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HomeMy WebLinkAbout2024-04-02 Appointment Item Number: 11.a. CITY OF OF IOWA CITY � fil COUNCIL ACTION REPORT April 2, 2024 Civil Service Commission - One vacancy to fill a four-year term, April 2, 2024 - April 3, 2028. (Term expires for Richard Wyss) Attachments: Vacancy Notice & Coversheet.pdf Board Demographics & Attendance.pdf Hartig, Connor - Application.pdf Wyss, Richard - Application.pdf NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: CIVIL SERVICE COMMISSION One Vacancy: Four-Year Term 04102(2024—04/03/2028 • Duties: Approve all entrance and promotional examinations used by the City of Iowa City for civil service positions; • Holds appeal hearings involving the suspension, demotion, or discharge of employees holding civil service rights. Ascertains to the best of its ability the facts of the case to determine matters involving the rights of civil service employees and may affirm, modify, or reverse any case on its merits per Chapter 400 of the Code of Iowa. • The Commission meets when deemed necessary. Iowa City-appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions_ An application can be completed and submitted on the City of Iowa City website at www.icgov.org or by contacting the City Clerk's office. Questions about the Iowa City Civil Service Commission should be directed to Karen Jennings, Human Resources Administrator at 356-5025. Board/Commission Application Cover Board/Commission: Civil service Commission One Vacancy to fill a four-year term April 2, 2024—April 3, 2028 It is hereby established,as a formal policy of the City Council of Iowa City,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 Announcement Date: 2/20/24 Application Deadline: 3/26/24 Council Appointment Date: 4/2/24 Date of Non-Gender Appointment: 5/20/24 After date above Council may appoint without regard to gender Gender Balance Requirement; 1-Male Current Gender Balance: Female: 2 Male: 0 Gender Name and Address Male Hartig, Connor 108 S. Linn St. Apt 25 Male Wyss, Richard (Currently serving second term) 16 Jeremy Ct. ! d / 0 :2 ] k ) Y : k + o 27M � ] | § $ 6f f {c ) ) � / ) / \ \ \ { tcl r \ 0 E- / ƒ k { ) {\ 0 » ) U) U) : ƒ 7 En 0 >00 ` ) { } o - E f E / ( - \ - \ ) \ \ / z IL) \ \ - - Board/Commission: Civil Service Commission Attendance Record Year 2024 (Meeting Date) Term 219124 Name Expires Rick Wyss 411124 X Chi O boko 417125 O/E Ashley Jennies 1 4/6126 1 X KEY: X = Present O = Absent O/E = Absent/Excused NM = No Meeting --- = Not a Member Advisory Board/Commission Application Form Submit Date: Mar 14, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Connor Hartig First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 108 S. Linn Street Apt 25 _ Home Address Suite or Apt Iowa City _ IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 2 years, 9 months Home: (563) 845-1232 Primary Phone Alternate Phone connorhartigl232@gmail.com Email Address Service Manager at Chil le Mexican Grill Occupation Gender (*This question is mandatory 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 section of the application below.) W Male Boards & Commissions Connor Hartig Which Boards would you like to apply for? Civil Service Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Ad Hoc Truth and Reconcilliation Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: Political Science B.A., Philosophy in Philosophy, Human Rights Certification, Pre -Law (expected May 2024) Leadership and Non -Discrimination Training (2022/23 through Chipotle) Academics and Professionalism Committee Member of Phi -Alpha Delta (Pre -Law Fraternity) (2021-present) Dubuque Caucus Precinct Captain & County Democrats Committee Member (2020) What is your present knowledge of each advisory board you are interested in? The knowledge I have pertaining to each advisory board is limited to the content provided on the Advisory Board/Commission site, as I just recently heard about the opportunity from the instructor of my "Governance and Human Rights" course. Although I do not have a thorough understanding of the work that each commission has done, I am eager and willing to put in the work to establish that knowledge. Potential Conflicts of Interest 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. 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. Connor Hartig Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? r Yes r 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 20 Country of Origin United States Sexual Orientation Gay Religion Agnostic Connor Hartig Do you have a disability No Ethnicity German 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Connor Hartig Advisory Board/Commission Application Form Submit Date: Mar 17, 2024 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Richard D Wyss First Name Middle Last Name Initial First Name (Phonetic spelling) Richard Last Name (Phonetic spelling) Weese 16 Jeremy Ct. Home Address Suite or Apt Iowa City IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 39 years Home: (319) 594-7884 Primary Phone Alternate Phone rickwyss@gmail.com Email Address Retired Police Officer Occupation Gender (*This question is mandatory 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 section of the application below.) Male Richard D Wyss Boards & Commissions Which Boards would you like to apply for? Civil Service Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I was a Police Officer for the City of Iowa City for almost 30 years. I enjoyed the opportunity I was provided in that capacity, and would like to continue my service as a member of the Civil Service Commission. During my tenure on the Civil Service Commission I have had the opportunity to review and approve entrance exams, observe applicant testing and interviews, as well as hiring, promotion and retirement celebrations. Having experience as a Patrol Officer as well as a Supervisor/Command Officer, I feel I have a balanced perspective of issues faced by all levels of Staff, from a new Recruit to Management. I am familiar with the issues Departments face recruiting, retaining and disciplining staff, and the importance of improving Community services provided by maintaining and expanding the qualifications, diversity and effectiveness of Staff within the limitations provided by Chapter 400 of the Code of Iowa. If appointed I would be honored to continue to serve on the Civil Service Commission. What is your present knowledge of each advisory board you are interested in? I am about to complete my second term on the Civil Service Commission. Potential Conflicts of Interest 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. 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. Richard D Wyss Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: University of Iowa Medical Center Downtown. (part time employment). Res. #22-78 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 serve on another Iowa City board or commission? r Yes r 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 Country of Origin Sexual Orientation Religion Do you have a disability Ethnicity Richard D Wyss 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Richard D Wyss Item Number: 11.b. CITY OF OF IOWA CITY � fil COUNCIL ACTION REPORT April 2, 2024 Human Rights Commission - One vacancy to fill an unexpired term, upon appointment - December 31 , 2025. (Ahmed Ismail resigned) Attachments: Vacancy Notice & Coversheet.pdf Board Demographics & Attendance.pdf Abdullahi, Idriss - Application.pdf Covington, Mika - Application.pdf Dettbarn, Avery - Application.pdf Dimambu, Clinton - Application.pdf Fennell-Chametzky, Aaron - Application.pdf Hartig, Connor - Application.pdf Hirst, Donna - Application.pdf Kiche, Anne - Application.pdf Medina, Isaac - Application.pdf Parker, James - Application.pdf Steger, Deandre - Application.pdf Tippe, Allison - Application.pdf Vogel, Eric - Application.pdf NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION One Vacancy: Unexpired Term Upon Appointment—December 31, 2025 Duties of the Commission include: Disseminating information to educate the public on illegal discrimination and civil rights, such as organizing and facilitating educational public forums that address one or more of the broad range of topics included within the rubric of human rights; • making recommendations to the City Council for such further legislation concerning discrimination as it may deem necessary and desirable; • cooperating within the limits of any appropriations made for its operation with other agencies or organizations both public and private whose purposes are not inconsistent with those of Title 2 of the City Code(Human Rights Ordinance) • planning programs and activities designed to eliminate racial, religious, cultural and other intergroup tensions including but not limited to sex, color, creed, disability, gender identity, sexual orientation, marital status, age, and national origin. • The Human Rights Commission meets the third Tuesday of each month at 5:30 p.m. in the Lobby Conference Room at City Hall, 410 E. Washington Street. Iowa City-appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, March 26, 2024. An application can be completed and submitted on the City of Iowa City website at www.icgov.org or by contacting the City Clerk's office. Questions about the Iowa City Human Rights Commission should be directed to Stefanie Bowers, Human Rights Coordinator at 356-5022. Board/Commission Application Cover Board/Commission: Human Rights Commission One vacancy to fill an unexpired term Upon Appointment—December 31, 2025 It is hereby established, as a formal policy of the City Council of Iowa City,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 Announcement Date: 2/20/24 Application Deadline: 3/26/24 Council Appointment Date: 4/2/24 Date of Non-Gender Appointment: 5/20/24 After date above Council may appoint without regard to gender Gender Balance Requirement: 1-Male Current Gender Balance: Female: 5 Male: 3 Gender Name and Address Male Abdullahi, Idriss 34 Lincoln Ave. Apt 6 Female Covington, Mika 2401 Hwy 6 East Apt 40-106 Female Dettbarn, Avery 614 S.Johnson St. Apt 3 Male Dimambu, Clinton 1819 Lower Muscatine Rd. Male Fennell-Chametzky,Aaron 810 Roosevelt St. Male Hartig, Connor 108 S. Linn St. Apt 25 Female Hirst, Donna 810 N. Linn St. Female Kiche, Anne 2958 Keel Boat Loop Male Medina, Isaac 44 Post Rd. Male Parker,James 1908 B. St. Male Steger, Deandre 100 Mayflower Hall Room 535C-1 Female Tippe, Allison 1105 Prairie du Chien Rd. Male Vogel, Eric 518 N. Van Buren ) ) ) ! ! k 2 ) \ Cu $ \ 2! ) \ $) t § ( ) _ ! § f ± f ) ; j16 :na.