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HomeMy WebLinkAbout2024-11-19 Appointment Item Number: 11.a. r 1 CITY OF IOWA CITY � Q ' COUNCIL ACTION REPORT November 19, 2024 Climate Action Commission - Three vacancies to fill three-year terms, January 1, 2025 - December 31, 2027 (Terms expire for Michal Eynon-Lynch, Gabriel Sturdevant, John Fraser). Attachments: Vacancy Notice Board Demographics Attendance Sheet Application Coversheet Balde, Daouda - Application Bork, Emma - Application Byriel, Katie - Application Fraser, John H - Application Havel-sturdevant, Jinxx D - Application Krylov, Nadja - Application Peterson, Katherine - Application Traer, Robert - Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: CLIMATE ACTION COMMISSION Three Vacancies: Three-Year Terms January 1, 2025— December 31, 2027 • Duties of the Climate Action Commission include advising the City Council on climate issues; • researching, analyzing and promoting climate actions, with particular attention to equity; • educating and engaging with the public on climate action and the City's climate and sustainability goals; • assisting City staff, City Council, and members of the community with implementing approved initiatives that support the City's climate and sustainability goals, including the Climate Action and Adaption Plan and any related or updated plan here after. • The Climate Action Commission meets the first Monday of each month at 3:30 p.m. in the MPO (Metropolitan Planning Organization) Conference Room at City Hall, 410 E. Washington Street, subject to change. Iowa City-appointed members of boards and commissions must be at least 18 years of age and Iowa City residency is preferred, but members are not required to be Iowa City residents as long as they are residents of Johnson County and meet the requirements of knowledge and expertise for guiding climate objectives. 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, November 12, 2024. An application can be completed and submitted on the City of Iowa City website at vww.icgov.orq or by contacting the City Clerk's office. Questions about the Iowa City Climate Action Commission should be directed to Sarah Gardner, Coordinator at (319) 887-6162. cu c o 3 § } } / ,� % % ) oR R I 27 T- B o z z z 0 \ \ � < \ j ) C ) . % O) o \ } / �k § \ r 2 / 2 $ g $ / $ / $ o ¥ 22 2 / 2 / 2 / 2 / u % = 2 = 2 = Isms@ % R 2 @ @ 7 2 ¢ 0 0 0 0 0 wn cu$ . k ) \ \ \ \ ] ] ] \ c = _ _ _ _ > > > m ƒ r t / \ k \ g2 / C £ _ # 0 \ % \ A o o e < 0 •c > _ % _ _ m ƒ ® \ \ r 2 m < — CL ® O 0 \ / k \ 0 2 0\ o a- co m � _ e ± & 0 \ % m k a) 0 § / j k k + r \ & w a ) \ \ \ \ \ ' 70 R R R \ §I / § § §O N N N N N E Q Q Q Q Q Q Q Q Q \ � & 6 6 6 6 6 6 6 6 6 % J � ° 9 Ef a) q_ � z On E k 7 \ 0 E = _ _ _ _ x U 3 3 J J 3 / 3 3 3 ,% 0 O ) % o cu cu y } ± Q .E 0 ± L a) '§7 < D m 0 � g £ % \{ § / § k °E ° . ]% 2 = = = \k .m 2 CG% %% / %� <z > > > 2 > = = & _ \o_ . Climate Action Commission October 2024 Page 4 of 4 CLIMATE ACTION COMMISSION ATTENDANCE RECORD 2023-2024 N 0 F- ri F- N W A (f1 Ql CO l0 W N N A V� A N 0) w U� W 0 J NAME TERM EXP. N \ N N N N N N N N NJ N W N W A A A A A A A A A W Michael 12/31/2025 NM O/E X O/E O/E X O/E X X Anderson Michal Eynon- 12/31/2024 X X X NM X X X X X O/E X X Lynch John Fraser 12/31/2024 X X X NM X X X O/E X X X X Jamie Gade 12/31/2025 O/ X X NM X X X X X X O/E X E Ben Grimm 10/31/2023 X X X NM X O/E X X O/E O/E X X Zach Haralson 12/31/2025 NM X X X X O/E X O/E X Matt Krieger 12/31/2023 O/ X O/E E Wim Murray MiclAmerican X X X NM X X X X X X X X Rep Michelle Sillman 12/31/20025 X X X NM O/E X X O/E X X X O/E Brinda Shetty UI Rep X X O/E NM X X X X X O/E X X Angie Smith 12/31/2025 X X NM X X X X X X X O/E Gabe Sturdevant 12/31/2024 X O/E X NM X X X X O/E X X X Matt Walter 12/31/2023 X O/E X KEY: X= Present 0 =Absent 0/E=Absent/ExcusedNM= No Meeting * No longer on Commission 4 Board/Commission Application Cover Board/Commission: Climate Action Commission Three vacancies to fill three-year terms January 1, 2025— December 31, 2027 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: 10/01/2024 Application Deadline: 11/12/2024 Council Appointment Date: 11/19/2024 Name and Address Name and Address Balde, Daouda Peterson, Katherine 845 Cross Park Ave Apt 2D 201 N 1st Ave Apt 405 Iowa City IA 52240 Iowa City IA 52245 Bork, Emma T Traer, Robert 100 Currier Hall #S323 311 Woolf Ave Iowa City IA 52242 Iowa City IA 52246 Byriel, Katie 624 S Clinton St Iowa City IA 52240 Fraser,John H (Currently serving 2"d term) 2040 Little Creek Ln Iowa City IA 52246 Havel-sturdevant,Jinxx D 1908 Delwood Dr Iowa City IA 52240 Krylov, Nadja 1927 Earl Rd Iowa City IA 52246 Advisory Board/Commission Application Form Submit Date: Apr 26, 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) Daouda Balde First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 845 Cross Park Avenue Apt 2D _ Home Address Suite or Apt Iowa City IA 52240 City 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? 8 years Mobile: 3199362582 Home: 3199362582 Primary Phone Alternate Phone daouda2890@gmail.com _ Email Address Test 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.) rJ Male Boards & Commissions Daouda Balde Which Boards would you like to apply for? Climate Action 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? r Yes a No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in nonprofit management? (3 Yes 0 No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you receive rental assistance? o Yes a No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in construction? G Yes (3 No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in finance? r Yes r No Interests & Experiences Experience and/or activities which you feel qualify you for this position: I would like to be part of board because landlord in Iowa City do not respect tenants rights. I would like to advocate for these people. What is your present knowledge of each advisory board you are interested in? I have knowledge in nonprofits management. 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. Daouda Balde 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 33 Daouda Balde Country of Origin Guinea, Conakry Sexual Orientation Religion Muslim Do you have a disability No Ethnicity Fulani Race Black Gender Identity Mal *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 Daouda Balde Advisory Board/Commission Application Form Submit Date: Dec 04, 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) Emma Bork First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 100 Currier Hall #S323 Home Address Suite or Apt Iowa City IA 52242 City 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? This is my second year. The above address is current and will be changing after the school year is over. Home: (515) 493-8445 Primary Phone Alternate Phone emmaabork@gmail.com Email Address Student at the University of Iowa 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.) * 17 Female Emma Bork Boards & Commissions Which Boards would you like to apply for? Climate Action 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 majoring in Environmental Policy and Planning and I have a good amount of knowledge on the environment, but I would love to use that knowledge in a professional setting and gain more experience. What is your present knowledge of each advisory board you are interested in? After hearing from two former members, I know the CAC is an advisory board to the Council where environmental issues within Iowa City are brought up and voted on. I was also told that they are looking for more students to be representatives and that appealed to me. 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. Emma Bork 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 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 Sexual Orientation Religion Do you have a disability Ethnicity Emma Bork 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. W I Agree Emma Bork Advisory Board/Commission Application Form Submit Date: Jan 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) Katie Byriel First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 624 S Clinton St Home Address Suite or Apt Iowa City IA 52240 City 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? 2 years Mobile: (515) 777-5576 _ Primary Phone Alternate Phone kbyriel@uiowa.edu 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.) rJ Female Boards & Commissions Katie Byriel Which Boards would you like to apply for? Climate Action 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: Sustainability Science B.S and minor in Hydrology Environmental Science Environmental volunteering through Hickory Hill Park Volunteering at Glenbrooke Park, and Saylorville Lake, Ankeny IA Member of the UI Earth and Environmental Science Club Co-president of high school Environmental Club UI Environmental seminar Attending Iowa City zoning and planning council meetings What is your present knowledge of each advisory board you are interested in? My present knowledge of the Climate Action Commission is that it is working to create a more sustainable framework for Iowa City, through identifying and communicating what contributes to the environmental state of Iowa City. I also know that the council promotes environmental awareness throughout the community through outreach, events, and program engagement. I have read the City Council's climate Action and Adaptation plan regarding goals for Iowa City's carbon emissions, and how they might be reduced by 2030. Working to reach established goals like this I understand to be of big importance to 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. Katie Byriel 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: Current Employment: University of Iowa Events and Ticket Office Starbucks 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 Religion Do you have a disability No Katie Byriel Ethnicity Race Caucasian Gender Identity She/Her *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 Katie Byriel Advisory Board/Commission Application Form Submit Date: Nov 11, 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) Are you 18 years of age or older? r Yes r No John H. Fraser First Name Middle Last Name Initial First Name (Phonetic spelling) Jon Last Name (Phonetic spelling) Fra-zer 2040 Little Creek Lane 2040 Little Creek Lane Home Address Suite or Apt Iowa City IA _ 52246 City 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? 37 years Home: (319) 621-1043 Mobile: (319) 621-1043 Primary Phone Alternate Phone johnhfraser3@gmail.com Email Address Management Consultant Occupation Boards & Commissions John H. Fraser Which Boards would you like to apply for? Climate Action Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) John Interests & Experiences Experience and/or activities which you feel qualify you for this position: 37 years What is your present knowledge of each advisory board you are interested in? I am applying for another term (would be my last) on the Climate Action Commission. I was a member of the original Climate Action Board and have served various functions including Board Chair. I feel strongly that Climate Action initiatives are critical to our community, our state, our nation and the world. Particularly now, more than ever, strategic assertiveness, implemented appropriately is critical for our earth's survival. Thank you. 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. John H. Fraser 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: I am retired from The United States Naval Air Reserve I am retired from Amana Refrigeration I am retired from The University of iowa I continue to provide (as requested/contracted) Leadership Coaching and Leadership Training as an Independent Consultant and Coach. I continue to maintain a relationship as an adjunct lecturer at the Tippie College of Business and am International Institute of Business (IIB) Board Member. 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? o 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: Gender 17 Male Age 81 Country of Origin United States John H. Fraser Sexual Orientation Straight Religion Protestant Do you have a disability No Ethnicity American 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. W I Agree John H. Fraser Advisory Board/Commission Application Form Submit Date: Dec 01, 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) jinxx D Havel-sturdevant First Name Middle Last Name Initial First Name (Phonetic spelling) jin-kks Last Name (Phonetic spelling) Ha-vel Stur-de-vant 1908 Delwood Drive Home Address Suite or Apt Iowa City IA 52240 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 30+ Mobile: (319) 930-6756 Home: (319) 354-9676 Primary Phone Alternate Phone jinxx-havelsturdevant@uiowa.edu Email Address Full time student at the University of Iowa 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 jinxx D Havel-sturdevant Boards & Commissions Which Boards would you like to apply for? Climate Action Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Climate Action Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am a junior at the University of Iowa majoring in both EPPL (Environmental Policy and Planning) and International Studies: Sustainable Development. Also working towards a certificate within sustainability. What is your present knowledge of each advisory board you are interested in? My husband (Gabriel Sturdevant) is currently a member on the Climate Action Commission. I am unfamiliar with the other commissions but I am willing to learn. 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. Jinxx D Havel-sturdevant 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: I do not have any conflicts of interest with businesses or non-profit entities. 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 Bi Religion Catholic Jinxx D Havel-sturdevant Do you have a disability Yes Ethnicity Race Gender Identity cisgender *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) 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 Jinxx D Havel-sturdevant Advisory Board/Commission Application Form Submit Date: Nov 07, 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) Are you 18 years of age or older? r Yes r No Nadja Krylov First Name Middle Last Name Initial First Name (Phonetic spelling) Nadya Last Name (Phonetic spelling) Krylov 1927 Earl Road Home Address Suite or Apt Iowa City IA 52246 City 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? 9 years Mobile: (708) 689-7401 Primary Phone Alternate Phone nk3mcg@gmail.com Email Address Writer Occupation Boards & Commissions Nadja Krylov Which Boards would you like to apply for? Climate Action 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: Certified Climate Reality project presenter (since 2007, trained by Al Gore in Nashville after an Inconvenient Truth came out.) Led a number of presentations, including in Russia, as part of my consulting work there up to 2001; generally familiar with climate issues, as well as solutions. Have produced presentations on the effects of architecture on global warming and change (at the University of Illinois School of Architecture, Champaign.) Have produced desktop studies for the Swedish Cryosphere Foundation, about the acquisition of farm machinery in Russia in support of projects to prevent agricultural waste burning, with black smoke floating into northern Scandinavia and melting their snows, so am generally aware of the role of agriculture. Special Assistant to the Governor, Jerry Brown, curating a number of projects so I'm generally familiar with government work. I have a degree in History from UC Irvine, California, and an MBA from Henley Business School in the UK, and have been very much interested in how to coordinate public policy and business concerns so they create results greater than the sum of their parts. What is your present knowledge of each advisory board you are interested in? I've read the minutes of the last meeting of the Climate Action Commission and would be interested in engaging with the projects and issues it described. While I've made a list of what I think qualifies me to join the commission, I also realize I've had no experience at all at a municipal level and realize that success depends on a lot of implicit knowledge of the ways of Iowa City and the relationships among the people/institutions involved that, of which I have zero. So, in terms of the question about my present knowledge, there it is -- I read the agenda and minutes! And I realize a lot of what I "know" with regard to climate initiatives may be less important than what I don't know about working on a board in a city, but I'd like to learn. 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. Nadja Krylov 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. #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: Gender W Female Nadja Krylov Age 76 Country of Origin Displaced Person born in West Germany of Ukrainian forced labor mother and prisoner of war father Sexual Orientation straight Religion Buddhist Do you have a disability no Ethnicity Race white Gender Identity Cisgender *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) 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. Nadja Krylov Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Nadja Krylov Advisory Board/Commission Application Form Submit Date: Nov 11, 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) Are you 18 years of age or older? r Yes r No Katherine Peterson First Name Middle Last Name Initial First Name (Phonetic spelling) KATH-er-ine Last Name (Phonetic spelling) PEE-ter-sun 201 N 1st Ave Apt 405 Home Address Suite or Apt Iowa City IA 52245 City 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? 