of Iowa City?
7 years
Occupation:
Information Technology and Data Analysis
Gender*
*This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position: *
> Political Science Honors graduate of the University of Iowa with a focus in bias, protest, and political
revolution. Published academically on related topics.
> Grew up in a poor single parent household and became a first generation college student. Understands the
struggles of navigating our educational system without any prior experience or guidance.
> Familiar with boards and their functions through my work with the board at New Pioneer Food Co-op
> Very passionate about Iowa City's history and it's relationship with underserved communities.
> Appreciative of the inclusivity that Iowa City offers while understanding that our work has just begun
What is your present knowledge of each advisory board you are interested in?*
> Familiar with the functions of the committees and their relationship with Iowa City as a whole
> Understands the limits of the boards as well as their importance
> Good sense of board relationships and how to constructively and inclusively navigate topics and build
solutions
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
33
Country of Origin
United States
Sexual Orientation
Heterosexual
Religion
None
Do you have a disability?
No
Ethnicity
Race
White
Gender identity
Cisgender
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will
not consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
10/6/2022
First Name*
Michael
Last Name*
Halley
First Name ( Phonetic spelling )
Optional
641-233-0445
Last Name ( Phonetic spelling )
Optional
Ha -lee
Home Address*
310 Finkbine Lane
City
#2
State
IA
Zip Code*
52246
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
641-233-0445
Email Address*
mhalley25@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
One week
Occupation:
Account Manager at Ideal Energy, LLC
Gender*
'This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position:
Served 12-years on Fairfield, Iowa city council and completed the Iowa League of Cities Certified Elected
Municipal Official program, so I'm very familiar with city government. More recently I served as an unofficial
advisor to the City of Fairfield Diversity, Equity, and Inclusion Committee, though I was not an official member.
I've advocated for human rights during my time as an elected official and would like to expand that work here in
Iowa City.
What is your present knowledge of each advisory board you are interested it *
I read information provided on the city's website, read the most recent meeting minutes, and watched the most
recent meeting on Channel 4. 1 have a general understanding of the commission's responsibilities and activities.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
47
Country of Origin
United States
Sexual Orientation
Heterosexual
Religion
None
Do you have a disability?
No
Ethnicity
White
Race
White
Gender identity
Male
*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*
mv� m f rj
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.
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
10/4/2022
First Name*
Thorn
Last Name*
Hawthorne
First Name ( Phonetic spelling )
Optional
Last Name ( Phonetic spelling )
Optional
Home Address*
327 Highland Drive
City *
Iowa City
State
IA
Zip Code*
52246
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
8179805820
Email Address*
hello@thornhawthorne.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
Occupation: *
Communications Specialist
Gender*
*This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position: *
As a communications specialist working in the next town over, I serve alongside city council and every board and
commission. I've become extremely familiar with everything about the process and would really love to be able
to do the same work in Iowa City since I live here. I'm transgender, disabled, and a descendant of refugees, so
I'm also particularly well versed in related social justice and human rights issues.
What is your present knowledge of each advisory board you are interested in?*
I've been interested in and watching public meetings since I moved to Iowa City
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
26
Country of Origin
America
Sexual Orientation
Queer
Religion
Do you have a disability?
Yes
Ethnicity
Not Latino
Race
Middle Eastern / White
Gender identity
Transgender/Agender
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will
not consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
11 /8/2022
First Name*
Grace
Last Name*
Kreger
First Name ( Phonetic spelling )
Optional
5157107634
Last Name ( Phonetic spelling )
Optional
Home Address*
20 S. Lucas Street, Apartment D
City *
Iowa City
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
5157107634
Email Address*
gkreger@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
11 years
Occupation:
Program Director Assistant, Reach for Your Potential, Inc.
Gender*
'This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position:
I have ten years combined professional experience serving individuals with disabilities and low-income, at -risk
youth (MYEP - Direct Support Professional/Program Facilitator, RFYP - Program Director Assistant, NCJC -
Youth Counselor). I have extensive professional and volunteer experience working on political campaigns, most
recently serving as an elected delegate in 2018 and 2020. 1 have additional formal volunteer experience with
Iowa City Hospice, Iowa Youth Writing Project, and Girls on the Run. As an undergraduate student at the
University of Iowa, I studied nonfiction creative writing with a focus on gender studies, social justice, trauma, and
empowerment. I am passionate about advocating for and defending the rights of others.