� _ = t \�\ \ }° \ \!a ! ! E i E I Cc Q ir,s � / \» - \ § / \ !)2 «\\ mi) ;, )! \ { }) ) )\ .9 a ) � / \)! / /! Emu » e ; o ) a ) So :2 12 r E0 I _ \ � ( � CO § \ r / } § \ ) } ) ) ) ( \ { wn EEE E & ! 0 ° y � ; & � ! % ) ) ) \ Human Rights Commission ATTENDANCE RECORD YEAR 2024 (Meeting Date) TERM 1/23 2/27 314 3/26 4/23 5/28 6125 7/23 8/27 9/24 10/22 11/26 12724 NAME EXP. ahnavi Pandya 2024 X X X Sylvia Jons 2024 Z A A Doug Kollaseh 2024 X X X lana Qadoura 2025 X X X aeant 2025 A X ark Pries 2025 X A X Roger Lusala 2026 X X X Kelsey Paul Shantc 2026 X X X Liz Mendez Shannon 2026 X X X KEY: P = Present A =Absent Z =Present via Zoom Advisory Board/Commission Application Form Submit Date: Mar 20, 2024 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Idriss A Abdullahi First Name Middle Last Name Initial First Name (Phonetic spelling) d-rees Last Name (Phonetic spelling) Ab-dul-lahee 34 Lincoln Ave Apt 6 Home Address Suite or Apt Iowa City IA 52246 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 3 years Mobile: (515) 771-9427 Primary Phone Alternate Phone iabdu112003@gmail.com Email Address Student, Direct Support Professional, Business Coach Occupation Gender (*This question is mandatory 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 section of the application below.) ❑p Male Idriss A Abdullahi Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Submitted Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: My experience in providing hands-on support to individuals in need, assisting with daily tasks essential for their well-being, and promoting holistic well-being and independence aligns closely with the responsibilities of a human rights commissioner. Through my work, I have demonstrated a dedication to upholding human rights principles by ensuring individuals have access to basic necessities and fostering inclusion within the community. Additionally, my role as a business coach, particularly in empowering minorities to develop businesses within underappreciated communities, highlights my commitment to addressing systemic inequalities and promoting economic empowerment—a crucial aspect of human rights. Overall, my diverse experience equips me with the skills and perspective necessary to effectively serve as a human rights commissioner and advocate for the rights and dignity of all individuals. What is your present knowledge of each advisory board you are interested in? From my current knowledge, the Human Rights Commission aims to create a supportive environment for the recognition, promotion, protection, and enforcement of human rights and treaty obligations outside of the judicial system. Additionally, it serves as a platform for public enlightenment and dialogue on human rights issues, with the goal of minimizing controversy. Potential Conflicts of Interest 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. Idriss A Abdullahi 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: Systems Unlimited & MDC Iowa Res. #22-78 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 serve on another Iowa City board or commission? r Yes c 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 20 Idriss A Abdullahi Country of Origin Kenya Sexual Orientation Heterosexual Religion Islam Do you have a disability No Ethnicity Somali Race African 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Idriss A Abdullahi Advisory Board/Commission Application Form Submit Date: Jun 07, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Mika J Covington First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 2401 Highway 6 East, Apt 40-106 _ Home Address Suite or Apt Iowa City _ IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 5 years Mobile: (712) 314-8258 Primary Phone Alternate Phone mika.j.covington@gmail.com Email Address Nonprofit President Occupation Gender (*This question is mandatory 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 section of the application below.) * [;F Female Boards & Commissions Mika J Covington Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am the co-founder and President of Next Generation of Cystinosis. NGC is a nonprofit org, run for and by adults living with the ultra-rare disease called cystinosis. We work to represent the interests and needs of adults living with cystinosis, provide support to the community, lobby the state legislature to pass a Rare Disease Advisory Committee and help locate resources. I have worked with the ACLU of Iowa on a lawsuit to establish civil rights for transgender people in Iowa. The decision from the IA Supreme Court this last May. I currently serve on the UIHC Patient and Family Advisory Board. I volunteered with the Iowa Pride Network from 2010 to 2013 on their College Leadership Team organizing and leading IPN's Southwest Iowa Regional Gay-Straight Alliance Coalition. Finally, I have been involved with organizations focused on protecting people's civil rights. I am not an attorney. Finishing my BA in psychology and German (language, culture, history, politics). I speak English and intermediate German. I am proficient in Microsoft Word, Excel, PowerPoint, and Google Apps. What is your present knowledge of each advisory board you are interested in? I understand that the Human Rights Commission ensures that the Iowa Civil Rights Code is enforced. They help employers and residents understand the law and participate in events such as)uneteenth and Pride, which I would volunteer to help at those events. Potential Conflicts of Interest 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. 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. Mika J Covington Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: I serve on the Board of Next Generation of Cystinosis. I am not paid for that position. I do not believe there would be a financial interest issue. 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 serve on another Iowa City board or commission? r Yes r 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 32 Country of Origin USA Sexual Orientation Queer Religion Methodist Mika J Covington Do you have a disability Yes Ethnicity Race White Gender Identity Transgender woman *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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. ❑p I Agree Mika J Covington Advisory Board/Commission Application Form Submit Date: Mar 15, 2024 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Avery C Dettbarn First Name Middle Last Name Initial First Name (Phonetic spelling) A-ver-ee Last Name (Phonetic spelling) Debt-barn 614 S Johnson Street Apt 3 Home Address Suite or Apt Iowa City IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 2 years Mobile: (563) 451-0173 Primary Phone Alternate Phone averydettbarn@gmail.com Email Address Server, Iowa Chop House Occupation Gender (*This question is mandatory 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 section of the application below.) * C Female Avery C Dettbarn Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Avery C Dettbarn Experience and/or activities which you feel qualify you for this position: In my collegiate career, I have done many activities and had many experiences that qualify me to serve on Iowa City's Human Rights Commission. I am majoring in Political Science and working on a Human Rights Certificate at the University of Iowa, and these two areas of study have given me great experience and perspective about politics and human rights, including how they intersect, and how we can use politics to help promote and protect the rights of people. Specifically, my study in human rights has taught me how to identify human rights violations and how one can promote the protection of human rights in different ways. This combination of Political Science and Human Rights study allows me to have a unique perspective on how to approach the protection of human rights from a political viewpoint, which I know will be useful to me on the commission. Along with this, I am currently an At- Large Senator for the University of Iowa's Undergraduate Student Government, and I know this activity and experience qualify me for the position on the Iowa City's Human Rights Commission. As a senator for USG, I must listen to the concerns and needs of students on campus and work to either draft legislation or advocate for resolutions/legislation to help support students and ensure they are living a safe and happy life on campus. This experience gives me the necessary skills to identify issues constituencies face and how I need to properly approach the situation to ensure I am being empathetic, while also being a strong advocate to address the issue at hand. Another activity that I feel qualifies me for this position is my role as a member and the social media coordinator for the University Democrats at Iowa. Through this