2 years Home: (630) 352-7708 Primary Phone Alternate Phone katherine.mary.peterson@gmail.com Email Address Metadata librarian _ Occupation Boards & Commissions Katherine Peterson Which Boards would you like to apply for? Climate Action 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: My job involves providing access to eResources by providing robust and accurate descriptions that includes information such as a resource's accessibility features and inclusive subject terms. My job also involves cataloging materials in the Iowa Digital Archives and has made me more familiar with the University of Iowa and Iowa City's history. In 2023, 1 attained my mental Health First Aid Certification from the National Council for Mental Wellbeing. In 2023, 1 earned my Building University of Iowa Leadership for Diversity (BUILD) certification. In 2024, 1 earned my University of Iowa LGBTQ safe zone training. In 2022, 1 earned a Masters in Library and Information Science from the University of Illinois. From 2020-2022, 1 was a graduate assistant for the iSchool Help Desk at the University of Illinois where I provided tech support to students, faculty, and staff. What is your present knowledge of each advisory board you are interested in? Human Rights Commission: The work of the commission includes advocating for human rights in the capacity of educating the public, partnering with related organizations, and recommending legislation to City Council. The commission has invovlement with awarding the Racial Equity and Social justice Grant and with awarding Iowa City's Human Rights awards. The commission is also divided into three committees based on the areas of work outlined in the strategic plan, which is currently under review and revision. Climate Action Commission: The work of the commission involves advising City Council on initiatives related to climate action and helping to implement those initiatives if approved. Meetings often involve guest speakers sharing about their projects with commission members. In 2019 the Iowa City City Council declared to reduce carbon emissions by 45% from 2010 levels by 2030 and to reach net zero emissions by 2050. the Accelerating Iowa City's Action Plan was created to reach these goals. 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. Katherine Peterson 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: University of 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: Gender W Female Katherine Peterson Age 28 Country of Origin United States Sexual Orientation Ace Religion Agnostic Do you have a disability No Ethnicity Race White Gender Identity 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. Katherine Peterson Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Katherine Peterson Advisory Board/Commission Application Form Submit Date: Nov 04, 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) Are you 18 years of age or older? r Yes r No Robert Traer First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 311 Woolf Avenue Home Address Suite or Apt Iowa City IA 52246 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 4 years Home: (909) 541-6650 _ Primary Phone Alternate Phone _rtraer@gmail.com _ Email Address Retired environmental ethics professor Occupation Boards & Commissions Robert Traer Which Boards would you like to apply for? Climate Action 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 taught environmental ethics for more than a decade and am the author of the university textbook "Doing Environmental Ethics" (Routledge, third edition 2020). As an Iowa City Climate Ambassador, I have made presentations at Oaknoll retirement community and the Senior Center, and led three sessions beginning on September 17th at St. Andrew Presbyterian Church. What is your present knowledge of each advisory board you are interested in? The training for becoming an Iowa City Climate Ambassador including reviewing the City's climate action plan and reports on the progress being made. 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. Robert Traer 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: I do not have any conflicts of interest. 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: Gender m Male Age 81 Country of Origin USA Sexual Orientation Husband, father, grandfather Robert Traer Religion Christian Do you have a disability No Ethnicity Dutch/English kace 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. W I Agree Robert Traer Item Number: 11.b. r 1 CITY OF IOWA CITY � Q ' COUNCIL ACTION REPORT November 19, 2024 Human Rights Commission - One vacancy to fill an unexpired term, upon appointment - December 31, 2024, plus a three-year term (01/01/25 - 12/31/27) (Anya Schafer-Van Houtte resigned). Attachments: Vacancy Notice Board Demographics Attendance Sheet Application Coversheet Bartenhagen, Kate M - Application Bender, Barry D - Application Brommel, Kelli A - Application Dettbarn, Avery C - Application Gross, Steven - Application Guo, Rebecca Rong - Application Hardesty, Eric - Application Harkin, Emily - Application Heil, Megan - Application Heller, Sophia E - Application Hirst, Donna L - Application Kane, Janine - Application Koch, Susan J - Application Kraynak, John J - Application Medina, Isaac - Application Mohamed, Lubna S - Application Nelson, Mathe E - Application Peterson, Katherine - Application Rodriguez, Suzanna M - Application Ruhrer-Johnson, Estella J - Application Savarese, David J - Application Tippe, Allison K - Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION One Vacancy: Upon Appointment— December 31, 2024 plus a 3-year term (01/01/25-12/31/27) Two Vacancies: Three-Year Terms January 1, 2025— December 31, 2027 • 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, November 12, 2024. An application can be completed and submitted on the City of Iowa City website at www.icgov.orq or by contacting the City Clerk's office. Questions about the Iowa City Human Rights Commission should be directed to Stefanie Bowers, Equity Director at (319) 356-5022. / 7 ] d \ o 0 § % § § § § e 2 L ] ] � ] LL L ) f § / (D 7 ] ] \ / ) $ \ j / / / / / / / ) = 2 - e e ± f ) \ / ) / .q ] j ) § § .f a) E E t E = o = / f f \ f ® \ \ < 7 ) 0 0 2 2 \ 6 \ § \ § 2 3Jo ] ) } .) % < m # p ? m co CD \ \ ( ( a) ( ( ( \ � ] ] � ] ) - ® & a� / £ § f a - �.% 2 2 � � ) T-> / \ j \� / 233 - C § \ ) ) � y� sq E = : a 72 % � & ; _ £ = , u ; a f &) / .2 \ 3 / / ) \ \ ) \ / 32 / kIn- ) \ ƒ \ 1 1§ /ƒ ] \ � � o � 2 \ Cl) - �� % ® k \ \ \3 3 \ \ (0 m \ & & \ ± : 3 § E [ § Q Q Q Q Q Q Q _ % - E \ - E / J c U 7 _CL \ _ _ _ _ _ ) J e \ f \ \ \ 2 \ R � � \ � \ � § ! o (L 17 \ \ p \ } \ \ ) / 2 / } } } \ ƒ / 3 A A � R ■ Q u U W gz 2 x x x x x x N N � � 3 x x * * * x * 2 N CIA 7 7 & & & Qnk � � II II II � c = 2 ; ■ c f \ 5 2 _ W 2 n ® 2 ■ � § ? 2 Board/Commission Application Cover Board/Commission: Human Rights Commission One vacancy to fill an unexpired term, upon appointment—December 31, 2024, plus a three-year term (January 1, 2025—December 31, 2027) 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: 10/01/2024 Application Deadline: 11/12/2024 Council Appointment Date: 11/19/2024 Name and Address Name and Address Name and Address Name and Address Bartenhagen, Kate M Harkin, Emily Medina, Isaac Tippe, Allison K 1801 Earl Rd 811 E College St Apt 3-4 44 Post Rd 1105 Prairie du Chien Rd Iowa City IA 52246 Iowa City IA 52240 Iowa City IA 52245 Iowa City IA 52245 Bender, Barry D Heil, Megan Mohamed, Lubna S 1010 Scott Park Dr#209 406 S Gilbert St Apt 927 1905 Gleason Ave Iowa City IA 52245 Iowa City IA 52442 Iowa City IA 52240 Brommel, Kelli A Heller, Sophia E Nelson, Mathe E 2 Princeton Ct 19 E Burlington St Apt 107 965 Longfellow Ct Iowa City IA 52242 Iowa City IA 52240 Iowa City IA 52240 Dettbarn, Avery C Hirst, Donna L Peterson, Katherine 614 S Johnson St Apt 3 810 N Linn St 201 N 11t Ave Iowa City IA 52240 Iowa City IA 52245 Iowa City IA 52245 Gross, Steven Kane,Janine Rodriguez, Suzanna M 805 Hudson Ave 2608 Catskill Ct 405 Reno St Iowa City IA 52246 Iowa City IA 52245 Iowa City IA 52245 Guo, Rebecca Rong ' Koch, Susan J Ruhrer-Johnson, Estella J 1940 Plaen View Dr 25 Sumac Ct 1010 W Benton St Apt 216F Iowa City IA 52246 Iowa City IA 52246 Iowa City IA 52246 ' Hardesty, Eric Kraynak,John J Savarese, David J 711 Woodside Dr 738 Rundell St 418 N Gilbert St Iowa City IA 52246 Iowa City IA 52240 Iowa City IA 52245 Advisory Board/Commission Application Form Submit Date: Jun 25, 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) Kate M Bartenhagen First Name Middle Last Name Initial First Name (Phonetic spelling) Kate Last Name (Phonetic spelling) Bartenhagen 1801 Earl Rd. Home Address Suite or Apt Iowa City IA 52246 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 1 year recently, 10 years in the 80s Home: (408) 823-1882 Mobile: (408) 823-1882 Primary Phone Alternate Phone katebartmft@gmail.com Email Address Licensed marriage and family therapist _ 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 Kate M Bartenhagen 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: In my work, as a therapist, I work with diverse populations. Also, I lived in Silicon Valley/San Jose for 25 years and have been exposed to an interacted with individuals from all different backgrounds, cultures, and experiences. I have a deep appreciation for and respect of all people. What is your present knowledge of each advisory board you are interested in? It is limited; however, I am very interested and excited to learn. 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. Kate M Bartenhagen 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. #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 60 Country of Origin United States Sexual Orientation Heterosexual Religion Buddhist Kate M Bartenhagen Do you have a disability No Ethnicity European-American 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. V I Agree Kate M Bartenhagen Advisory Board/Commission Application Form Submit Date: Nov 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) Are you 18 years of age or older? r Yes r No Barry D Bender First Name Middle Last Name Initial First Name (Phonetic spelling) 3192100099 Last Name (Phonetic spelling) 1010 scott park dr 209 Home Address Suite or Apt IOWA CITY IA _ 52245 City 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? 20 yrs Mobile: (319) 210-0099 Primary Phone Alternate Phone barrybender4@gmail.com Email Address school crossing guard part- ti me Occupation Boards & Commissions Barry D Bender 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: some community organizing in the 70s. Managerial skill for Warner music. MA, political science What is your present knowledge of each advisory board you are interested in? outsideer 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. Barry D Bender List your answers here: no financial interests 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? 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: Gender m Male Age 79 Country of Origin United States Sexual Orientation straight male Religion jewish Do you have a disability no Barry D Bender Ethnicity jewish Race jewish Gender Identity straight 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 Barry D Bender Advisory Board/Commission Application Form Submit Date: Nov 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) Are you 18 years of age or older? r Yes r No Kelli A Brommel First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 2 Princeton Ct. Home Address Suite or Apt Iowa City IA 52242 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 13 years Home: (319) 471-5990 _ Primary Phone Alternate Phone kelli@deadchannel.com Email Address Library Assistant Occupation Boards & Commissions Kelli A Brommel 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 have been a teacher and a youth librarian. I'm currently a cataloging library assistant. As a librarian, I am dedicated to providing solid, useful information to the public. I'm a big proponent of the Ad Fontes Media Bias Chart as a tool for examining sources in terms of bias and factuality. In my current role as a cataloger, I have participated in efforts to change subject heading cutters which use outdated and offensive terminology. I go out of my way to learn about life experiences different than my own, from participating in the BUILD courses at the university, to my own personal reading choices. I am aware of the many historical inequities in this country which continue on today, in various insidious forms. I appreciate that Iowa City seeks to work for greater equity and humanity for the community and I would like to be a part of that. What is your present knowledge of each advisory board you are interested in? I know very little, but I hope to learn more by taking an active part in the commission. I attended a Lens Series webinar in June that may have been connected to the work of the commission. It was a conversation with Sikowis Nobiss about re-indigenizing the land. She made a very interesting point about not preserving the prairie as some pristine, inaccessible place, but living in and on the prairie by both protecting and utilizing its gifts. This may seem to have more to do with lawns- and perhaps not the purview of this commission- but I would argue that the green spaces of yards and areas around multi-person housing ought to contain native plant life and provide the possibility of gardens. All humans deserve space to grow food, and all deserve healthy green spaces. 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. Kelli A Brommel 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: I work for the University of Iowa, which is a nonprofit organization. I am not an administrator or executive director of any kind, so I don't raise money for the university or have purchasing power. I'm (currently) a merit level employee, working in the cataloging department of the Main Library. 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: Kelli A Brommel Gender W Female Age 54 Country of Origin United States Sexual Orientation bisexual Religion none Do you have a disability no Ethnicity European American 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. Kelli A Brommel Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Kelli A Brommel 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 Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 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.) * W 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 (. 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: Oct 25, 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) Are you 18 years of age or older? r Yes r No Steven Gross First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) GROWss 805 Hudson Ave _ Home Address Suite or Apt Iowa City IA _ 52246 City 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? 2 months Mobile: (443) 546-0184 Primary Phone Alternate Phone steven.gross00@gmail.com Email Address Nonprofit Operations Coordinator Occupation Boards & Commissions Steven Gross 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: Through any work I do, I am guided by my values which are shaped by my Jewish upbringing and being a student of abolition—being a part of communal and collective efforts to create lasting equity and dismantling systems of oppression. It would be my privilege to bring my experience and perspective as a young, radical, queer, Jewish person to the Humans Rights Commission to contribute to ending discrimination and fostering community in Iowa City. I had the privilege of being a part of the 2022 Gender Justice Giving Project cohort at the Bread & Roses Community Fund. In this cross-class, multi-racial, gender-diverse, intergenerational organizing cohort, we worked together to fundraise for our movement, review grant applications, interview potential grantees, and collectively make decisions on grants based on what we raised. I was deeply motivated by the supportive and collaborative energy of the cohort and was able to work diligently to play my part in our collective efforts. I was thrilled to be able work directly alongside a team with shared values and make sustained impact for the organizations in our community. What is your present knowledge of each advisory board you are interested in? I had the chance to read through the current strategic plan for the Human Rights Commission and am excited to be a part of making it come to fruition. 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. Steven Gross 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: Moving Traditions 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: Gender None Selected /.=_ 24 Country of Origin Sexual Orientation Queer Steven Gross Religion Jewish 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. W I Agree Steven Gross Advisory Board/Commission Application Form Submit Date: Jul 11, 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) Rebecca Rong Guo First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 1940 Plaen View Drive Home Address Suite or Apt Iowa City IA 52246 City 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? 20 Mobile: (319) 284-1734 Primary Phone Alternate Phone rongchun_guo@yahoo.com Email Address Project Director of Oncology Trial-CRO company _ Occupation 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.) Rebecca Rong Guo Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have served in the leadership committee and graduate student committee over the last 19 years. I served as a volunteer poll worker for 20 years in Johnson county. Human right and democracy are the foundation of united states of America. It is an honor and privileges' to serve. What is your present knowledge of each advisory board you are interested in? I read all the online postings of Human Rights Commission Board. There are always more to learn and I am a believer of life long learning and practitioner of what I learn. 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: I am not a city employee. Rebecca Rong Guo 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 (. 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: Gender W Female Age 47 Country of Origin Mongolia Sexual Orientation Female Religion Open Minded Do you have a disability No Ethnicity Asia Pacific Islander Rebecca Rong Guo Asia Pacific Islander 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 Rebecca Rong Guo Advisory Board/Commission Application Form Submit Date: Oct 24, 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) Are you 18 years of age or older? r Yes r No Eric Hardesty First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 711 Woodside Dr Home Address Suite or Apt Iowa City IA 52246 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 1 year Mobile: (605) 210-0624 _ Primary Phone Alternate Phone erichardesty@icloud.com Email Address of Pharmaceutical Care - University of Iowa Hospitals and Clinics Occupation Boards & Commissions Eric Hardesty 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 have leadership experience, volunteer experience, organizational experience, and most importantly compassion for all humans. I have a heart that won't quit and a desire to help people. I can devote time and commitment to the board and will be an active community member. What is your present knowledge of each advisory board you are interested in? The human rights commission is very important in investigating and mediating complaints of discrimination. They advise to restore justice, mediate community disputes, and stand up for the rights of marginalized and vulnerable members of society. 