What is your present knowledge of each advisory board you are interested in?*
The HRC educates the public on discrimination and civil rights via public forums, activities, and programs. The
HRC also provides suggestions to City Council regarding legislation concerning discrimination. The HRC meets
once a month, and members serve for three years. This is an unpaid, volunteer position.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
31
Country of Origin
United States of America
Sexual Orientation
Bisexual
Religion
Unitarian
Do you have a disability?
No
Ethnicity
Caucasian
Race
White
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*
"a
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.
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
15 years
Occupation:
Pastor, retired
Gender*
'This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position:
5 years as a Human Rights Commissioner in the City of Dubuque, Iowa (1978-1983); continual training in
Human Rights work as a theologian, pastor, and citizen; completing a first term with the IC Human Rights
Commission during which time I have received training in implicit bias, critical race theory, E.Q. (emotional
intelligence) toward understanding the necessity for D.E.I. (diversity, equity and inclusion) to enrich and hold
secure life of every resident. The IC HRC has just begun a 3 year strategic plan "Breaking Bread" in which I had
a contributing role and am prepared to invest all the more in the realization of this plan. I am an old (73), white,
heterosexual, married, male with a passion for the human rights of every person - a willing and eager voice with
time and energy to to serve.
What is your present knowledge of each advisory board you are interested in?*
I'm completing a first term on the IC Human Rights Commission. My attendance record is near perfect as we
navigated our way thru the COVID-19 pandemic. I have led the training sessions for citizens to learn how to
apply for Iowa City's annual Human Rights grants and then contributed to the ranking and awarding of these
grants; I have served on the Human Rights Award committee this and last year. my relationships with Stefanie
Bowers, Equity and Human Rights Director, and commissioners is positive and supportive.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
r Advisory Board/Commission Application Form
� ' rY pp
r°i�y This application is a public document and as such can be reproduced and distributed for the
25
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
8/29/2022
First Name*
Holly
Last Name*
Stevenson
First Name ( Phonetic spelling )
Optional
3198008421
Last Name ( Phonetic spelling )
Optional
Home Address*
4430 E Court St
City *
Iowa City
State
IA
Zip Code*
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3198008421
Email Address*
hastevenson@optimaelifeservices.com
Boards & Commissions
Select a Board or Commission you are interested in:
Human Rights Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
Occupation: *
Director of Diversity, Equity and Inclusion
Gender*
'This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position: *
I currently serve as the Director of Diversity, Equity and Inclusion for Optimae LifeServices. We serve over 40 of
Iowa counties and I am based out of Iowa City. I have my PhD in Philosophy, focusing on social injustice, from
The University of Iowa and I also have my MAs in Philosophy and Gender, Women and Sexuality Studies. I am
published on issues pertaining to marginalization and intersectionality and I also offer a unique perspective being
from the UX and also having an invisible disability.
What is your present knowledge of each advisory board you are interested in?*
At present, I am aware that this board is doing invaluable work to both spread awareness and education to all
members of the community regarding their rights but also to promote social justice progress to make Iowa City a
city that is advancing DEI initiatives and making them a priority.
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
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
27
Country of Origin
United Kingdom
Sexual Orientation
Straight
Religion
N/A
Do you have a disability?
Yes
Ethnicity
Race
White
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*
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.
How long have you been a resident of Iowa City?
1 year
Occupation:
Executive Director, Immigrant Entrepreneurs Summit
Gender*
*This question is mandatory in order for the City to comply with the State's gender balance requirement, which treats gender as binary. "Gender Identity"
may be provided in the Demographics sectionof the application below.
Male
Female
Experience and/or activities which you feel qualify you for this position: *
I am the Executive Director for a nonprofit organization that works with immigrant and minority business owners
to help educate and advocate for business success. We hold business summits in Eastern Iowa as well as in
other parts of the Midwest to bring people together to support and encourage the immigrant entrepreneurial
experience. Additionally, I serve as Branch Manager and Marketing Manager at Community CPA, a regional CPA
firm that is an immigrant and woman -owned business, and which serves a large immigrant and minority client
base.
What is your present knowledge of each advisory board you are interested in?*
I am interested in the Human Rights Commission. Currently, I know some of the members who were formerly
part of the commission, and I know that it advocates for civil rights in Iowa City, as well as make
recommendations for the city..
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 family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
City Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children,
children for whom the Council Member assumes parental responsibility, mother, father, son-in-law,
daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -
siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first
cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom
the employee is in an intimate relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.