organization, members strive to achieve positive social change along with expanding inclusivity and uplifting voices across campus. This membership has given me the experience to work with legislators, governmental candidates, and other organizations to uplift positive social change around campus and ensure that all communities feel welcome on campus. This includes engaging with students to ensure each of their needs are being met and that they feel their human rights are being honored and protected on campus. This position also taught me how to deal with sensitive situations especially with people coming to you with sensitive information. I have learned how to be empathetic and caring to people while also engaging in conversation to learn how to support people while keeping them safe. Some of these changes have included writing letters to legislators about certain bills to protect the rights of LGBTQ+ youth in Iowa and also partnering with cultural organizations around campus to provide safe spaces to marginalized communities on campus and hear what they want to see changed on campus, in Iowa, and around the world. Each of my experiences and activities throughout my life, and especially in College have taught me the necessary tools and skills to be a productive member of the Human Rights Commission. I have learned how to balance many priorities, ensuring I give my all in each thing I do. I have also learned communication skills between executive boards in my organizations, to general members in organizations, and engaging with students and Iowa City residents. I know I also have a strong work ethic, organization skills, and writing and research skills, but I think the quality I have that most sets me apart from my peers is my dedication and passion for advocating and protecting human rights. I am passionate about helping every Iowa City resident feel safe in Iowa City, which begins with ensuring their rights as humans are being protected. Recommending legislation to protect Iowa City's residents' human rights is also something I am very passionate about as I have learned through my studies how legislation can impact human rights. I also really enjoy and am passionate about planning activities such as the safe space on campus for students, and I know this would help me plan Iowa City activities to promote the rights of individuals and eliminate racial, religious, and cultural tensions. I know my passion for human rights, along with my experience with my studies and the skills I have learned through activities gives me the necessary qualities to represent the needs of Iowa City citizens and their needs for protection of human rights on the Iowa City Human Rights Commission. Avery C Dettbarn What is your present knowledge of each advisory board you are interested in? I am currently in a class at the University of Iowa taught by Stefanie Bowers titled Governance and Human Rights, and in this, Stefanie explained Iowa City's Human Rights Commission and some of the issues the commission hears and experiences. Along with this, I have done some research online about the duties and tasks of the Commission, including reading the Human Rights Commission's website on duties and looking at Iowa City's website and the chapter on the Human Rights Commission and the duties, powers, and structure of the commission. I have a good framework of knowledge about the Human Rights Commission, and if appointed as a member of the Commission, I am passionate to learn more about the Commission! Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: N/A Avery C Dettbarn Res. #22-78 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 serve on another Iowa City board or commission? r Yes c 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 20 Country of Origin United States Sexual Orientation Straight Religion N/A Do you have a disability No Ethnicity White Race White Avery C Dettbarn 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Avery C Dettbarn Advisory Board/Commission Application Form Submit Date: Nov 03, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Clinton M Dimambu First Name Middle Last Name Initial First Name (Phonetic spelling) CLINTON Last Name (Phonetic spelling) DIMAMBU 1819 LOWER MUSCATINE RD Home Address Suite or Apt IOWA IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 5 Mobile: (319) 333-6490 Primary Phone Alternate Phone clintondimambul4@gmail.com Email Address Organizer _ Occupation Gender (*This question is mandatory 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 section of the application below.) ❑p Male Clinton M Dimambu Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in property management? o Yes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in nonprofit management? o Yes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you receive rental assistance? o Yes m No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in construction? oYes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in finance? oYes o No Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have Knowledge. What is your present knowledge of each advisory board you are interested in? I have Knowledge in Human Right and zoning Potential Conflicts of Interest 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. Clinton M Dimambu 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: Res. #22-78 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 serve on another Iowa City board or commission? r Yes c 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 28 Clinton M Dimambu Country of Origin DR Congo Sexual Orientation Male Religion Catholic Do you have a disability no Ethnicity black Race black 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Clinton M Dimambu Advisory Board/Commission Application Form Submit Date: Jun 25, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Aaron J Fennell-chametzky First Name Middle Last Name Initial First Name (Phonetic spelling) Air-in Last Name (Phonetic spelling) Fenn-1 (like the letter 1) Cha-met-ski 810 Roosevelt St Home Address Suite or Apt Iowa City IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 21 years Mobile: (319) 471-2683 Primary Phone Alternate Phone fcaaron02@gmail.com Email Address Paraeducator Occupation Gender (*This question is mandatory 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 section of the application below.) ❑p Male Aaron J Fennell-chametzky Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: Experience volunteering for presidential campaigns, attending rallies such as a gathering against the overturning of Roe v. Wade and as an ally at a march on Transgender Day of Visibility, going to a number of my college's Office of Intercultural Life events, being a Student Senate member in high school, and being close to done with my degree- majoring in history, minoring in Gender, Sexuality, and Women's Studies, and getting a certification to teach secondary social studies- all of which I feel relate to this position. What is your present knowledge of each advisory board you are interested in? All I know about it is what is listed on the card I was given: the duties of "Make recommendations on the racial equity and social justice grants" and "Plan programs and activities to eliminate unlawful discrimination," as well as the requirements and term length. Potential Conflicts of Interest 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. 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. Aaron J Fennell-chametzky Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: Pedal Power MYEP Iowa City Community School District 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 serve on another Iowa City board or commission? r Yes r 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 21 Country of Origin United States Sexual Orientation Bisexual Religion None Aaron J Fennell-chametzky Do you have a disability A very mild one- high functioning autism. I don't anticipate it would impact my ability to fill a role like this one Ethnicity Race White Gender Identity Cisgender 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. p 1 Agree Aaron J Fennell-chametzky Advisory Board/Commission Application Form Submit Date: Mar 14, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Connor Hartig First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 108 S. Linn Street Apt 25 _ Home Address Suite or Apt Iowa City _ IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 2 years, 9 months Home: (563) 845-1232 Primary Phone Alternate Phone connorhartigl232@gmail.com Email Address Service Manager at Chil le Mexican Grill Occupation Gender (*This question is mandatory 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 section of the application below.) W Male Boards & Commissions Connor Hartig Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Ad Hoc Truth and Reconcilliation Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: Political Science B.A., Philosophy in Philosophy, Human Rights Certification, Pre -Law (expected May 2024) Leadership and Non -Discrimination Training (2022/23 through Chipotle) Academics and Professionalism Committee Member of Phi -Alpha Delta (Pre -Law Fraternity) (2021-present) Dubuque Caucus Precinct Captain & County Democrats Committee Member (2020) What is your present knowledge of each advisory board you are interested in? The knowledge I have pertaining to each advisory board is limited to the content provided on the Advisory Board/Commission site, as I just recently heard about the opportunity from the instructor of my "Governance and Human Rights" course. Although I do not have a thorough understanding of the work that each commission has done, I am eager and willing to put in the work to establish that knowledge. Potential Conflicts of Interest 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. 