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. Eric Hardesty 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 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: Gender m Male Age 39 Country of Origin United States Sexual Orientation Gay Eric Hardesty Religion n/a Do you have a disability no Ethnicity American kace 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. W I Agree Eric Hardesty Advisory Board/Commission Application Form Submit Date: Nov 12, 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) Are you 18 years of age or older? r Yes r No Emily Harkin First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 811 E College Street, Apt. 3-4 Home Address Suite or Apt Iowa City IA 52240 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 4 years Mobile: (515) 210-0317 _ Primary Phone Alternate Phone _emilyharkin77@gmail.com _ Email Address AmeriCorps Member Occupation Boards & Commissions Emily Harkin 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 have been involved in the protection and promotion of human rights for all the years that I have been in Iowa City. I started volunteering for many community needs, like at the Community Food Pantry, in 2021. From this experience, I became deeply inspired and moved on to become a Nonprofit Management and Community Outreach Intern at the Center for Worker justice, from May to August of 2023, where I focused on language accessibility by developing and leading an English as a Second Language (ESL) program for around 20 immigrants who spoke Arabic, Spanish, and French with the coordination of three instructors (totaling one community member and two English instructors at the University of Iowa). During this internship at the Center for Worker Justice, I also focused on labor rights by assisting in attaining around $20,000 of lost wages in two months by investigating workplaces with victims, filing complaints to the government, and communicating with elected representatives. In the next couple of months, from September to December of 2023, 1 started working at for the University of Iowa Human Rights Center as a Rex Honey Intern who assisted in a mentored human rights research project, funded by a Library of Congress grant, that researched the collective lived experiences of union workers. This desire to protect and promote human rights in my community, that I fostered in my during my B.A. at the University of Iowa, led me to my full-time job as an AmeriCorps at Iowa Legal Aid, where I assist lawyers with the Farmworker Rights Project, Fair Housing Project, and Older Iowans Hotline and has led me to feel qualified to apply to the Iowa City's Human Rights Commission. I can bring skills and knowledge of conducting and utilizing research for informed decision-making, communication with community members, and more to this position. What is your present knowledge of each advisory board you are interested in? Presently, I understand that the Human Rights Commission has primary duties (educating the public on civil and human rights, planning programs and activities to eliminate discrimination, and making recommendations to the City Council) and is trying to achieve that by focusing on three different strategic areas that have a core function of deepening inter-relationships between the commission and the community, community organizations, and the city councilors. I understand that they have been continuing their duties and implementing their strategic goals through a variety of programs around Iowa City through events like the Tenants' Rights Workshop and various other implementations of the Race Equity and Social justice grant. 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. Emily Harkin 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: Iowa Legal Aid 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 (- 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: Emily Harkin Gender W Female Age 21 Country of Origin United States Sexual Orientation Heterosexual Religion Do you have a disability No Ethnicity Non-Latino/Hispanic 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. Emily Harkin Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Emily Harkin Advisory Board/Commission Application Form Submit Date: Jul 16, 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) Megan Heil First Name Middle Last Name Initial First Name (Phonetic spelling) 5635135249 Last Name (Phonetic spelling) 406 S. Gilbert Street _ Apartment 927 Home Address Suite or Apt Iowa City IA 52442 City 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? 2 years Mobile: (563) 513-5249 Primary Phone Alternate Phone heilmegan2@gmail.com _ Email Address Student Occupation Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Megan Heil 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: As a rising third-year student at the University of Iowa, I have been working towards degrees in Ethics & Public Policy and Social Justice, as well as an undergraduate certificate of Human Rights through the College of Law. While pursuing this education, I have volunteered as a Rex Honey intern at the University of Iowa Center for Human Rights. In this position, I transcribed YouTube videos to improve accessibility and learned about a whole host of human rights issues; I also learned about local organizations and efforts dedicated to human rights. At the University, I also helped restart the Students for Human Rights organization, now known as SHRAI. I am the current Vice President of the organization, and have helped plan advocacy initiatives and events for the previous and coming semesters. I have developed connections with faculty at the Center for Human Rights, as well as with other student organization leaders and community organizations. Outside of school, I serve with AmeriCorps at the Immigrant Welcome Network of Johnson County (IWNJQ. Here, I have really honed my community outreach skills and event planning abilities. We have communicated and collaborated with numerous rights organizations, such as the Center for Worker Justice, the Housing Fellowship, and crisis services such as CommUnity. I feel greatly connected to the Johnson County community and its resources, and feel confident in my ability to educate others about these resources. I also feel confident in my ability to develop programs and events with other community organizations to improve outreach, inform the community about their rights, and promote human rights as a whole. Through both the university and IWNJC, I have improved my knowledge of state and federal legislation connected to human rights. I can interpret bills and court decisions in order to educate others and use my sociology background to determine how these laws and rulings will affect peoples' lives. I've helped others navigate the bureaucratic system, introducing them to social services, assisting in finding legal employment pathways, and applying for housing programs. I feel very passionate about educating others about their rights and ensuring they are protected in my community and globally. What is your present knowledge of each advisory board you are interested in? I know that the Human Rights Commission engages in education and outreach to inform people of their rights and to identify discrimination. I also understand that they build relationships with community organizations to develop programs and events to engage community members. 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. Megan Heil 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: Gender W Female Megan Heil Age 20 Country of Origin United States Sexual Orientation Religion Do you have a disability Ethnicity Race Gender Identity *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) 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 Megan Heil Advisory Board/Commission Application Form Submit Date: Nov 01, 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) Are you 18 years of age or older? r Yes r No Sophia E Heller First Name Middle Last Name Initial First Name (Phonetic spelling) so-fee-a Last Name (Phonetic spelling) hell - ur Apt. 107 19 E Burlington St Home Address Suite or Apt Iowa City IA 52240 City 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? 4 years Mobile: (563) 639-4417 Primary Phone Alternate Phone sheller802@gmail.com Email Address Student Occupation Boards & Commissions Sophia E Heller 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 a human rights certificate student at the University of Iowa and I have taken Stefanie Bowers' class on government and human rights where I learned about the Iowa City Human Rights Commission. In this class, I engaged in discussion with my peers and local government actors on human rights. Through this, I was able to contact Iowa City Recycling about apartments in the area that did not take down their cardboard only signs after the policy was lifted banning other recyclables. I am active locally in human rights through various community organizations where I have volunteered. I also worked for the Iowa City Government as a swim instructor where I taught children of the Iowa City camps in the summer and adults how to swim. Through this experience I really got to know the Iowa City community and interact with the community in a way that University students do not usually experience. What is your present knowledge of each advisory board you are interested in? The Human Rights Commission of Iowa City was created in 1964 as a way to deal with discrimination within the community. Now the human rights commission consists of nine residents who serve 3-year terms. The Human Rights commission works on public information campaigns about discrimination and people's rights against discrimination and what might count as discrimination. The Human Rights commission also works on promoting international human rights within the Iowa City community. 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. Sophia E Heller 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: Gender W Female Sophia E Heller Age 21 Country of Origin United States Sexual Orientation Straight Religion Agnostic Do you have a disability Temporary Disability Ethnicity American of Irish Descent kace White Gender Identity 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. Sophia E Heller Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Sophia E Heller 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 810NLINNST _ Home Address Suite or Apt Iowa City IA 52245 City 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? 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.) W 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 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: 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 (. 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. W I Agree Donna L Hirst Advisory Board/Commission Application Form Submit Date: Jun 26, 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) 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 Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 8.8 years Mobile: (563) 599-3230 _ Primary Phone Alternate Phone janineckane@gmail.com Email Address Retired 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.) * W Female Janine Kane 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 Interests & Experiences Experience and/or activities which you feel qualify you for this position: Human Rights: Throughout my personal life, I have been invested in diversity and equity. I have seen the detriments of segregation in schools and communities, and have witnessed the lifelong benefits of inclusion of all in every setting. I have sought relationships with diverse others in order to increase understanding and use my privileges to advocate accordingly. As a school psychologist, I worked with families from all socioeconomic backgrounds and many cultures and backgrounds, and assured that their rights as student, parent, or guardian were respected and assured, breaking down barriers by establishing trust and lines of communication. I was an active member of GWAEA's Equity Advisory Committee, and upon my retirement, was asked to stay on the committee as a community representative. When teaching students at Loras College, I prioritized diversity in my daily activities on campus, including serving as a member of the Diversity Committee and by providing opportunities for students to learn about the rights of all individuals, especially those who were from underrepresented groups, received special education services, and/or were members of the LGBTQ+ community. Library: 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. Janine Kane What is your present knowledge of each advisory board you are interested in? Human Rights: I have attended and actively participated in events offered by the City that relate to diversity and inclusion. Through conversations that occurred at these events, I have become more aware of challenges that are present in our community regarding civil rights and discrimination, and was encouraged to apply for a position on this committee. I am greatly concerned about the current political climate in our State and Nation, as it appears that human rights are continually debated, not equitably available, and are subject to removal for certain groups. I support our State Motto: liberties are essential for all Iowa and U.S. residents, and believe rights need to not only be maintained but also to be expanded appropriately. I would appreciate the opportunity to apply my experience and knowledge to aid the City in assuring that individuals' rights are not infringed upon. Library: 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 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 was my employer until 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. Janine Kane 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 (. 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 63 Country of Origin United States Sexual Orientation Heterosexual Religion None Do you have a disability Yes Ethnicity White Race White Janine Kane 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 Janine Kane Advisory Board/Commission Application Form Submit Date: Nov 12, 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) Are you 18 years of age or older? r Yes r No Susan J Koch First Name Middle Last Name Initial First Name (Phonetic spelling) Susan Last Name (Phonetic spelling) Cook 25 Sumac Court Home Address Suite or Apt Iowa City IA 52246 City 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? 4 years Home: (217) 361-5503 Home: (217) 361-5503 Primary Phone Alternate Phone susanj_koch@yahoo.com Email Address retired academic Occupation Boards & Commissions Susan J Koch 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 spent my career in higher education serving first for over 20 years as a faculty member and teaching in the areas of health and human rights, conflict resolution, and maternal/child health. During my faculty career I was a delegate to the UN Fourth World Conference on Women in China in 1995 and co-authored the book, "Conflict Resolution in the Schools" in 1996. While on the faculty at the University of Northern Iowa I co-founded (with Michele Yehieli) the UNI Global Health Corps with $1 million in funding from a U.S. Public Service Training Grant. The purpose of the GHC was to prepare students to work successfully with diverse and underserved populations both domestically and abroad. During my time serving as Associate Provost and Graduate Dean (University of Northern Iowa), Provost (Northern Michigan University, and Chancellor (University of Illinois at Springfield), I made equity, inclusion and diversity top priorities and advocated for those goals in institutional strategic plans. While serving for nine years as Chancellor at the University of Illinois Springfield (one of three campuses of the University of Illinois System), I led successful efforts to increase the number of students enrolled from underrepresented groups while at the same time significantly increasing fundraising for scholarships to support students. Since retirement I have been a contributing writer for the Chicago Tribune and Des Moines Register. I believe the communication skills I have honed over many years of leadership - listening, speaking and writing - would be a particular value to the Commission and its priorities. What is your present knowledge of each advisory board you are interested in? I have reviewed the Human Rights Commission responsibilities, meeting details and 2022 Strategic Plan. I believe my professional background and interest in volunteering to serve on the Commission and contribute to the larger community will provide a strong start. Should I be selected, I look forward to getting to know each member of the Commission, Equity Director, Stephanie Bowers, and any other community members who can contribute to the Commissions important work. Having lived in the community for four years and intending to remain here, I see this opportunity as a way I can contribute to making Iowa City an even better community for everyone. 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. Susan J Koch 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. #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: Gender W Female Susan J Koch Age 75 Country of Origin U.S. Sexual Orientation hetrosexual Religion Christian Do you have a disability no Ethnicity European American kace 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. Susan J Koch Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Susan J Koch Advisory Board/Commission Application Form Submit Date: Oct 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) Are you 18 years of age or older? r Yes r No John J Kraynak First Name Middle Last Name Initial First Name (Phonetic spelling) J ahn Last Name (Phonetic spelling) Kray nak 738 Rundell Street Home Address Suite or Apt Iowa City IA 52240 City 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? Alexandria Mobile: (213) 271-0560 Primary Phone Alternate Phone jjkinlaca@gmail.com Email Address Retired Occupation Boards & Commissions John J Kraynak 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 recently spent 5 years as the Membership Chair for the Sacramento Gay Men's Chorus, ensuring equity, access and belonging in a 40 year old arts non-profit. I also was the Board Chair for the Midtown (Sacramento) Homeless Assistance Resource Team, hosting four weekly drop in centers offing dignity and services to the downtown unhoused community. Making sure folks are seen is a passion for me. What is your present knowledge of each advisory board you are interested in? I've been following and watching former meetings and actions. 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. John J Kraynak 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: I'm a giving member of Trinity Episcopal Church 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: Gender m Male Age 59 Country of Origin United States Sexual Orientation Gay John J Kraynak Religion Christian/Episcopalian Do you have a disability Yes Ethnicity Race 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 John J Kraynak 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 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 _ 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.) rJ Male Boards & Commissions Isaac Medina 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.) 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 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: 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 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 I Agree Isaac Medina Advisory Board/Commission Application Form Submit Date: Jul 29, 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) Lubna S Mohamed First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 1905 Gleason Ave Home Address Suite or Apt Iowa city IA 52240 City 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? 10 years Mobile: (319) 330-1421 Home: (319) 333-1613 Primary Phone Alternate Phone mohamed.lubna@iowacityschools.org Email Address Para substitute - Arabic interpreter _ Occupation 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.) Lubna S Mohamed Interests & Experiences Experience and/or activities which you feel qualify you for this position: I'm from Sudan and we have a lot of people from Sudan in Iowa city, Coraville and north liberty, I deal with issues and also I'm a member at the NAACP, I usually work closely with Mr Sanders and reported to him the issues and discrimination issues in my community. What is your present knowledge of each advisory board you are interested in? As a member of NAACP i have an experience about the discrimination in housing, educations and different area addition to my Sudanese community racial discrimination issues. 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: None Lubna S Mohamed 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 (. 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: Gender W Female Age Country of Origin Sexual Orientation Religion Do you have a disability Ethnicity Race Gender Identity Lubna 5 Mohamed *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 Lubna 5 Mohamed Advisory Board/Commission Application Form Submit Date: Nov 10, 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) Are you 18 years of age or older? r Yes r No Mathe E Nelson First Name Middle Last Name Initial First Name (Phonetic spelling) 3198539025 Last Name (Phonetic spelling) 965 Longfellow Court Home Address Suite or Apt Iowa City IA _ 52240 City 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? 9 Mobile: (319) 853-9025 Business: (318) 329-2287 Primary Phone Alternate Phone motivational@immigrantmomsofiowa.org Email Address Founder of IMMIGRANT MOMS OF IOWA Occupation Boards & Commissions Mathe E Nelson 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 bring a diverse background in advocacy, community service, and policy development, each of which has prepared me well to contribute meaningfully to the Human Rights Commission. My commitment to advancing human rights and promoting equity across diverse communities has been demonstrated through both my professional roles and personal dedication. What is your present knowledge of each advisory board you are interested in? In my professional career, I have held roles that required in-depth knowledge of public policy and a keen understanding of the social challenges affecting marginalized populations. For example, in my current position at IMMIGRANT MOMS OF IOWA, As the president of Immigrant Moms of Iowa, I have played a crucial leadership role within the organization, overseeing its operations, setting strategic direction, and advocating for the immigrant community, particularly mothers and their families. This role allowed me to directly engage with policy frameworks and collaborate with community organizations, government representatives, and advocacy groups to foster more inclusive environments and address systemic inequities. 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. Mathe E Nelson 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: I work for the Johnson County Public Health and I am currently working on my non-profit organization called IMMIGRANT MOMS OF IOWA. I also have a project that I 'm working on called: Mouna Beauty Supply Store. 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 (.- 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: Gender 9 Female 39 Country of Origin Ivory Coast Mathe E Nelson Sexual Orientation Female Religion Muslim Do you have a disability No Ethnicity Not Hispanic or Latino 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. W I Agree Mathe E Nelson Advisory Board/Commission Application Form Submit Date: Nov 11, 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) Are you 18 years of age or older? r Yes r No Katherine Peterson First Name Middle Last Name Initial First Name (Phonetic spelling) KATH-er-ine Last Name (Phonetic spelling) PEE-ter-sun 201 N 1st Ave Apt 405 Home Address Suite or Apt Iowa City IA 52245 City 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? 2 years Home: (630) 352-7708 Primary Phone Alternate Phone katherine.mary.peterson@gmail.com Email Address Metadata librarian _ Occupation Boards & Commissions Katherine Peterson 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: My job involves providing access to eResources by providing robust and accurate descriptions that includes information such as a resource's accessibility features and inclusive subject terms. My job also involves cataloging materials in the Iowa Digital Archives and has made me more familiar with the University of Iowa and Iowa City's history. In 2023, 1 attained my mental Health First Aid Certification from the National Council for Mental Wellbeing. In 2023, 1 earned my Building University of Iowa Leadership for Diversity (BUILD) certification. In 2024, 1 earned my University of Iowa LGBTQ safe zone training. In 2022, 1 earned a Masters in Library and Information Science from the University of Illinois. From 2020-2022, 1 was a graduate assistant for the iSchool Help Desk at the University of Illinois where I provided tech support to students, faculty, and staff. What is your present knowledge of each advisory board you are interested in? Human Rights Commission: The work of the commission includes advocating for human rights in the capacity of educating the public, partnering with related organizations, and recommending legislation to City Council. The commission has invovlement with awarding the Racial Equity and Social justice Grant and with awarding Iowa City's Human Rights awards. The commission is also divided into three committees based on the areas of work outlined in the strategic plan, which is currently under review and revision. Climate Action Commission: The work of the commission involves advising City Council on initiatives related to climate action and helping to implement those initiatives if approved. Meetings often involve guest speakers sharing about their projects with commission members. In 2019 the Iowa City City Council declared to reduce carbon emissions by 45% from 2010 levels by 2030 and to reach net zero emissions by 2050. the Accelerating Iowa City's Action Plan was created to reach these goals. 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. Katherine Peterson 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: University of 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: Gender W Female Katherine Peterson Age 28 Country of Origin United States Sexual Orientation Ace Religion Agnostic Do you have a disability No Ethnicity Race White Gender Identity 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. Katherine Peterson Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Katherine Peterson Advisory Board/Commission Application Form Submit Date: Nov 07, 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) Are you 18 years of age or older? r Yes r No Suzanna M Rodriguez First Name Middle Last Name Initial First Name (Phonetic spelling) Ssoo - ssa h - na h Last Name (Phonetic spelling) Rroh - dree - gehs 405 Reno Street Home Address Suite or Apt Iowa City IA 52245 City 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? life Home: (312) 339-3272 Primary Phone Alternate Phone rodriguezmsusanna@gmail.com Email Address Coordinator, Institute for International Business UIOWA Occupation Boards & Commissions Suzanna M Rodriguez 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 have co-lead some organizing efforts in the human rights area as an employee resource group at a previous employer and within the City of Chicago when I was living there. What is your present knowledge of each advisory board you are interested in? My understanding is that The Human Rights Commission Board organizing ideas and events to bring citizens together to fight discrimination and systemic oppression. 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. Suzanna M Rodriguez List your answers here: I work for UIOWA as an admin. I do not really have any financial interest anywhere except to pay bills. I do have a child who attends Willowwind and pay tuition there. 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: Gender W Female J--- 42 Country of Origin United States Sexual Orientation Religion Do you have a disability Ethnicity Mexican American Suzanna M Rodriguez Race 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. W I Agree Suzanna M Rodriguez Advisory Board/Commission Application Form Submit Date: Oct 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) Are you 18 years of age or older? r Yes r No Estella J Ruhrer-johnson First Name Middle Last Name Initial First Name (Phonetic spelling) EST-ella Last Name (Phonetic spelling) Rue-ER 1010 W Benton st apt 216f Iowa city Iowa Home Address Suite or Apt Iowa City IA 52262 City 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? Three years Home: (712) 577-5385 Primary Phone Alternate Phone ruhrerjohnson@uiowa.edu Email Address Full time student, Part time Desk clerk at Hillcrest Residence Hall _ Occupation Boards & Commissions Estella j Ruhrer-johnson 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 excited to be applying for this position. To best organize my advocacy, I will list my activities with small descriptions of my involvement. LGBTQIA+ Constituency Senator for Undergraduate Student Government- Works with the student body to curate an accepting and inclusive environment for queer students to thrive. I was also elected to this role for the 2023-2024 school year but had resigned to serve in the executive cabinet for Justice and Equity. D.E.I Committee Vice Chair for Johnson County Democrats- Works with Johnson County Democrats to uplift and embrace cultural competency. Member of the Council on the Status of Women at the University of Iowa- Attends monthly meetings and vote on initiatives and events that impact Iowa City. IDEA (Inclusion Diversity Equity Access) coordinator for March For Our Lives Iowa State team: Assesses policy plans proposed by March For Our Lives to ensure they are as equitable as possible. President of Iowa Safe Schools Student Leadership Council What is your present knowledge of each advisory board you are interested in? To my understanding, the Iowa City Human Rights Commission provides support to underserved communities. Those who hold minority status in Iowa are constantly scrutinized by our state legislators. This commission aims to better serve those with less social mobility. I am extremely well-versed in public advocacy and community organizing, I hope to serve my city in this capacity. 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. Estella J Ruhrer-johnson 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. #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: Gender None Selected Estella j Ruhrer-johnson Age 21 Country of Origin United States Sexual Orientation Lesbian Religion Non-Religious/ Spiritual Do you have a disability No Ethnicity White Race White Gender Identity Female/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. Estella J Ruhrer-johnson Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Estella j Ruhrer-johnson Advisory Board/Commission Application Form Submit Date: Nov 11, 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) Are you 18 years of age or older? r Yes r No David J Savarese First Name Middle Last Name Initial First Name (Phonetic spelling) DJ Last Name (Phonetic spelling) Sa Vuh Reese 418 N Gilbert St Home Address Suite or Apt Iowa City IA 52245 City 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? July 2017 7+ years Home: (641) 260-1634 Home: (641) 990-2600 Primary Phone Alternate Phone dj.savarese@gmail.com Email Address FOUNDER & DIRECTOR, THE LIVES-IN-PROGRESS COLLECTIVE Occupation Boards & Commissions David J Savarese 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 work to disrupt ableism as an artful activist, public speaker and scholar, multi-genre writer, teacher and practicing optimist. Co-Chair of The Alliance for Citizen Directed Supports, I designed and direct the Lives-in-Progress Collective, a national, grassroots project focused on expanding and transforming self-direction, particularly for multiply marginalized and/or alternatively communicating people. A 2022-23 Iowa Arts Fellow and Zoeglossia Fellow, he is the author of Swoon, whose title poem is nominated for a Pushcart Prize. He has also published Studies in Brotherly Love, a co-authored chapbook based on the artwork of minimally speaking autist Malcolm Corley, and A Doorknob for the Eye, a poetic series focused on the artwork of 7 autistics. Recent poems have also appeared on Poem-a-Day and The Poetry Foundation website. Co-producer, narrative commentator, and subject of the Peabody Award-winning, Emmy-nominated documentary film Deej: Inclusion Shouldn't Be a Lottery (2017), he teaches inclusive, multigenerational, global poetry writing classes through Listen2Us and poetry writing courses for alternatively communicating autistics through the LYNX Project in Chicago. An advocate for the communication and literacy-based educational rights of all students, he founded Listen2Us: Writing Our Own Futures as an Open Society Foundations Human Rights Initiative Community Youth Fellow. A Pushcart Prize nominee and a notable essay in Best American Essays (2018), his lyric essay "Passive Plants" disrupts the cultural assumptions underlying communication and movement biases. A public scholar, he teaches and presents nationally on a range of topics, including an NEH-sponsored talk on "Disrupting Ableism Through Artful Activism." His published scholarship includes an article on multimodal communication, "Disrupting the Garden Wall"; the co-authored essay "Enmeshing Selves, Words and Media, or Two Life Writers in One Family Talk about Art and Disability"; an essay on his embodied experience, "Coming to My Senses," and "Unearthing the Concepts That Bury Us," a chapter in the scholarly anthology Disability in Dialogue. One of only two AAC-using American autistics to be fully included from kindergarten through college graduation, he has been actively disrupting the status quo since he left foster care at five and has been successfully designing and completing social justice projects since receiving a Herbert Hoover Uncommon Student Award in 2010. A resident of Grinnell, IA, from 2001- 2012, he graduated from Grinnell High School in 2011. Before moving to Iowa City, DJ graduated with a double major in Anthropology and Creative Writing from Oberlin College in 2017. What is your present knowledge of each advisory board you are interested in? I have to confess I'm not very familiar with what the Human Rights Commission Board has been doing in Iowa City, but I believe my lived experience and expertise and engagement with the arts community here as an Iowa Arts Fellow 2022-23 and nationally as an advocate, writer, filmmaker, and former OSF Human Rights Initiative Community Youth Fellow would broaden the commission's perspective and offer the board and city additional ideas and energy. Potential Conflicts of Interest David J Savarese 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: Co-Chair, The Alliance for Citizen Directed Supports (national, based in PA) 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 (.- No (Optional) Demographic Information David J Savarese 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: Gender 17 Male Age 32 Country of Origin USA Sexual Orientation NA Religion NA Do you have a disability YES Ethnicity American 1 Caucasian Gender Identity NA *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) David J Savarese 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 David J Savarese 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 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? 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.) rJ 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 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: 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. W I Agree Allison K Tippe Item Number: 11.c. r 1 CITY OF IOWA CITY ��a, COUNCIL ACTION REPORT November 19, 2024 Human Rights Commission - Two vacancies to fill three-year terms, January 1, 2025 - December 31, 2027 (Terms expire for Jahnavi Pandya & Doug Kollasch). Attachments: Vacancy Notice Board Demographics Attendance Sheet Application Coversheet Bartenhagen, Kate M - Application Bender, Barry D - Application Brommel, Kelli A - Application Dettbarn, Avery C - Application Gross, Steven - Application Guo, Rebecca Rong - Application Hardesty, Eric - Application Harkin, Emily - Application Heil, Megan - Application Heller, Sophia E - Application Hirst, Donna L - Application Kane, Janine - Application Koch, Susan J - Application Kollasch, Douglas M - Application Kraynak, John J - Application Medina, Isaac - Application Mohamed, Lubna S - Application Nelson, Mathe E - Application Peterson, Katherine - Application Rodriguez, Suzanna M - Application Ruhrer-Johnson, Estella J - Application Savarese, David J - Application Tippe, Allison K - Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION One Vacancy: Upon Appointment— December 31, 2024 plus a 3-year term (01/01/25-12/31/27) Two Vacancies: Three-Year Terms January 1, 2025— December 31, 2027 • 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, November 12, 2024. An application can be completed and submitted on the City of Iowa City website at www.icgov.orq or by contacting the City Clerk's office. Questions about the Iowa City Human Rights Commission should be directed to Stefanie Bowers, Equity Director at (319) 356-5022. / 7 ] d \ o 0 § % § § § § e 2 L ] ] � ] LL L ) f § / (D 7 ] ] \ / ) $ \ j / / / / / / / ) = 2 - e e ± f ) \ / ) / .q ] j ) § § .f a) E E t E = o = / f f \ f ® \ \ < 7 ) 0 0 2 2 \ 6 \ § \ § 2 3Jo ] ) } .) % < m # p ? m co CD \ \ ( ( a) ( ( ( \ � ] ] � ] ) - ® & a� / £ § f a - �.