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. Connor Hartig Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? r Yes r 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 20 Country of Origin United States Sexual Orientation Gay Religion Agnostic Connor Hartig Do you have a disability No Ethnicity German 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Connor Hartig Advisory Board/Commission Application Form Submit Date: Mar 09, 2024 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Donna L Hirst First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) Hirst 810 N LINN ST Home Address Suite or Apt Iowa City IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? since 1970 Mobile: (319) 594-2469 Home: (319) 594-2469 Primary Phone Alternate Phone donna-hirst@uiowa.edu Email Address retired librarian Occupation Gender (*This question is mandatory 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 section of the application below.) * p Female Donna L Hirst Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am very active in community human rights initiatives: Johnson County Interfaith Coalition (esp. Steering Committee, voting, education, healthcare, fundraising); Center for Worker Justice, League of Women Voters, 100 Grannies (environment). Congregational United Church of Christ Mission Board, Shelter House Book Sale Steering Committee. Through JCIC I work with 4 black churches (Purpose Place, New Creations International, Bethel AME, and New Life Apostolic. In my 43 years as a librarian I was active in library and university diversity initiatives. What is your present knowledge of each advisory board you are interested in? I have read the information on your website, scanned a few agendas, and attended several community events. I requested information from Mark Pries and got a lengthy note back about obligations, time commitments, and activities. Potential Conflicts of Interest 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. 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. Donna L Hirst Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: I have no financial interests in any organizations I am affiliated with except that I regularly give donations to local non-profits. Res. #22-78 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 serve on another Iowa City board or commission? r Yes r 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 75 Country of Origin United States Sexual Orientation female Religion Christian Donna L Hirst Do you have a disability no 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. ❑p I Agree Donna L Hirst Advisory Board/Commission Application Form Submit Date: May 29, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Anne 0 Kiche First Name Middle Last Name Initial First Name (Phonetic spelling) 3194003877 Last Name (Phonetic spelling) Keycha' 2958 Keel Boat Loop Home Address Suite or Apt Iowa City IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? oYes oNo How long have you been a resident of Iowa City? 30 Home: (319) 400-3877 Home: (319) 400-3877 Primary Phone Alternate Phone aokiche@gmail.com Email Address Educator Occupation Gender (*This question is mandatory 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 section of the application below.) * C Female Anne 0 Kiche Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Human Rights Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: A strong advocate for marginalized communities. Chair of African community network, Director of DEI at AAUW. Strong advocate RVAP among other responsibilities. What is your present knowledge of each advisory board you are interested in? Advocates for human and civil rights. Mediate discrimination complains Potential Conflicts of Interest 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. 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. Anne 0 Kiche Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: None 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 serve on another Iowa City board or commission? r Yes r 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 58 Country of Origin Kenya Sexual Orientation Heterosexual Religion SDA Anne 0 Kiche Do you have a disability No Ethnicity Black Race Black 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Anne 0 Kiche Advisory Board/Commission Application Form Submit Date: Mar 08, 2024 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Isaac Medina First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 44 Post Rd _ Home Address Suite or Apt Iowa City _ IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 3 Home: (641) 351-9688 Primary Phone Alternate Phone isaacmedina20l4@gmail.com Email Address Attorney Occupation Gender (*This question is mandatory 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 section of the application below.) W Male Boards & Commissions Isaac Medina Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) 1 Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am passionate about public libraries and the service that they provide to our communities. I see myself supporting the goals of the Public Library at to make sure that they have the resources they need to reach all members of our community. What is your present knowledge of each advisory board you are interested in? I have a surface level knowledge of the board and their duties and I am interested in learning more and help support our public library. Potential Conflicts of Interest 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. 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. Isaac Medina Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: I am currently employed by Trey Sucher Law, PLC. Res. #22-78 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 serve on another Iowa City board or commission? r Yes r 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 28 Country of Origin USA Sexual Orientation Heterosexual Religion Catholic Isaac Medina Do you have a disability No Ethnicity Hispanic/Latino Race N/A 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Isaac Medina Advisory Board/Commission Application Form Submit Date: Jun 21, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) James L Parker First Name Middle Last Name Initial First Name (Phonetic spelling) Jayms Last Name (Phonetic spelling) Pahr-kehr 1908 B Street Home Address Suite or Apt Iowa City IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 18 years Mobile: (319) 331-9419 Primary Phone Alternate Phone jparkeria@gmail.com Email Address Registered nurse _ Occupation Gender (*This question is mandatory 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 section of the application below.) Male James L Parker Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: -10+ years as an RN working ob-gyn/ent/urology post surgical, med/surg float pool, emergency department, psychiatric/mental health division -fluent in french, beginner fluency in Spanish -2.5 years living abroad in France as a young adult -active in the Boy Scouts of America throughout my youth and returned to it as an adult; obtained rank of Eagle in 1992 and completed Wood Badge Leadership course in 2007. -BS in Management with an IT concentration; BS in Nursing; MS in Nursing student with anticipated graduation in December 2023; plan to obtain a PMHNP license in Iowa after graduation. -currently serving as a young men advisor (ages 13-15) at church -Addiction recovery program facilitator with weekly meetings -moved around in my childhood and adolescence to various states providing racial, cultural and socioeconomic experiences -10 years in the over-the-road transportation industry -3 years as a jailer and 911 dispatcher in Smith County Texas What is your present knowledge of each advisory board you are interested in? Next to nothing. Potential Conflicts of Interest 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. 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. James L Parker Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: UnityPoint Health 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 serve on another Iowa City board or commission? r Yes r 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 49 Country of Origin United States Sexual Orientation Male Religion The Church of Jesus Christ of Latter Day Saints James L Parker Do you have a disability No Ethnicity Non-hispanic 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree James L Parker Advisory Board/Commission Application Form Submit Date: Oct 29, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Deandre Steger First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 100 Mayflower Hall Room 535C-1 _ Home Address Suite or Apt Iowa City _ IA 52242 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 12 months Home: (319) 804-6477 Primary Phone Alternate Phone Osteger.deandre@gmail.com Email Address Student Occupation Gender (*This question is mandatory 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 section of the application below.) W Male Boards & Commissions Deandre Steger Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I'm a member of the Food Pantry, the Basic Needs at Ulowa Student Board, Diversity Council, Dean of Students Advisory Board, and the Foundationalist, and I use those different avenues of community engagement to highlight different aspects of myself. The Foundationalist is literary based, the Diversity Council highlights actively listening to communities of color and representing them, the Dean of Students Advisory Board provides a space to directly engage with University Staff, and the Food Pantry provides necessary items for the Student Population. I love all of my experiences. What is your present knowledge of each advisory board you are interested in? I like to think of the Iowa City Human Rights Commission as a collaborate effort to learn, recognize, and act against prejudice and discrimination against the factors that separate but strengthen us, like sex, color, disability, sexual orientation, marital status, age, and nationality. The Committee meets on the fourth Tuesday of every week and it's open to the public. Depending on the event, it can be held at 410 E Washington St or as needed. Potential Conflicts of Interest 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. 