% 2 2 � � ) T-> / \ j \� / 233 - C § \ ) ) � y� sq E = : a 72 % � & ; _ £ = , u ; a f &) / .2 \ 3 / / ) \ \ ) \ / 32 / kIn- ) \ ƒ \ 1 1§ /ƒ ] \ � � o � 2 \ Cl) - �� % ® k \ \ \3 3 \ \ (0 m \ & & \ ± : 3 § E [ § Q Q Q Q Q Q Q _ % - E \ - E / J c U 7 _CL \ _ _ _ _ _ ) J e \ f \ \ \ 2 \ R � � \ � \ � § ! o (L 17 \ \ p \ } \ \ ) / 2 / } } } \ ƒ / 3 A A � R ■ Q u U W gz 2 x x x x x x N N � � 3 x x * * * x * 2 N CIA 7 7 & & & Qnk � � II II II � c = 2 ; ■ c f \ 5 2 _ W 2 n ® 2 ■ � § ? 2 Board/Commission Application Cover Board/Commission: Human Rights Commission Two vacancies to fill three-year terms January 1, 2025— December 31, 2027 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: 10/01/2024 Application Deadline: 11/12/2024 Council Appointment Date: 11/19/2024 Name and Address I Name and Address Name and Address Name and Address Bartenhagen, Kate M Harkin, Emily Kraynak,John J Ruhrer-Johnson, Estella J 1801 Earl Rd 811 E College St Apt 3-4 738 Rundell St 1010 W Benton St Apt 216F Iowa City IA 52246 Iowa City IA 52240 Iowa City IA 52240 Iowa City IA 52246 Bender, Barry D Heil, Megan Medina, Isaac Savarese, David J 1010 Scott Park Dr#209 406 S Gilbert St Apt 927 44 Post Rd 418 N Gilbert St Iowa City IA 52245 Iowa City IA 52442 Iowa City IA 52245 Iowa City IA 52245 Brommel, Kelli A Heller, Sophia E Mohamed, Lubna S Tippe, Allison K 2 Princeton Ct 19 E Burlington St Apt 107 1905 Gleason Ave 1105 Prairie du Chien Rd Iowa City IA 52242 Iowa City IA 52240 Iowa City IA 52240 Iowa City IA 52245 Dettbarn, Avery C Hirst, Donna L Nelson, Mathe E 614 S Johnson St Apt 3 810 N Linn St 965 Longfellow Ct Iowa City IA 52240 Iowa City IA 52245 Iowa City IA 52240 ' Gross, Steven ' Kane,Janine Peterson, Katherine 805 Hudson Ave 2608 Catskill Ct 201 N 11t Ave Iowa City IA 52246 Iowa City IA 52245 Iowa City IA 52245 Guo, Rebecca Rong Koch, Susan J Rodriguez, Suzanna M 1940 Plaen View Dr 25 Sumac Ct 405 Reno St Iowa City IA 52246 Iowa City IA 52246 Iowa City IA 52245 Hardesty, Eric Kollasch, Douglas M (Currently serving an unexpired term) 711 Woodside Dr 3 Jensen Ct Iowa City IA 52246 Iowa City IA 52246 Advisory Board/Commission Application Form Submit Date: Jun 25, 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) Kate M Bartenhagen First Name Middle Last Name Initial First Name (Phonetic spelling) Kate Last Name (Phonetic spelling) Bartenhagen 1801 Earl Rd. Home Address Suite or Apt Iowa City IA 52246 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 1 year recently, 10 years in the 80s Home: (408) 823-1882 Mobile: (408) 823-1882 Primary Phone Alternate Phone katebartmft@gmail.com Email Address Licensed marriage and family therapist _ 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 Kate M Bartenhagen 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: In my work, as a therapist, I work with diverse populations. Also, I lived in Silicon Valley/San Jose for 25 years and have been exposed to an interacted with individuals from all different backgrounds, cultures, and experiences. I have a deep appreciation for and respect of all people. What is your present knowledge of each advisory board you are interested in? It is limited; however, I am very interested and excited to learn. 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. Kate M Bartenhagen 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. #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 60 Country of Origin United States Sexual Orientation Heterosexual Religion Buddhist Kate M Bartenhagen Do you have a disability No Ethnicity European-American 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. V I Agree Kate M Bartenhagen Advisory Board/Commission Application Form Submit Date: Nov 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) Are you 18 years of age or older? r Yes r No Barry D Bender First Name Middle Last Name Initial First Name (Phonetic spelling) 3192100099 Last Name (Phonetic spelling) 1010 scott park dr 209 Home Address Suite or Apt IOWA CITY IA _ 52245 City 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? 20 yrs Mobile: (319) 210-0099 Primary Phone Alternate Phone barrybender4@gmail.com Email Address school crossing guard part- ti me Occupation Boards & Commissions Barry D Bender 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: some community organizing in the 70s. Managerial skill for Warner music. MA, political science What is your present knowledge of each advisory board you are interested in? outsideer 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. Barry D Bender List your answers here: no financial interests 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? 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: Gender m Male Age 79 Country of Origin United States Sexual Orientation straight male Religion jewish Do you have a disability no Barry D Bender Ethnicity jewish Race jewish Gender Identity straight 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 Barry D Bender Advisory Board/Commission Application Form Submit Date: Nov 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) Are you 18 years of age or older? r Yes r No Kelli A Brommel First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 2 Princeton Ct. Home Address Suite or Apt Iowa City IA 52242 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 13 years Home: (319) 471-5990 _ Primary Phone Alternate Phone kelli@deadchannel.com Email Address Library Assistant Occupation Boards & Commissions Kelli A Brommel 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 have been a teacher and a youth librarian. I'm currently a cataloging library assistant. As a librarian, I am dedicated to providing solid, useful information to the public. I'm a big proponent of the Ad Fontes Media Bias Chart as a tool for examining sources in terms of bias and factuality. In my current role as a cataloger, I have participated in efforts to change subject heading cutters which use outdated and offensive terminology. I go out of my way to learn about life experiences different than my own, from participating in the BUILD courses at the university, to my own personal reading choices. I am aware of the many historical inequities in this country which continue on today, in various insidious forms. I appreciate that Iowa City seeks to work for greater equity and humanity for the community and I would like to be a part of that. What is your present knowledge of each advisory board you are interested in? I know very little, but I hope to learn more by taking an active part in the commission. I attended a Lens Series webinar in June that may have been connected to the work of the commission. It was a conversation with Sikowis Nobiss about re-indigenizing the land. She made a very interesting point about not preserving the prairie as some pristine, inaccessible place, but living in and on the prairie by both protecting and utilizing its gifts. This may seem to have more to do with lawns- and perhaps not the purview of this commission- but I would argue that the green spaces of yards and areas around multi-person housing ought to contain native plant life and provide the possibility of gardens. All humans deserve space to grow food, and all deserve healthy green spaces. 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. Kelli A Brommel 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: I work for the University of Iowa, which is a nonprofit organization. I am not an administrator or executive director of any kind, so I don't raise money for the university or have purchasing power. I'm (currently) a merit level employee, working in the cataloging department of the Main Library. 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: Kelli A Brommel Gender W Female Age 54 Country of Origin United States Sexual Orientation bisexual Religion none Do you have a disability no Ethnicity European American 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. Kelli A Brommel Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Kelli A Brommel 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 Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 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.) * W 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 (. 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: Oct 25, 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) Are you 18 years of age or older? r Yes r No Steven Gross First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) GROWss 805 Hudson Ave _ Home Address Suite or Apt Iowa City IA _ 52246 City 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? 2 months Mobile: (443) 546-0184 Primary Phone Alternate Phone steven.gross00@gmail.com Email Address Nonprofit Operations Coordinator Occupation Boards & Commissions Steven Gross 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: Through any work I do, I am guided by my values which are shaped by my Jewish upbringing and being a student of abolition—being a part of communal and collective efforts to create lasting equity and dismantling systems of oppression. It would be my privilege to bring my experience and perspective as a young, radical, queer, Jewish person to the Humans Rights Commission to contribute to ending discrimination and fostering community in Iowa City. I had the privilege of being a part of the 2022 Gender Justice Giving Project cohort at the Bread & Roses Community Fund. In this cross-class, multi-racial, gender-diverse, intergenerational organizing cohort, we worked together to fundraise for our movement, review grant applications, interview potential grantees, and collectively make decisions on grants based on what we raised. I was deeply motivated by the supportive and collaborative energy of the cohort and was able to work diligently to play my part in our collective efforts. I was thrilled to be able work directly alongside a team with shared values and make sustained impact for the organizations in our community. What is your present knowledge of each advisory board you are interested in? I had the chance to read through the current strategic plan for the Human Rights Commission and am excited to be a part of making it come to fruition. 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. Steven Gross 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: Moving Traditions 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: Gender None Selected /.=_ 24 Country of Origin Sexual Orientation Queer Steven Gross Religion Jewish 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. W I Agree Steven Gross Advisory Board/Commission Application Form Submit Date: Jul 11, 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) Rebecca Rong Guo First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 1940 Plaen View Drive Home Address Suite or Apt Iowa City IA 52246 City 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? 20 Mobile: (319) 284-1734 Primary Phone Alternate Phone rongchun_guo@yahoo.com Email Address Project Director of Oncology Trial-CRO company _ Occupation 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.) Rebecca Rong Guo Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have served in the leadership committee and graduate student committee over the last 19 years. I served as a volunteer poll worker for 20 years in Johnson county. Human right and democracy are the foundation of united states of America. It is an honor and privileges' to serve. What is your present knowledge of each advisory board you are interested in? I read all the online postings of Human Rights Commission Board. There are always more to learn and I am a believer of life long learning and practitioner of what I learn. 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: I am not a city employee. Rebecca Rong Guo 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 (. 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: Gender W Female Age 47 Country of Origin Mongolia Sexual Orientation Female Religion Open Minded Do you have a disability No Ethnicity Asia Pacific Islander Rebecca Rong Guo Asia Pacific Islander 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 Rebecca Rong Guo Advisory Board/Commission Application Form Submit Date: Oct 24, 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) Are you 18 years of age or older? r Yes r No Eric Hardesty First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 711 Woodside Dr Home Address Suite or Apt Iowa City IA 52246 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 1 year Mobile: (605) 210-0624 _ Primary Phone Alternate Phone erichardesty@icloud.com Email Address of Pharmaceutical Care - University of Iowa Hospitals and Clinics Occupation Boards & Commissions Eric Hardesty 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 have leadership experience, volunteer experience, organizational experience, and most importantly compassion for all humans. I have a heart that won't quit and a desire to help people. I can devote time and commitment to the board and will be an active community member. What is your present knowledge of each advisory board you are interested in? The human rights commission is very important in investigating and mediating complaints of discrimination. They advise to restore justice, mediate community disputes, and stand up for the rights of marginalized and vulnerable members of society. 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. Eric Hardesty 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 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: Gender m Male Age 39 Country of Origin United States Sexual Orientation Gay Eric Hardesty Religion n/a Do you have a disability no Ethnicity American kace 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. W I Agree Eric Hardesty Advisory Board/Commission Application Form Submit Date: Nov 12, 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) Are you 18 years of age or older? r Yes r No Emily Harkin First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 811 E College Street, Apt. 3-4 Home Address Suite or Apt Iowa City IA 52240 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 4 years Mobile: (515) 210-0317 _ Primary Phone Alternate Phone _emilyharkin77@gmail.com _ Email Address AmeriCorps Member Occupation Boards & Commissions Emily Harkin 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 have been involved in the protection and promotion of human rights for all the years that I have been in Iowa City. I started volunteering for many community needs, like at the Community Food Pantry, in 2021. From this experience, I became deeply inspired and moved on to become a Nonprofit Management and Community Outreach Intern at the Center for Worker justice, from May to August of 2023, where I focused on language accessibility by developing and leading an English as a Second Language (ESL) program for around 20 immigrants who spoke Arabic, Spanish, and French with the coordination of three instructors (totaling one community member and two English instructors at the University of Iowa). During this internship at the Center for Worker Justice, I also focused on labor rights by assisting in attaining around $20,000 of lost wages in two months by investigating workplaces with victims, filing complaints to the government, and communicating with elected representatives. In the next couple of months, from September to December of 2023, 1 started working at for the University of Iowa Human Rights Center as a Rex Honey Intern who assisted in a mentored human rights research project, funded by a Library of Congress grant, that researched the collective lived experiences of union workers. This desire to protect and promote human rights in my community, that I fostered in my during my B.A. at the University of Iowa, led me to my full-time job as an AmeriCorps at Iowa Legal Aid, where I assist lawyers with the Farmworker Rights Project, Fair Housing Project, and Older Iowans Hotline and has led me to feel qualified to apply to the Iowa City's Human Rights Commission. I can bring skills and knowledge of conducting and utilizing research for informed decision-making, communication with community members, and more to this position. What is your present knowledge of each advisory board you are interested in? Presently, I understand that the Human Rights Commission has primary duties (educating the public on civil and human rights, planning programs and activities to eliminate discrimination, and making recommendations to the City Council) and is trying to achieve that by focusing on three different strategic areas that have a core function of deepening inter-relationships between the commission and the community, community organizations, and the city councilors. I understand that they have been continuing their duties and implementing their strategic goals through a variety of programs around Iowa City through events like the Tenants' Rights Workshop and various other implementations of the Race Equity and Social justice grant. 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. Emily Harkin 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: Iowa Legal Aid 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 (- 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: Emily Harkin Gender W Female Age 21 Country of Origin United States Sexual Orientation Heterosexual Religion Do you have a disability No Ethnicity Non-Latino/Hispanic 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. Emily Harkin Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Emily Harkin Advisory Board/Commission Application Form Submit Date: Jul 16, 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) Megan Heil First Name Middle Last Name Initial First Name (Phonetic spelling) 5635135249 Last Name (Phonetic spelling) 406 S. Gilbert Street _ Apartment 927 Home Address Suite or Apt Iowa City IA 52442 City 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? 