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. Deandre Steger Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: N /A Res. #22-78 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 serve on another Iowa City board or commission? r Yes r 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 19 Country of Origin United States Sexual Orientation Bisexual Religion N /A Deandre Steger Do you have a disability N /A Ethnicity African American, White Race Mixed 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Deandre Steger Advisory Board/Commission Application Form Submit Date: Nov 14, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Allison K Tippe First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 1105 Prairie du Chien Rd _ Home Address Suite or Apt Iowa City _ IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 7 years Mobile: (319) 321-4459 Primary Phone Alternate Phone a.k.tippe@gmail.com Email Address Social Worker Occupation Gender (*This question is mandatory 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 section of the application below.) * [;F Female Boards & Commissions Allison K Tippe Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Human Rights Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have been a licensed social worker since 2009 and currently work as a victim advocate with the Domestic Violence Intervention Program in Iowa City. I have spent several years working as a reproductive rights activist, working as a doula in underserved communities. Additionally, I have What is your present knowledge of each advisory board you are interested in? Human Rights Commission educates the public on discrimination and civil rights within our community. They consider grantees and grant applications presented to the commission. Additionally, they design programs and events within the Iowa City community to help educate the public about issues of race, class, gender, sexual orientation, and national/ethnic identities. Potential Conflicts of Interest 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. 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. Allison K Tippe Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: Domestic Violence Intervention Program - full-time employment Res. #22-78 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 serve on another Iowa City board or commission? r Yes r 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 36 Country of Origin United States Sexual Orientation Bisexual Religion Agnostic Allison K Tippe 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. ❑p I Agree Allison K Tippe Advisory Board/Commission Application Form Submit Date: Oct 30, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Eric W Vogel First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 518 n Van Buren _ 5 Home Address Suite or Apt Iowa City _ IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 4 yrs Home: (319) 936-8123 Primary Phone Alternate Phone ericvogel75@gmail.com Email Address Contractor Occupation Gender (*This question is mandatory 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 section of the application below.) fJ Male Boards & Commissions Eric W Vogel Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in property management? o Yes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in nonprofit management? o Yes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you receive rental assistance? e Yes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in construction? o Yes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in finance? f•Yes r No Interests & Experiences Experience and/or activities which you feel qualify you for this position: Maintenance for 60 plus rental properties for 15 years What is your present knowledge of each advisory board you are interested in? Absolutely no knowledge but I am 100% sure I can take on the task and be beneficial for Iowa City Potential Conflicts of Interest 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. Eric W Vogel 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: Res. #22-78 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 serve on another Iowa City board or commission? r Yes c 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 48 Eric W Vogel Country of Origin USA Sexual Orientation Male Religion Na Do you have a disability Yes Ethnicity Iowa City Race White 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. ❑p I Agree Eric W Vogel City Council Supplemental Meeting Packet CITY OF IOWA CITY April 2, 2024 Information submitted between distribution of packet on Thursday and 4:OOpm on Monday. Late Handout(s): 9.a. Rezoning - 302-316 E Bloomington Street - Local Historic Landmark - See correspondence from the following: Cecile Kuenzli, Susan Isham, Ceil Miller Bouchet, Barbara Schelar, Alison Guernsey, Susan Futrell, Jordan Sellergren and Northside Businesses, Adam Phillips, Diann McChristy, Dave Tingwald, Sheila Boyd, Brooke Dearborn Huston, Nancy Romalov, Jerry Alberhasky, Virginia Hayes, Devin Redmond, Mary Rockafellow, Amanda Mosley, Dawn Frary, Nate Pollpeter, Lisa Petrie, Mike Fallon, Jackie Biger, Vera and Peter Gross, Naomi Greyser, Kristin Addis, Patricia Addis, Alex and Jeremy Ackerman, Jill Harper, Mark Weinstein, Fran Jensen, Randy Brauns, Will Thomson 9.c. Rezoning - 1810, 1816, and 1828 Lower Muscatine Rd - See correspondence from the following: Jane Shuttleworth, Tracy Daby, Anne Marie Kraus, Cheryl Ridgeway, Ruth Manna, 11.b. Human Rights Commission - See revised application from Isaac Medina April 2, 2024 City of Iowa City Item Number: 11.b. CITY OF OF IOWA CITY � fil COUNCIL ACTION REPORT April 2, 2024 Human Rights Commission - See revised application from Isaac Medina Attachments: revised application from Isaac Medina -01i1 .L Advisory Board/Commission Application Form Submit Date: Mar 19, 2024 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile Late Handouts Distributed . NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) (Date) Isaac Medina First Name Middle fast Name initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 44 Post Rd Home Address Suite or Apt Iowa City IA 52245 Cry state Postal Code Is your home address (listed above) within the corporate limits of Iowa City? r• Yes r No How long have you been a resident of Iowa City? 3 Home: (641) 351-9688 Pd i-Phone Alternate Phone isaacmedina2014@gmaii.com Email Address Attorney Occupation Gender (*This question is mandatory 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 section of the application below.) F Male Boards & Commissions Isaac Medina Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Library Board of Trustees Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am passionate about public libraries and the service that they provide to our communities. I see myself supporting the goals of the Public Library at to make sure that they have the resources they need to reach all members of our community. I am also passionate about human rights and deal a whole lot with issues that intersect with immigrant in our communities. I am currently on my third year of working as an attorney who's primary area of practice is immigration. Being an attorney has allowed me to hone in my critical thinking skills, writing and speaking as well as attention to detail. Given these are transferable skills I am confident that I could put them to use in these boards and commissions. What is your present knowledge of each advisory board you are interested in? I have a surface level knowledge of the board and their duties and I am interested in learning more and help support our public library and or the human rights commission. Potential Conflicts of Interest 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. 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. Isaac Medina Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: I am currently employed by Trey Sucher Law, PLC. Res. #22-78 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 serve on another Iowa City board or commission? t Yes r 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 28 Country of Origin USA Sexual Orientation Heterosexual Religion Catholic Isaac Medina Do you have a disability No Ethnicity Hispanic/Latino Race N/A 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W 1 Agree Isaac Medina Item Number: 11.c. CITY OF OF IOWA CITY � fil COUNCIL ACTION REPORT April 2, 2024 Library, Board of Trustees - One vacancy to fill an unexpired term, upon appointment - June 30, 2029. (Lucilia Green resigned) Attachments: Vacancy Notice & Coversheet.pdf Board Demographics & Attendance.pdf Bontrager, Aaron - Application.pdf Boothroy, Bonnie - Application.pdf Chrischelles, Gene - Application.pdf Kane, Janine - Application.pdf Kerr, Laura - Application.pdf Medina, Isaac - Application.pdf O'Saurus, Maxwell - Application.pdf Stone, Anna - Application.pdf Templeman, Trevor - Application.pdf NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF LIBRARY TRUSTEES One Vacancy: Unexpired Term Upon Appointment-June 30, 2029 • The Board of Library Trustees is a semi-autonomous body of nine persons empowered by State Law to plan, direct, and control all affairs of the Public Library. This includes having control of funds allocated or given to the library, determining long-range goals of Library service, adopting written policies to govern operation of the Library, and employing a competent staff to help plan and implement the Board's service goals. • Iowa City appointed members of boards and commissions must be 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. • The Library Board meets the fourth Thursday of each month at 5:00 p.m, Iowa City-appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, March 26, 2024. An application can be completed and submitted on the City of Iowa City website at www.icgov.org or by contacting the City Clerk's office. Questions about the Iowa City Board of Library Trustees should be directed to Elsworth Carman, Library Director at 356-5241. 