2 years Mobile: (563) 513-5249 Primary Phone Alternate Phone heilmegan2@gmail.com _ Email Address Student Occupation Boards & Commissions Which Boards would you like to apply for? Human Rights Commission Board Member Information: Eligible Megan Heil 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: As a rising third-year student at the University of Iowa, I have been working towards degrees in Ethics & Public Policy and Social Justice, as well as an undergraduate certificate of Human Rights through the College of Law. While pursuing this education, I have volunteered as a Rex Honey intern at the University of Iowa Center for Human Rights. In this position, I transcribed YouTube videos to improve accessibility and learned about a whole host of human rights issues; I also learned about local organizations and efforts dedicated to human rights. At the University, I also helped restart the Students for Human Rights organization, now known as SHRAI. I am the current Vice President of the organization, and have helped plan advocacy initiatives and events for the previous and coming semesters. I have developed connections with faculty at the Center for Human Rights, as well as with other student organization leaders and community organizations. Outside of school, I serve with AmeriCorps at the Immigrant Welcome Network of Johnson County (IWNJQ. Here, I have really honed my community outreach skills and event planning abilities. We have communicated and collaborated with numerous rights organizations, such as the Center for Worker Justice, the Housing Fellowship, and crisis services such as CommUnity. I feel greatly connected to the Johnson County community and its resources, and feel confident in my ability to educate others about these resources. I also feel confident in my ability to develop programs and events with other community organizations to improve outreach, inform the community about their rights, and promote human rights as a whole. Through both the university and IWNJC, I have improved my knowledge of state and federal legislation connected to human rights. I can interpret bills and court decisions in order to educate others and use my sociology background to determine how these laws and rulings will affect peoples' lives. I've helped others navigate the bureaucratic system, introducing them to social services, assisting in finding legal employment pathways, and applying for housing programs. I feel very passionate about educating others about their rights and ensuring they are protected in my community and globally. What is your present knowledge of each advisory board you are interested in? I know that the Human Rights Commission engages in education and outreach to inform people of their rights and to identify discrimination. I also understand that they build relationships with community organizations to develop programs and events to engage community members. 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. Megan Heil 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: Gender W Female Megan Heil Age 20 Country of Origin United States Sexual Orientation Religion Do you have a disability Ethnicity Race Gender Identity *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) 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 Megan Heil Advisory Board/Commission Application Form Submit Date: Nov 01, 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) Are you 18 years of age or older? r Yes r No Sophia E Heller First Name Middle Last Name Initial First Name (Phonetic spelling) so-fee-a Last Name (Phonetic spelling) hell - ur Apt. 107 19 E Burlington St Home Address Suite or Apt Iowa City IA 52240 City 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? 4 years Mobile: (563) 639-4417 Primary Phone Alternate Phone sheller802@gmail.com Email Address Student Occupation Boards & Commissions Sophia E Heller 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 a human rights certificate student at the University of Iowa and I have taken Stefanie Bowers' class on government and human rights where I learned about the Iowa City Human Rights Commission. In this class, I engaged in discussion with my peers and local government actors on human rights. Through this, I was able to contact Iowa City Recycling about apartments in the area that did not take down their cardboard only signs after the policy was lifted banning other recyclables. I am active locally in human rights through various community organizations where I have volunteered. I also worked for the Iowa City Government as a swim instructor where I taught children of the Iowa City camps in the summer and adults how to swim. Through this experience I really got to know the Iowa City community and interact with the community in a way that University students do not usually experience. What is your present knowledge of each advisory board you are interested in? The Human Rights Commission of Iowa City was created in 1964 as a way to deal with discrimination within the community. Now the human rights commission consists of nine residents who serve 3-year terms. The Human Rights commission works on public information campaigns about discrimination and people's rights against discrimination and what might count as discrimination. The Human Rights commission also works on promoting international human rights within the Iowa City community. 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. Sophia E Heller 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: Gender W Female Sophia E Heller Age 21 Country of Origin United States Sexual Orientation Straight Religion Agnostic Do you have a disability Temporary Disability Ethnicity American of Irish Descent kace White Gender Identity 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. Sophia E Heller Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Sophia E Heller 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 810NLINNST _ Home Address Suite or Apt Iowa City IA 52245 City 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? 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.) W 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 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: 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 (. 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. W I Agree Donna L Hirst Advisory Board/Commission Application Form Submit Date: Jun 26, 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) 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 Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 8.8 years Mobile: (563) 599-3230 _ Primary Phone Alternate Phone janineckane@gmail.com Email Address Retired 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.) * W Female Janine Kane 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 Interests & Experiences Experience and/or activities which you feel qualify you for this position: Human Rights: Throughout my personal life, I have been invested in diversity and equity. I have seen the detriments of segregation in schools and communities, and have witnessed the lifelong benefits of inclusion of all in every setting. I have sought relationships with diverse others in order to increase understanding and use my privileges to advocate accordingly. As a school psychologist, I worked with families from all socioeconomic backgrounds and many cultures and backgrounds, and assured that their rights as student, parent, or guardian were respected and assured, breaking down barriers by establishing trust and lines of communication. I was an active member of GWAEA's Equity Advisory Committee, and upon my retirement, was asked to stay on the committee as a community representative. When teaching students at Loras College, I prioritized diversity in my daily activities on campus, including serving as a member of the Diversity Committee and by providing opportunities for students to learn about the rights of all individuals, especially those who were from underrepresented groups, received special education services, and/or were members of the LGBTQ+ community. Library: 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. Janine Kane What is your present knowledge of each advisory board you are interested in? Human Rights: I have attended and actively participated in events offered by the City that relate to diversity and inclusion. Through conversations that occurred at these events, I have become more aware of challenges that are present in our community regarding civil rights and discrimination, and was encouraged to apply for a position on this committee. I am greatly concerned about the current political climate in our State and Nation, as it appears that human rights are continually debated, not equitably available, and are subject to removal for certain groups. I support our State Motto: liberties are essential for all Iowa and U.S. residents, and believe rights need to not only be maintained but also to be expanded appropriately. I would appreciate the opportunity to apply my experience and knowledge to aid the City in assuring that individuals' rights are not infringed upon. Library: 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 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 was my employer until 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. Janine Kane 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 (. 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 63 Country of Origin United States Sexual Orientation Heterosexual Religion None Do you have a disability Yes Ethnicity White Race White Janine Kane 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 Janine Kane Advisory Board/Commission Application Form Submit Date: Nov 12, 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) Are you 18 years of age or older? r Yes r No Susan J Koch First Name Middle Last Name Initial First Name (Phonetic spelling) Susan Last Name (Phonetic spelling) Cook 25 Sumac Court Home Address Suite or Apt Iowa City IA 52246 City 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? 4 years Home: (217) 361-5503 Home: (217) 361-5503 Primary Phone Alternate Phone susanj_koch@yahoo.com Email Address retired academic Occupation Boards & Commissions Susan J Koch 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 spent my career in higher education serving first for over 20 years as a faculty member and teaching in the areas of health and human rights, conflict resolution, and maternal/child health. During my faculty career I was a delegate to the UN Fourth World Conference on Women in China in 1995 and co-authored the book, "Conflict Resolution in the Schools" in 1996. While on the faculty at the University of Northern Iowa I co-founded (with Michele Yehieli) the UNI Global Health Corps with $1 million in funding from a U.S. Public Service Training Grant. The purpose of the GHC was to prepare students to work successfully with diverse and underserved populations both domestically and abroad. During my time serving as Associate Provost and Graduate Dean (University of Northern Iowa), Provost (Northern Michigan University, and Chancellor (University of Illinois at Springfield), I made equity, inclusion and diversity top priorities and advocated for those goals in institutional strategic plans. While serving for nine years as Chancellor at the University of Illinois Springfield (one of three campuses of the University of Illinois System), I led successful efforts to increase the number of students enrolled from underrepresented groups while at the same time significantly increasing fundraising for scholarships to support students. Since retirement I have been a contributing writer for the Chicago Tribune and Des Moines Register. I believe the communication skills I have honed over many years of leadership - listening, speaking and writing - would be a particular value to the Commission and its priorities. What is your present knowledge of each advisory board you are interested in? I have reviewed the Human Rights Commission responsibilities, meeting details and 2022 Strategic Plan. I believe my professional background and interest in volunteering to serve on the Commission and contribute to the larger community will provide a strong start. Should I be selected, I look forward to getting to know each member of the Commission, Equity Director, Stephanie Bowers, and any other community members who can contribute to the Commissions important work. Having lived in the community for four years and intending to remain here, I see this opportunity as a way I can contribute to making Iowa City an even better community for everyone. 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. Susan J Koch 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. #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: Gender W Female Susan J Koch Age 75 Country of Origin U.S. Sexual Orientation hetrosexual Religion Christian Do you have a disability no Ethnicity European American kace 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. Susan J Koch Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Susan J Koch Advisory Board/Commission Application Form Submit Date: Nov 07, 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) Are you 18 years of age or older? r Yes r No Douglas M Kollasch First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 3 Jensen Court Home Address Suite or Apt Iowa City IA 52246 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 4 years Home: (515) 971-6719 _ Primary Phone Alternate Phone douglas.kollasch@gmail.com Email Address Manacling Consultant Occupation Boards & Commissions Douglas M Kollasch 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 have served on the Human Rights Commission since September 2022, completing the term of a member who had resigned. This year, I was elected by my fellow commissioners to serve as chair, which has been a tremendous privilege for me. I have learned a lot and built many strong relationships during the partial term that is concluding. I am involved in several LGBTQ+ advocacy groups, including serving as the first president of Hawkeye Pride, the UI's LGBTQ+ Alumni Network, and the National LGBTQ Task Force. The climate in our state and nation has already led to the removal of rights for many citizens, with more likely to come. Internationally, human rights are under attack in many places across the globe. This makes the work of the Iowa City HRC extremely important. I want to continue advocating and fighting for the rights of every human to be treated with equity, fairness, and justice. What is your present knowledge of each advisory board you are interested in? I am currently the chair of the commission to which I am applying for reappointment. 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. Douglas M Kollasch 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. #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: Gender m Male Age 46 Country of Origin USA Sexual Orientation Gay Douglas M Kollasch Religion None Do you have a disability No Ethnicity 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. W I Agree Douglas M Kollasch Advisory Board/Commission Application Form Submit Date: Oct 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) Are you 18 years of age or older? r Yes r No John J Kraynak First Name Middle Last Name Initial First Name (Phonetic spelling) J ahn Last Name (Phonetic spelling) Kray nak 738 Rundell Street Home Address Suite or Apt Iowa City IA 52240 City 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? Alexandria Mobile: (213) 271-0560 Primary Phone Alternate Phone jjkinlaca@gmail.com Email Address Retired Occupation Boards & Commissions John J Kraynak 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 recently spent 5 years as the Membership Chair for the Sacramento Gay Men's Chorus, ensuring equity, access and belonging in a 40 year old arts non-profit. I also was the Board Chair for the Midtown (Sacramento) Homeless Assistance Resource Team, hosting four weekly drop in centers offing dignity and services to the downtown unhoused community. Making sure folks are seen is a passion for me. What is your present knowledge of each advisory board you are interested in? I've been following and watching former meetings and actions. 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. John J Kraynak 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: I'm a giving member of Trinity Episcopal Church 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: Gender m Male Age 59 Country of Origin United States Sexual Orientation Gay John J Kraynak Religion Christian/Episcopalian Do you have a disability Yes Ethnicity Race 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 John J Kraynak 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 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 _ 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.) rJ Male Boards & Commissions Isaac Medina 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.) 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 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: 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 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 I Agree Isaac Medina Advisory Board/Commission Application Form Submit Date: Jul 29, 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) Lubna S Mohamed First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 1905 Gleason Ave Home Address Suite or Apt Iowa city IA 52240 City 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? 10 years Mobile: (319) 330-1421 Home: (319) 333-1613 Primary Phone Alternate Phone mohamed.lubna@iowacityschools.org Email Address Para substitute - Arabic interpreter _ Occupation 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.) Lubna S Mohamed Interests & Experiences Experience and/or activities which you feel qualify you for this position: I'm from Sudan and we have a lot of people from Sudan in Iowa city, Coraville and north liberty, I deal with issues and also I'm a member at the NAACP, I usually work closely with Mr Sanders and reported to him the issues and discrimination issues in my community. What is your present knowledge of each advisory board you are interested in? As a member of NAACP i have an experience about the discrimination in housing, educations and different area addition to my Sudanese community racial discrimination issues. 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: None Lubna S Mohamed 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 (. 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: Gender W Female Age Country of Origin Sexual Orientation Religion Do you have a disability Ethnicity Race Gender Identity Lubna 5 Mohamed *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 Lubna 5 Mohamed Advisory Board/Commission Application Form Submit Date: Nov 10, 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) Are you 18 years of age or older? r Yes r No Mathe E Nelson First Name Middle Last Name Initial First Name (Phonetic spelling) 3198539025 Last Name (Phonetic spelling) 965 Longfellow Court Home Address Suite or Apt Iowa City IA _ 52240 City 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? 9 Mobile: (319) 853-9025 Business: (318) 329-2287 Primary Phone Alternate Phone motivational@immigrantmomsofiowa.org Email Address Founder of IMMIGRANT MOMS OF IOWA Occupation Boards & Commissions Mathe E Nelson 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 bring a diverse background in advocacy, community service, and policy development, each of which has prepared me well to contribute meaningfully to the Human Rights Commission. My commitment to advancing human rights and promoting equity across diverse communities has been demonstrated through both my professional roles and personal dedication. What is your present knowledge of each advisory board you are interested in? In my professional career, I have held roles that required in-depth knowledge of public policy and a keen understanding of the social challenges affecting marginalized populations. For example, in my current position at IMMIGRANT MOMS OF IOWA, As the president of Immigrant Moms of Iowa, I have played a crucial leadership role within the organization, overseeing its operations, setting strategic direction, and advocating for the immigrant community, particularly mothers and their families. This role allowed me to directly engage with policy frameworks and collaborate with community organizations, government representatives, and advocacy groups to foster more inclusive environments and address systemic inequities. 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. Mathe E Nelson 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: I work for the Johnson County Public Health and I am currently working on my non-profit organization called IMMIGRANT MOMS OF IOWA. I also have a project that I 'm working on called: Mouna Beauty Supply Store. 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 (.- 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: Gender 9 Female 39 Country of Origin Ivory Coast Mathe E Nelson Sexual Orientation Female Religion Muslim Do you have a disability No Ethnicity Not Hispanic or Latino 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. W I Agree Mathe E Nelson Advisory Board/Commission Application Form Submit Date: Nov 11, 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) Are you 18 years of age or older? r Yes r No Katherine Peterson First Name Middle Last Name Initial First Name (Phonetic spelling) KATH-er-ine Last Name (Phonetic spelling) PEE-ter-sun 201 N 1st Ave Apt 405 Home Address Suite or Apt Iowa City IA 52245 City 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? 2 years Home: (630) 352-7708 Primary Phone Alternate Phone katherine.mary.peterson@gmail.com Email Address Metadata librarian _ Occupation Boards & Commissions Katherine Peterson 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: My job involves providing access to eResources by providing robust and accurate descriptions that includes information such as a resource's accessibility features and inclusive subject terms. My job also involves cataloging materials in the Iowa Digital Archives and has made me more familiar with the University of Iowa and Iowa City's history. In 2023, 1 attained my mental Health First Aid Certification from the National Council for Mental Wellbeing. In 2023, 1 earned my Building University of Iowa Leadership for Diversity (BUILD) certification. In 2024, 1 earned my University of Iowa LGBTQ safe zone training. In 2022, 1 earned a Masters in Library and Information Science from the University of Illinois. From 2020-2022, 1 was a graduate assistant for the iSchool Help Desk at the University of Illinois where I provided tech support to students, faculty, and staff. What is your present knowledge of each advisory board you are interested in? Human Rights Commission: The work of the commission includes advocating for human rights in the capacity of educating the public, partnering with related organizations, and recommending legislation to City Council. The commission has invovlement with awarding the Racial Equity and Social justice Grant and with awarding Iowa City's Human Rights awards. The commission is also divided into three committees based on the areas of work outlined in the strategic plan, which is currently under review and revision. Climate Action Commission: The work of the commission involves advising City Council on initiatives related to climate action and helping to implement those initiatives if approved. Meetings often involve guest speakers sharing about their projects with commission members. In 2019 the Iowa City City Council declared to reduce carbon emissions by 45% from 2010 levels by 2030 and to reach net zero emissions by 2050. the Accelerating Iowa City's Action Plan was created to reach these goals. 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. Katherine Peterson 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: University of 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: Gender W Female Katherine Peterson Age 28 Country of Origin United States Sexual Orientation Ace Religion Agnostic Do you have a disability No Ethnicity Race White Gender Identity 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. Katherine Peterson Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Katherine Peterson Advisory Board/Commission Application Form Submit Date: Nov 07, 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) Are you 18 years of age or older? r Yes r No Suzanna M Rodriguez First Name Middle Last Name Initial First Name (Phonetic spelling) Ssoo - ssa h - na h Last Name (Phonetic spelling) Rroh - dree - gehs 405 Reno Street Home Address Suite or Apt Iowa City IA 52245 City 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? life Home: (312) 339-3272 Primary Phone Alternate Phone rodriguezmsusanna@gmail.com Email Address Coordinator, Institute for International Business UIOWA Occupation Boards & Commissions Suzanna M Rodriguez 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 have co-lead some organizing efforts in the human rights area as an employee resource group at a previous employer and within the City of Chicago when I was living there. What is your present knowledge of each advisory board you are interested in? My understanding is that The Human Rights Commission Board organizing ideas and events to bring citizens together to fight discrimination and systemic oppression. 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. Suzanna M Rodriguez List your answers here: I work for UIOWA as an admin. I do not really have any financial interest anywhere except to pay bills. I do have a child who attends Willowwind and pay tuition there. 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: Gender W Female J--- 42 Country of Origin United States Sexual Orientation Religion Do you have a disability Ethnicity Mexican American Suzanna M Rodriguez Race 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. W I Agree Suzanna M Rodriguez Advisory Board/Commission Application Form Submit Date: Oct 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) Are you 18 years of age or older? r Yes r No Estella J Ruhrer-johnson First Name Middle Last Name Initial First Name (Phonetic spelling) EST-ella Last Name (Phonetic spelling) Rue-ER 1010 W Benton st apt 216f Iowa city Iowa Home Address Suite or Apt Iowa City IA 52262 City 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? Three years Home: (712) 577-5385 Primary Phone Alternate Phone ruhrerjohnson@uiowa.edu Email Address Full time student, Part time Desk clerk at Hillcrest Residence Hall _ Occupation Boards & Commissions Estella j Ruhrer-johnson 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 excited to be applying for this position. To best organize my advocacy, I will list my activities with small descriptions of my involvement. LGBTQIA+ Constituency Senator for Undergraduate Student Government- Works with the student body to curate an accepting and inclusive environment for queer students to thrive. I was also elected to this role for the 2023-2024 school year but had resigned to serve in the executive cabinet for Justice and Equity. D.E.I Committee Vice Chair for Johnson County Democrats- Works with Johnson County Democrats to uplift and embrace cultural competency. Member of the Council on the Status of Women at the University of Iowa- Attends monthly meetings and vote on initiatives and events that impact Iowa City. IDEA (Inclusion Diversity Equity Access) coordinator for March For Our Lives Iowa State team: Assesses policy plans proposed by March For Our Lives to ensure they are as equitable as possible. President of Iowa Safe Schools Student Leadership Council What is your present knowledge of each advisory board you are interested in? To my understanding, the Iowa City Human Rights Commission provides support to underserved communities. Those who hold minority status in Iowa are constantly scrutinized by our state legislators. This commission aims to better serve those with less social mobility. I am extremely well-versed in public advocacy and community organizing, I hope to serve my city in this capacity. 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. Estella J Ruhrer-johnson 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. #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: Gender None Selected Estella j Ruhrer-johnson Age 21 Country of Origin United States Sexual Orientation Lesbian Religion Non-Religious/ Spiritual Do you have a disability No Ethnicity White Race White Gender Identity Female/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. Estella J Ruhrer-johnson Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Estella j Ruhrer-johnson Advisory Board/Commission Application Form Submit Date: Nov 11, 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) Are you 18 years of age or older? r Yes r No David J Savarese First Name Middle Last Name Initial First Name (Phonetic spelling) DJ Last Name (Phonetic spelling) Sa Vuh Reese 418 N Gilbert St Home Address Suite or Apt Iowa City IA 52245 City 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? July 2017 7+ years Home: (641) 260-1634 Home: (641) 990-2600 Primary Phone Alternate Phone dj.savarese@gmail.com Email Address FOUNDER & DIRECTOR, THE LIVES-IN-PROGRESS COLLECTIVE Occupation Boards & Commissions David J Savarese 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 work to disrupt ableism as an artful activist, public speaker and scholar, multi-genre writer, teacher and practicing optimist. Co-Chair of The Alliance for Citizen Directed Supports, I designed and direct the Lives-in-Progress Collective, a national, grassroots project focused on expanding and transforming self-direction, particularly for multiply marginalized and/or alternatively communicating people. A 2022-23 Iowa Arts Fellow and Zoeglossia Fellow, he is the author of Swoon, whose title poem is nominated for a Pushcart Prize. He has also published Studies in Brotherly Love, a co-authored chapbook based on the artwork of minimally speaking autist Malcolm Corley, and A Doorknob for the Eye, a poetic series focused on the artwork of 7 autistics. Recent poems have also appeared on Poem-a-Day and The Poetry Foundation website. Co-producer, narrative commentator, and subject of the Peabody Award-winning, Emmy-nominated documentary film Deej: Inclusion Shouldn't Be a Lottery (2017), he teaches inclusive, multigenerational, global poetry writing classes through Listen2Us and poetry writing courses for alternatively communicating autistics through the LYNX Project in Chicago. An advocate for the communication and literacy-based educational rights of all students, he founded Listen2Us: Writing Our Own Futures as an Open Society Foundations Human Rights Initiative Community Youth Fellow. A Pushcart Prize nominee and a notable essay in Best American Essays (2018), his lyric essay "Passive Plants" disrupts the cultural assumptions underlying communication and movement biases. A public scholar, he teaches and presents nationally on a range of topics, including an NEH-sponsored talk on "Disrupting Ableism Through Artful Activism." His published scholarship includes an article on multimodal communication, "Disrupting the Garden Wall"; the co-authored essay "Enmeshing Selves, Words and Media, or Two Life Writers in One Family Talk about Art and Disability"; an essay on his embodied experience, "Coming to My Senses," and "Unearthing the Concepts That Bury Us," a chapter in the scholarly anthology Disability in Dialogue. One of only two AAC-using American autistics to be fully included from kindergarten through college graduation, he has been actively disrupting the status quo since he left foster care at five and has been successfully designing and completing social justice projects since receiving a Herbert Hoover Uncommon Student Award in 2010. A resident of Grinnell, IA, from 2001- 2012, he graduated from Grinnell High School in 2011. Before moving to Iowa City, DJ graduated with a double major in Anthropology and Creative Writing from Oberlin College in 2017. What is your present knowledge of each advisory board you are interested in? I have to confess I'm not very familiar with what the Human Rights Commission Board has been doing in Iowa City, but I believe my lived experience and expertise and engagement with the arts community here as an Iowa Arts Fellow 2022-23 and nationally as an advocate, writer, filmmaker, and former OSF Human Rights Initiative Community Youth Fellow would broaden the commission's perspective and offer the board and city additional ideas and energy. Potential Conflicts of Interest David J Savarese 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: Co-Chair, The Alliance for Citizen Directed Supports (national, based in PA) 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 (.- No (Optional) Demographic Information David J Savarese 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: Gender 17 Male Age 32 Country of Origin USA Sexual Orientation NA Religion NA Do you have a disability YES Ethnicity American 1 Caucasian Gender Identity NA *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) David J Savarese 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 David J Savarese 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 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? 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.) rJ 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 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: 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. W I Agree Allison K Tippe Item Number: 11.d. r 1 CITY OF IOWA CITY � Q ' COUNCIL ACTION REPORT November 19, 2024 Parks & Recreation Commission - Two vacancies to fill four-year terms, January 1, 2025 - December 31, 2028 (Terms expire for Aaron Broege & Alex Hachtman). Correspondence included in Council packet. Attachments: Vacancy Notice Board Demographics Attendance Sheet Application Coversheet Balde, Daouda - Application Beining, Kaleb - Application Gaunt, Michael D - Application Havel-sturdevant, Jinxx D - Application Klockau, David W - Application Mallory, Jeff- Application City Council correspondence - Aaron Broege NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: PARKS AND RECREATION COMMISSION Two Vacancies: Four-Year Terms January 1, 2025— December 31, 2028 • The duties of the members of the Parks and Recreation Commission are; to recommend and review policies, rules, regulations, ordinances, CIP (Capital Improvement Program) funds and budgets relating to parks, playgrounds, recreation centers, and cultural functions of the City and make such reports to the City Council as the Commission deems in the public interest; to exercise broad responsibility for the development of parks, recreation centers, playgrounds, and cultural facilities to serve the City--including the creation and appointment of advisory groups to make studies. • The Parks and Recreation Commission meets the second Wednesday 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, November 12, 2024. An application can be completed and submitted on the City of Iowa City website at .vww.icgov.orq or by contacting the City Clerk's office. Questions about the Iowa City Parks and Recreation Commission should be directed to Juli Seydell- Johnson, Director at (319) 356-5104. \ o a « § a 2 \ { d : ) \ a) § ! ~ E E 0 2 R \ a a ] ƒ co - e / { _ z § { ) : \ j + + + + + 2 / /An CL \ % \ \ \ - - # co 2 co 2 X / 2 o f \ ) a \ / ± E / / \ / / \ § \ § \ § § § \ § \ � g a) ¢ » G g m D . # \ L(Eu E E] aa ] a ] _ E ^ � _ � ) O / Eco Ap ± § cm0 ® �\ � - ) o \ { \Q E : E E 3rE # io ] + ( 23 0 E � D ! G yco L6 0 & 0 co 2 2 •U) (D y� m ? / E/ ] / E k a)3 E / co co co .10 \ LLO \ \ \ \ ) O / G E E & ( e z { > U E ] ± - CL - / § E_ _ _ x x ® 0 / J 2 2 2 ) \ ) \ ) ) ± z J e Co = co a / m / £ 7 E 'E - § I $ E 2 - o = E \ % m E m m % 7 E « J o a m \ 2 7 A > 3 J / / $ ) z 0- , PARKS AND RECREATION COMMISSION September 11, 2024 Page 14 of 14 PARKS AND RECREATION COMMISSION ATTENDANCE RECORD NAMETERM o 0 0 0 0 o a a a o 0 0 N N N N N N N N N N N N l- Z� M O rT M O M N O rl EXPIRES a N N M rl' M C� aC Cn Aaron 1.2/31/24 X X X X O/E NM X NM NM X X O/E Broe e Missie 12/31/25 X O/E X X X NM O/E NM NM X O/E X Forbes Alex 12/31/24 X X X X X NM X NM NM O/E X X Hachtman Virginia 12/31/27 * * * X X NM X NM NM X X O/E Hayes Rachel 12/31/26 X X X X X NM X NM NM X O/E O/E McPherson Connie 12/31/25 X X X X O/E NM X NM NM X X X Moore Brian 12/31/25 O/E O/E X X O/E NM X NM NM X X X Morelli Caleb 12/31/26 X X X O/E X NM O/E NM NM X O/E X Recker Alex 12/31/27 X O/E X X X NM O/E NM NM O/E X X Stanton KEY: X= Present O = Absent O/E =Absent/Excused NM =No meeting LQ = No meeting due to lack of quorum * =Not a member during this meeting Board/Commission Application Cover Board/Commission: Parks and Recreation Commission Two vacancies to fill four-year terms January 1, 2025— December 31, 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: 10/01/2024 Application Deadline: 11/12/2024 Council Appointment Date: 11/19/2024 Name and Address Balde, Daouda 845 Cross Park Ave Apt 2D Iowa City IA 52240 Beining, Kaleb 540 West Side Dr Iowa City IA 52246 Gaunt, Michael D 2209 Hazel Ct Iowa City IA 52240 Havel-sturdevant,Jinxx D 1908 Delwood Dr Iowa City IA 52240 ' Klockau, David W 943 Tamarack Trail Iowa City IA 52245 Mallory, Jeff 1380 Dodge St Ct Iowa City IA 52245 Advisory Board/Commission Application Form Submit Date: Apr 26, 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) Daouda Balde First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 845 Cross Park Avenue Apt 2D _ Home Address Suite or Apt Iowa City IA 52240 City 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? 