21712024 Board/Commission Application Cover Board/Commission: Library, Board of Trustees One vacancy to fill an unexpired term Upon Appointment—June 30, 2029 It is hereby established,as a formal policy of the City Council of Iowa City,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 Announcement Date: 2/20/24 Application Deadline: 3/26/24 Council Appointment Date: 4/2/24 Date of Non-Gender Appointment: 5/20/24 After date above Council may appoint without regard to gender Gender Balance Requirement: 1-Female Current Gender Balance: Female: 3 Male: 5 Gender Name and Address Male Brontrager, Aaron 2832 Brookside Dr. Female Boothroy, Bonnie 2817 Buckle Down Circle Male Chrichelles, Gene 1020 Deerfield Dr. Female Kane,Janine 2608 Catskill Ct. Female Kerr, Laura 821 E Market St. Male Medina, Isaac 44 Post Rd. Male O'Saurus, Maxwell 2510 Friendship St. Female Stone, Anna 301 Woolf Ave. Male Templeman,Trevor 641 Fairway Ln. S.E. / \ _ / 7 $ ) ) 1w / f }. - / \ $ 2 \ ) 2 t \ %\ \ \\\\ \ \/}\\/\\\\ \ WT \ . � � ! - %) k \ g ! { - - 2 _ yaw ! zB ; g \ . 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If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Aaron Bontrager First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) Bontrager 2832 Brookside Dr Home Address Suite or Apt Iowa city IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 8 years Home: (847) 738-3085 Primary Phone Alternate Phone aaron.bont@gmail.com Email Address Small Business Owner Occupation Gender (*This question is mandatory 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 section of the application below.) n Male Aaron Bontrager Boards & Commissions Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: 17 years of experience working in the public health and academic setting. Proven track record in grant writing and research. Also a life-long Iowa Citian who grew up going to the Iowa City Public Library and currently have two daughter's who actively use the Iowa City Library. What is your present knowledge of each advisory board you are interested in? Was referred to this open vacancy by a friend. Potential Conflicts of Interest 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. 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. Aaron Bontrager Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: N/A 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 serve on another Iowa City board or commission? r Yes r 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 Country of Origin Sexual Orientation Religion Do you have a disability Ethnicity Aaron Bontrager 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Aaron Bontrager Advisory Board/Commission Application Form Submit Date: May 26, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Bonnie Boothroy First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 2817 Buckle Down Circle _ Home Address Suite or Apt Iowa City _ IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 50 years Mobile: (319) 930-1750 Primary Phone Alternate Phone bboothroy@gmail.com Email Address retired Occupation Gender (*This question is mandatory 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 section of the application below.) * W Female Boards & Commissions Bonnie Boothroy Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: In 2014, after a 45-year career in education, I retired as associate executive director of School Administrators of Iowa (SAI), a position I had held for eight years. For 18 years prior to that I was a central office administrator in both an Area Education Agency and a local school district. Additional professional experience included 17 years in the Iowa City School District, where I was a teacher, reading specialist, staff development facilitator and elementary school principal. I was an adjunct faculty member at the Harvard Graduate School of Education's Instructional Rounds Institute, an adjunct instructor in the UI Department of Educational Policy and Leadership Studies, an instructor for the Drake University Educational Administration Program, and a supervisor at the UI Children's Reading Clinic. I served on numerous state advisory committees and national task forces and was a member of several professional organizations. I hold degrees from The University of Iowa (BA '68, MA '72 and PhD '86), where I also completed post-doctoral studies. In my work across the state, I had the privilege of observing first-hand the difference between a school staffed by a highly qualified teacher librarian and a school that had either no, or a lesser qualified teacher librarian. It was dramatic. Teacher librarians develop readers, create discerning consumers of information, develop responsible digital citizens, create school-wide collaboration, and enhance student learning across all curricular areas. I fully acknowledge that public libraries are different from school libraries. They have a different purpose, mission and client base. But the impact public libraries can make in patrons' lives and in their lifelong learning can be equally as dramatic. And they both deserve our advocacy and support. In our current political climate, the challenges to libraries, whether public or school, are significant. I was pleased that the ICPL Board issued a statement regarding Intellectual Freedom in response to bills proposed in the Iowa Legislature this year. Additionally, emerging issues such as social media's impact on youth, changing demographics in our community, unpredictable financial resources, and technology needs all must be proactively anticipated. I would welcome the chance to contribute to the ICPL as the organization strives to continue providing robust services and programming in these demanding, yet exciting, times. What is your present knowledge of each advisory board you are interested in? I have read and understand the Library Board's scope of responsibilities and have a general understanding of the relationship between the Library Board and the City of Iowa City governance. I've read the online information regarding recent Library Board agendas, minutes, reports, budget, strategic planning, and policies. Potential Conflicts of Interest 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. Bonnie Boothroy 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: None 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 serve on another Iowa City board or commission? r Yes r 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: Bonnie Boothroy Age 76 Country of Origin USA Sexual Orientation Heterosexual Religion Christian Do you have a disability No Ethnicity White Race Caucasian 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) 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. Bonnie Boothroy Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. r I Agree Bonnie Boothroy Advisory Board/Commission Application Form Submit Date: Mar 30, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Gene Chrischelles First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) chris-shill'-us 1020 Deerfield Drive Home Address Suite or Apt Iowa City IA 52246 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 35 Home: (319) 331-8636 Primary Phone Alternate Phone tgene@gmail.com Email Address Retired pharmacist Occupation Gender (*This question is mandatory 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 section of the application below.) p Male Gene Chrischelles Boards & Commissions Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: Experience and/or activities which you feel qualify you for this position: I recently finished my second term on the Board of Adjustment and I am interested in further volunteer service to the city. I firmly believe in the importance of the public library as a core institution in the city as an educational and entertainment source. I realize my application is after the deadline, but I just saw this opening and I am hoping that if it is not filled, I could be considered. What is your present knowledge of each advisory board you are interested in? I have no knowledge of the board per se, but I do know how to work on a board in a complementary fashion due to my two terms on the Board of Adjustment. As I stated above, I have strong feelings regarding the importance of the library in our community. I would like to do what I could to keep it strong and growing. Potential Conflicts of Interest 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. 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. Gene Chrischelles Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? r Yes r 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 67 Country of Origin Sexual Orientation Religion Do you have a disability Ethnicity Gene Chrischelles 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Gene Chrischelles Advisory Board/Commission Application Form Submit Date: May 29, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Janine Kane First Name Middle Last Name Initial First Name (Phonetic spelling) /j//uh//n//ee//n/ Last Name (Phonetic spelling) /k//ay//n/ 2608 Catskill Court Home Address Suite or Apt Iowa City IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 7.8 years Mobile: (563) 599-3230 Primary Phone Alternate Phone janineckane@gmail.com Email Address School Psychologist Occupation Gender (*This question is mandatory 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 section of the application below.) * C Female Janine Kane Boards & Commissions Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have held a library card and found the library to be a valuable resource since I was 5 years old, in each place I have lived since my childhood. I am currently a school psychologist who will soon retire, and I have also taught in higher education as well as held other paid and volunteer positions including a volunteer adult literacy tutor. As an assistant professor at Loras College for 7 years, I led various courses in the teacher preparation program. My highest priority during these years was to help future teachers understand the importance of literacy and the need to support ALL students regardless of academic ability, socioeconomic status, gender, sexual orientation, or any other categorization that society determines. In the 14 years I have served students and families in two of Iowa's Area Education Agencies, in rural and urban areas, I have continually urged families to utilize the many beneficial services provided by their local libraries. I share my positive perspective of reading, books, and libraries with students, especially those with whom I work who have experienced difficulty learning to read; helping them understand that they are capable and can learn in multisensory ways in addition to reading print materials (as they improve their reading skills) is one of my top goals. In our current political climate, I am increasingly concerned about the limiting of access to information in all formats to the citizens of our Nation and State. Being a member of the ICPL Board of Trustees would provide me with additional opportunities to advocate for free and equitable access to information at the local level and perhaps also serve as an avenue to expand my efforts in promoting the indispensability of public libraries now and in the future. I am proud to say that my daughter, Hannah, is a former employee of ICPL and a graduate of the UI Library and Information Science program. Through her work in public libraries in Wisconsin since her graduation, I have developed knowledge of issues public libraries face, innovative programming ideas, and potential opportunities for additional services to benefit children, youth, and adults. What is your present knowledge of each advisory board you are interested in? My understanding is that the Library Board of Trustees plans and directs policy and procedures for the Iowa City Public Library. Funding, goal-setting, and employment decisions are important functions of the Board. Members are appointed for six-year terms. If selected to serve, it is my plan to use my knowledge and experiences as I collaborate with members of the Board, library staff, and community stakeholders to positively impact the future of ICPL. Potential Conflicts of Interest Janine Kane 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: Grant Wood AEA is my current employer until my contract ends July 31, 2023. To the best of my knowledge, I have no financial interests in any entities that are engaged in contracts with the City of Iowa City. 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 serve on another Iowa City board or commission? r Yes c No (Optional) Demographic Information Janine Kane 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 61 Country of Origin United States Sexual Orientation Heterosexual Religion None Do you have a disability Yes Ethnicity White 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) Janine Kane 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. r I Agree Janine Kane Advisory Board/Commission Application Form Submit Date: May 28, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Laura Kerr First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 821 E Market st _ Home Address Suite or Apt Iowa City _ IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 7 Mobile: (641) 691-5221 Primary Phone Alternate Phone kerr.lauraann@gmail.com Email Address Librarian Occupation Gender (*This question is mandatory 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 section of the application below.) * W Female Boards & Commissions Laura Kerr Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have been a patron of the library for many years. I have a masters of information sciences from the University of Tennessee. I have been on multiple committees and organizations relating to libraries, public history, and archives. What is your present knowledge of each advisory board you are interested in? This board has goals to set policies, appropriate money as needed, establish good working practices and objectives for the library. Potential Conflicts of Interest 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. 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. Laura Kerr List your answers here: University of Iowa Libraries 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 serve on another Iowa City board or commission? r Yes c 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 28 Country of Origin United States Sexual Orientation Bisexual Religion Do you have a disability Yes Ethnicity Race Laura Kerr 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Laura Kerr Advisory Board/Commission Application Form Submit Date: Mar 19, 2024 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Isaac Medina First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 44 Post Rd _ Home Address Suite or Apt Iowa City _ IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? e Yes r No How long have you been a resident of Iowa City? 3 Home: (641) 351-9688 Primary Phone Alternate Phone isaacmedina20l4@gmail.com Email Address Attorney Occupation Gender (*This question is mandatory 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 section of the application below.) W Male Boards & Commissions Isaac Medina Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Library Board of Trustees Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am passionate about public libraries and the service that they provide to our communities. I see myself supporting the goals of the Public Library at to make sure that they have the resources they need to reach all members of our community. I am also passionate about human rights and deal a whole lot with issues that intersect with immigrant in our communities. I am currently on my third year of working as an attorney who's primary area of practice is immigration. Being an attorney has allowed me to hone in my critical thinking skills, writing and speaking as well as attention to detail. Given these are transferable skills I am confident that I could put them to use in these boards and commissions. What is your present knowledge of each advisory board you are interested in? I have a surface level knowledge of the board and their duties and I am interested in learning more and help support our public library and or the human rights commission. Potential Conflicts of Interest 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. 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. Isaac Medina Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: I am currently employed by Trey Sucher Law, PLC. Res. #22-78 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 serve on another Iowa City board or commission? r Yes r 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 28 Country of Origin USA Sexual Orientation Heterosexual Religion Catholic Isaac Medina Do you have a disability No Ethnicity Hispanic/Latino Race N/A 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. [;F I Agree Isaac Medina Advisory Board/Commission Application Form Submit Date: May 02, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Maxwell ) O'saurus First Name Middle Last Name Initial First Name (Phonetic spelling) +13097168542 Last Name (Phonetic spelling) +13097168542 2510 Friendship St Home Address Suite or Apt Iowa City IA 52245 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? oYes oNo How long have you been a resident of Iowa City? 2 years Mobile: (309) 716-8542 Primary Phone Alternate Phone osaurus.m@gmail.com Email Address Packaging technician Occupation Gender (*This question is mandatory 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 section of the application below.) ❑p Male Maxwell J O'saurus Boards & Commissions Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I think books are an extremely important part of a civilized society. Given libraries are the largest homes of books, I believe being a member of the library board would give me the opportunity to protect access to all books. What is your present knowledge of each advisory board you are interested in? I'm unsure of the entirety of what the library board of trustees does exactly, but I am aware of how to find out their duties. Potential Conflicts of Interest 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. 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. Maxwell J O'saurus Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? r Yes r 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 29 Country of Origin USA Sexual Orientation Religion Do you have a disability Maxwell J O'saurus Ethnicity Race White 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. r I Agree Maxwell J O'saurus Advisory Board/Commission Application Form Submit Date: Mar 22, 2024 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Anna M Stone First Name Middle Last Name Initial First Name (Phonetic spelling) Rhymes with BANANA Last Name (Phonetic spelling) Rhymes with BONE 301 Woolf Avenue Home Address Suite or Apt Iowa City IA 52246 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? o Yes o No How long have you been a resident of Iowa City? 43 years Mobile: (319) 621-4424 Home: (319) 338-2293 Primary Phone Alternate Phone aemoyers@gmail.com Email Address Community volunteer (former laywer and trust officer) Occupation Gender (*This question is mandatory 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 section of the application below.) * C Female Anna M Stone Boards & Commissions Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have lived in Iowa City my whole life and so have grown up with the ICPL. I've had a library card for as long as I can remember; my current one still bears my "Anna Moyers" signature from high school. Now, as an adult and with my own family, I have a renewed interest in the Library not only as a resident but also as a mom of an avid reader. We've done it all: Book Babies, summer crafts, the Bookmobile, various storytimes, placing holds, and chatting with the helpful librarians and getting their recommendations. We have a wonderful and robust library that my family has appreciated for years, and I would like to make sure that that continues. I am a lawyer, though I don't practice anymore, and also worked as a trust officer at a local bank. I have continued to serve on other area non-profit boards for almost twenty years. I was on the City's charter review commission about ten years ago. My training as an attorney and my other board and commission experience show that I am qualified to serve on the Library Board of Trustees. I have experience with establishing policies, financial management, and strategic goal-setting in a variety of settings. What is your present knowledge of each advisory board you are interested in? I can't remember a time when I wasn't aware of the Library Board of Trustees. My mom served on the Board of Trustees and was heavily involved with the ICPL in the past, and I've known other trustees as well, following the issues and their board service. I understand the purview of the Board of Trustees, and I also understand that it is an interesting time for libraries. I'm excited for the opportunity to be involved in this way. Potential Conflicts of Interest 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. Anna M Stone 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: None. I am not employed outside of the home. I am on the FilmScene board of directors through the end of 2024 and am also on the PTO at my daughter's school until June 2024. Res. #22-78 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 serve on another Iowa City board or commission? r Yes c 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: Anna M Stone Age 43 Country of Origin USA Sexual Orientation Straight Religion Catholic (kind of) Do you have a disability No Ethnicity White 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) 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. Anna M Stone Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. r I Agree Anna M Stone Advisory Board/Commission Application Form Submit Date: May 02, 2023 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. If appointed to a Board/Commission, all other applications will be removed from consideration. Profile • NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated. • Date of Application (Date will be captured on form submission) Trevor Templeman First Name Middle Last Name Initial First Name (Phonetic spelling) 3195416576 Last Name (Phonetic spelling) 641 Fairway LN SE Home Address Suite or Apt Iowa City IA 52240 City State Postal Cade Is your home address (listed above) within the corporate limits of Iowa City? O Yes O No How long have you been a resident of Iowa City? Iowa City Mobile: (319) 541-6576 Primary Phone Alternate Phone trevortempleman@gmail.com Email Address Social Studies Teacher Occupation Gender (*This question is mandatory 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 section of the application below.) p Male Trevor Templeman Boards & Commissions Which Boards would you like to apply for? Library, Board of Trustees Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Interests & Experiences Experience and/or activities which you feel qualify you for this position: Instructional coach and social studies teachers in the Cedar Rapids Community School District. A passionate advocate for libraries as a social, economic, and political hub for our community. A desire to work collaboratively with other board members and library staff to make decisions that are in the best interest of the library and our community. I live in and have, with my family, actively used the library as a resource, meeting space, and hub for conversation and community. What is your present knowledge of each advisory board you are interested in? The Board of Trustees is responsible for setting library policies, overseeing library operations, and advocating for the library's interests. Some of the specific responsibilities of the Board include: Approving the library's budget and financial policies Hiring and evaluating the library director Developing and reviewing library policies Advocating for the library's needs and interests with the City Council and other stakeholders Ensuring that the library is providing high-quality services to the community In addition to these responsibilities, Board members may be involved in various committees and task forces, such as the Budget Committee, the Personnel Committee, and the Strategic Planning Task Force. Overall, the Board of Trustees plays a critical role in ensuring that the Iowa City Public Library is meeting the needs of the community and fulfilling its mission to provide access to information, resources, and services that enrich people's lives. Potential Conflicts of Interest 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. Trevor Templeman 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. Most members of City Boards and Commissions are employed, and/or have a financial interest in one or more non-profit entities. 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. In order to navigate potential conflicts of interest for certain matters, please list any and all business or non-profit entities in which you have an employment or financial interest. List your answers here: 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 serve on another Iowa City board or commission? r Yes c 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 40 Trevor Templeman Country of Origin United States Sexual Orientation Male Religion Do you have a disability No 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) 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. Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. r I Agree Trevor Templeman Item Number: 12.a. CITY OF IOWA CITY COUNCIL ACTION REPORT April 2, 2024 Ad Hoc Truth & Reconciliation Commission - One vacancy to fill an unexpired term, upon appointment - December 31 , 2024 (Sikowis Nobiss Resigned) Correspondence included in Council packet. Airport Commission - One vacancy to fill a four-year term, July 1 , 2024 - June 30, 2028. (Term expires for Hellecktra Orozco) Community Police Review Board - Two vacancies to fill a four-year term, July 1, 2024 - June 30, 2028. (Terms expire for Amanda Remington & Orville Townsend Sr) Historic Preservation Commission (At-Large) - One vacancy to fill a three-year term, July 1 , 2024 - June 30, 2027. (Term expires for Margaret Beck) Historic Preservation Commission (College Green) - One vacancy to fill a three-year term, July 1 , 2024 - June 30, 2027. (Term expires for Noah Stork) Historic Preservation Commission (E. College St.) - One vacancy to fill an unexpired term plus a three-year term, upon appointment - June 30, 2027. (formerly advertised as unexpired term - Cole Eckhardt Resigned) Historic Preservation Commission (Woodlawn Ave.) - One vacancy to fill an unexpired term plus a three-year term, upon appointment - June 30, 2027. (formerly advertised as unexpired term - Kevin Larson resigned) Housing & Community Development Commission - Three vacancies to fill a three-year term, July 1 , 2024 - June 30, 2027. (Terms expires for Becci Reedus, Kaleb Beining, Karol Krotz) Attachments: Resignation Ad Hoc TRC - Nobiss Kellie Grace From: Stefanie Bowers Sent: Sunday, March 24, 2024 6:26 PM To: Kellie Grace Subject: FW: I quit From:Christine Nobiss<sikowis@greatplainsaction.org> Sent:Saturday, March 23, 2024 11:02 PM To:Stefanie Bowers<SBowers@iowa-city.org> Subject: I quit A **This email originated outside of the City of Iowa City email system. Please take extra care opening any links or attachments. ** Hello Stefanie, I told Chastity that I quit the TRC but she told me to tell you as well. I am so happy that we have been able to build a relationship outside of this commission! I look forward to working with you in different ways. Ay hal kitatamihin, Sikowis Nobiss, shejher Plains CreeJSauiteaux, George Gordon First Nation Executive Director, Great Plains Action Society sikowis ftreatplainsoction.ora Web -greatWainsaction.ore FB - @GreatPlainsActionSociety IG - @greatplainsactionsociety Tw - @PlainsAction t