8 years Mobile: 3199362582 Home: 3199362582 Primary Phone Alternate Phone daouda2890@gmail.com _ Email Address Test 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.) rJ Male Boards & Commissions Daouda Balde Which Boards would you like to apply for? Parks and Recreation 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? r Yes a No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in nonprofit management? (3 Yes 0 No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you receive rental assistance? o Yes a No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in construction? G Yes (3 No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in finance? r Yes r No Interests & Experiences Experience and/or activities which you feel qualify you for this position: I would like to be part of board because landlord in Iowa City do not respect tenants rights. I would like to advocate for these people. What is your present knowledge of each advisory board you are interested in? I have knowledge in nonprofits management. 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. Daouda Balde 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 33 Daouda Balde Country of Origin Guinea, Conakry Sexual Orientation Religion Muslim Do you have a disability No Ethnicity Fulani Race Black Gender Identity Mal *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 Daouda Balde Advisory Board/Commission Application Form Submit Date: May 16, 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) Kaleb Beining First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 540 west side drive Home Address Suite or Apt IOWA CITY IA 52246 City 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? 27 years Home: (319) 530-9249 _ Primary Phone Alternate Phone kalebbeining@gmail.com Email Address Property Manager, Construction, Property Investor _ 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.) rJ Male Boards & Commissions Kaleb Beining Which Boards would you like to apply for? Parks and Recreation Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) HCDC Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in property management? (3 Yes 0 No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in nonprofit management? (3 Yes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you receive rental assistance? 0 Yes (3 No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in construction? r Yes o No Question applies to Housing and Community Development Commission (HCDC) Board Member Information Do you have expertise in finance? r Yes a No Interests & Experiences Experience and/or activities which you feel qualify you for this position: I'm currently the HCDC chair-- I have served on HCDC since 2021. 8 years of experience in property management, 8 years of experience in affordable housing, 10 years of experience in construction. What is your present knowledge of each advisory board you are interested in? HCDC: I have served since 2021, with consistent attendance, and have been able to continue learning the activities and formalities of the commission, since I joined. I feel that my industry experience and current occupation is very applicable to help contribute to the commission. Parks & Rec: I have served as a contractor for 4 years, for the City of Cedar Rapids Park's and Rec Dep. I've grown an understanding of not only the duties of this commission, but also understand from a landscaping contractor's perspective. I would bring landscaping industry experience, contractor perspective, and park-user's perspective. Planning and Zoning: From my experience in construction, I've learned a great deal about planning and zoning. As a life-long Iowa City resident, I've had the pleasure to watch the development of our city, and would love to contribute. Kaleb Beining 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: Community Foundation of Johnson County, Schissel, LLC, Iowa Landscape, LLC 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? c: Yes c' No (Optional) Demographic Information Kaleb Beining The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 27 Country of Origin USA Sexual Orientation Religion Do you have a disability Ethnicity Zimbabwean/German 1 African American 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. Kaleb Beining Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Kaleb Beining Advisory Board/Commission Application Form Submit Date: Jun 03, 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) Michael D Gaunt First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 2209 Hazel Court _ Home Address Suite or Apt Iowa City IA 52240 City 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? Two years Mobile: (515) 988-4106 _ Primary Phone Alternate Phone iowagaunt@gmail.com Email Address Landscape Architect 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.) rJ Male Boards & Commissions Michael D Gaunt Which Boards would you like to apply for? Parks and Recreation Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Planning & Zoning Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: Although I've only been back in Iowa City for 2 years (June 2022), 1 am a graduate of City High and grew up on the east side of town. In the time I've been away I've been a licensed Landscape Architect since 1999 and have extensive site planning, civic infrastructure, and development planning experience professionally. This experience is primarily throughout the Des Moines metro area and central Iowa. I realize Iowa City has a different zoning code compared to many other municipalities, but I'm getting more and more familiar with how it works. I feel my background knowledge and experience could be a valuable asset to either the Parks and Recreation Commission of the Planning and Zoning Commission should an opening become available in the near future. I realize in looking at the rosters for each commission there are no expected openings this year, but I would certainly consider taking over should there be a resignation. I have extensive experience serving on the Executive Committee for the Iowa Chapter of ASLA (American Society of Landscape Architects) both as Chapter President (6 years total) and as the Chapter Trustee (3 years). What is your present knowledge of each advisory board you are interested in? Limited at the moment but I'll be attending or watching future meetings to better familiarize myself with the board members, specific duties, and typical agendas. 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. Michael D Gaunt 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: I work for McClure Engineering as part of the Development Team. It's possible that I would have to recuse myself from the occasional project. 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 (. 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 55 Country of Origin USA Sexual Orientation Heterosexual Michael D Gaunt Religion N/A Do you have a disability No Ethnicity White Race 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 Michael D Gaunt Advisory Board/Commission Application Form Submit Date: Dec 01, 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) jinxx D Havel-sturdevant First Name Middle Last Name Initial First Name (Phonetic spelling) jin-kks Last Name (Phonetic spelling) Ha-vel Stur-de-vant 1908 Delwood Drive Home Address Suite or Apt Iowa City IA 52240 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 30+ Mobile: (319) 930-6756 Home: (319) 354-9676 Primary Phone Alternate Phone jinxx-havelsturdevant@uiowa.edu Email Address Full time student at the University of Iowa 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 jinxx D Havel-sturdevant Boards & Commissions Which Boards would you like to apply for? Parks and Recreation Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Climate Action Commission Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am a junior at the University of Iowa majoring in both EPPL (Environmental Policy and Planning) and International Studies: Sustainable Development. Also working towards a certificate within sustainability. What is your present knowledge of each advisory board you are interested in? My husband (Gabriel Sturdevant) is currently a member on the Climate Action Commission. I am unfamiliar with the other commissions but I am willing to learn. 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. Jinxx D Havel-sturdevant 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: I do not have any conflicts of interest with businesses or non-profit entities. 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 Bi Religion Catholic Jinxx D Havel-sturdevant Do you have a disability Yes Ethnicity Race Gender Identity cisgender *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) 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 Jinxx D Havel-sturdevant Advisory Board/Commission Application Form Submit Date: Nov 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) David W Klockau First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 943 Tamarack Trail Home Address Suite or Apt Iowa City IA 52245 City 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? 41 years Home: (319) 351-6739 Mobile: (319) 359-9851 Primary Phone Alternate Phone dklockau@msn.com _ Email Address Sales and Service 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.) rJ Male Boards & Commissions David W Klockau Which Boards would you like to apply for? Parks and Recreation 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: As a long time IC resident I have enjoyed our parks and recreation areas. I also helped found a non profit which created the sand prairie preserve on the south side of IC What is your present knowledge of each advisory board you are interested in? I am familiar with most of our parks and recreation areas 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. David W Klockau List your answers here: My company is a contractor for the City of Iowa City, ABC Disposal Systems 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? 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 65 Country of Origin USA Sexual Orientation Heterosexual Religion Christian Do you have a disability No Ethnicity Northern European David W Klockau Race White Gender Identity 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. W I Agree David W Klockau Advisory Board/Commission Application Form Submit Date: Oct 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) Are you 18 years of age or older? r Yes r No Jeff Mallory First Name Middle Last Name Initial First Name (Phonetic spelling) Jef Last Name (Phonetic spelling) Maloree 1380 Dodge Street Court Home Address Suite or Apt Iowa City IA 52245 City 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? 5 years Home: (831) 747-7127 Primary Phone Alternate Phone jmallory@pacbell.net Email Address reti red Occupation Boards & Commissions Jeff Mallory Which Boards would you like to apply for? Parks and Recreation 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've been an active member of the Iowa City community since moving here from California in June 2019. 1 love the extensive park and recreational opportunities IC has developed for all ages and segments of the community. I've served on Boards of Directors for several community nonprofits in California, worked with the Community Foundation of Monterey County, helped administer men's recovery programs, worked with a variety of music- centered nonprofits in central California and worked with the Challenge Day program in Monterey High School for several years. I am a retired tech guy with extensive knowledge of hardware and software solutions and challenges for administering essential services and projects. I was manager of IT for the University of California Lick Observatory group and am familiar with the ways, means and bureaucracy of public institution administration. I have an active interest in seeing that IC Parks & Recs continues to support facilities and programs that benefit all segments of the IC population. What is your present knowledge of each advisory board you are interested in? I have attended Parks & Rec commission meetings and review their minutes, budgets and projects. I use the City pools, gyms and parks regularly. 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. Jeff Mallory 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. #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: Gender m Male Age 71 Country of Origin u5 Sexual Orientation gay Jeff Mallory Religion Buddhist Do you have a disability no Ethnicity white Race white Gender Identity male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) 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 Jeff Mallory Kellie Grace From: Eric Goers Sent: Thursday, November 14, 2024 3:02 PM To: Aaron Broege; *City Council; Kellie Grace Subject: RE: Second Term on the Parks & Rec Commission Aa ro n, Thanks for your past Commission service and for putting yourself forward to serve again. Because of the stated deadline in the application process, I'm afraid only those applicants who met the deadline can be considered for appointment at Tuesday's Council meeting. Eric R. Goers(he/him/his)* City Attorney 410 East Washington Street Iowa City, IA 52240 319-356-5030 egoe rs@ iowa-city.art 1 P 1 � Q4 owl CITY OF IOWA CITY UNESCO CITY OF LITERATURE *1 include my pronouns in my email signature so people know how they should refer to me and so those who receive my email know I am interested in how I should refer to them. � Iowa{ FARE FREI Learn more City Transit at ICGOV.ORGIFRRFFRFF Notice: Since e-mail messages sent between you and the City Attorney's Office and its employees are transmitted over the internet, the City Attorney's Office cannot assure that such messages are secure.You should be careful in transmitting information to the City Attorney's Office that you consider confidential. If you are uncomfortable with such risks, you may decide not to use e-mail to communicate with the City Attorney's Office. Without written notification that you do not wish to communicate with the City Attorney's Office via e-mail communication, the City Attorney's Office will assume you assent to such communication.This message is covered by the Electronic Communication Privacy Act, 18 U.S.C. Sections 2510-2515, is intended only for the use of the person to whom it is addressed and may contain information that is confidential and subject to the attorney-client privilege. It should not be forwarded to anyone else without consultation with the originating attorney. If you received this message and are not the addressee, you have received this message in error. Please notify the person sending the message and destroy your copy. Thank you. From:Aaron Broege<aaronjbroege@gmail.com> Sent:Wednesday, November 13, 2024 10:17 PM To: *City Council <CityCouncil@iowa-city.org>; Kellie Grace<KG race @iowa-city.org> Subject:Second Term on the Parks& Rec Commission i A RISK **This email originated outside of the City of Iowa City email system. Please take extra care opening any links or attachments. ** Good evening, At this time, I have submitted my application for a second term with the Iowa City Parks and Recreation Commission. I was informed by Juli at our Commission meeting tonight that the due date for the application was yesterday, so I'd like to apologize for my late submission. I would greatly appreciate your consideration for a second term, as it has been a joy and a privilege to serve on the Commission. Best, Aaron Broege 2 Item Number: 11.e. r 1 CITY OF IOWA CITY � Q ' COUNCIL ACTION REPORT November 19, 2024 Public Art Advisory Committee (At-Large) - One vacancy to fill a three-year term, January 1, 2025 - December 31, 2027 (Term expires for Rachel He Kinker). Attachments: Vacancy Notice Board Demographics Attendance Sheet Application Coversheet Davies, David J - Application Hadenfeldt, Seth E - Application Kinker, Rachel H - Application Moseley, Aaron R - Application Stout, Amanda - Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMITTEE: PUBLIC ART ADVISORY COMMITTEE One Vacancy: Three-Year Term January 1, 2025— December 31, 2027 (1)At-Large • Duties of the Public Art Advisory Committee include: developing by-laws and procedures for the Iowa City Public Art Program; • administering the Public Art Program by determining the placement of public art, the type of art to be used in a specific project, and the artist to be engaged; • overseeing the acceptance of gifts of art; • overseeing the maintenance and disposition of public art; • overseeing expenditures of the Public Art Program budget; • overseeing the Poetry in the Public Program. • The Public Art Advisory Committee meets the first Thursday of each month at 3:30 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, November 12, 2024. An application can be completed and submitted on the City of Iowa City website at www.icqov.orq or by contacting the City Clerk's office. Questions about the Iowa City Public Art Advisory Committee should be directed to Rachel Kilburg Varley, Coordinator at (319) 356-5248. r � m 0 ° k k a) a) ƒ / ) a a ƒ z { ) : \ j + + + .0 - / ) \ g g ) ] % , # x E CO0 3 ƒ E } 3 a ±� \ / < < 7 / \ / < -a co / % § § -E -E -E § \ k S < ? m G G 2 / \ a) 3 ° \ \ E \ / ) a ] a LL 3 E 2 > # » ) 2 D _ \ § 2 E e U g ® E - . # \ \ ¥ - * ! » 7E 6co C S ) & E e v e / # mo 33J2 » e3 < < § �2 3 § m q 2 � / \ co \ \ N co / N N N N \ [ \ \ / .� e e e 2 \ / 2i 2 g E % ° § 0 / \_ ) - - \CL O § ° = _ _ _ m / e2 \ + 2 \ \ > � \ { \ & \k & \k \ \ o % w G 7 7 % w G 7 e z \ } \ } } } } < } < a / E o \ [f - m % 2 E � _ \ of / a = § 'au, \ § ƒ k � < \ ) \ \) -1 I EL .N N N N N U N � � � � U � DRAFT, p.3 Public Art Advisory Committee Mtg, 111712024 Public Art Advisory Committee Attendance Record 2023-2024 Name Term 8/3/23 9/7/23 11/2/23 12/7/23 1/4/24 4/4/24 6/6/24 8/1/24 9/5/24 10/3/24 11/7/24 Expires Ron Knoche X X* X X X* X* X X O/E X X* Juli Seydell- X X O/E X* X O/E X X X X* X Johnson Steve Miller 12/31/23 X X X X X X X X --- --- --- Eddie 12/31/24 O/E 0 --- --- --- --- --- --- --- --- --- Boyken Andrea 12/31/25 X X X X O/E X O/E X X X X Truitt Dominic 6/30/23 O/E --- --- --- --- --- --- --- --- --- --- Dongilli Anita Jung 6/30/23 X X X X X O/E X X X 0 X Jenny 12/31/23 X O/E 0 X --- --- --- --- --- --- --- Gringer Jeremy 12/31/25 X 0 X X X X X X X O/E X Endsley Nate 6/30/26 X X X X O/E X X X O/E X O/E Sullivan Leslie Finer --- --- --- --- --- X X X X X X Rachel --- --- --- --- --- X X O/E X X O/E Kinker Key: X = Present X* = Delegate attended 0 = Absent O/E = Absent/Excused --- = Not a member Board/Commission Application Cover Board/Commission: Public Art Advisory Committee One vacancy to fill a three-year term January 1, 2025— December 31, 2027 (1) At-Large 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: 10/01/2024 Application Deadline: 11/12/2024 Council Appointment Date: 11/19/2024 Name and Address Davies, David J 119 Potomac Dr Iowa City IA 52245 Hadenfeldt, Seth E 426 Brown St Iowa City IA 52245 Kinker, Rachel H (Currently serving an unexpired term) 10 Spring Valley Dr NE Iowa City IA 52240 Moseley, Aaron R 821 E Market St Iowa City IA 52245 ' Stout, Amanda 220 Amhurst St Iowa City IA 52245 Advisory Board/Commission Application Form Submit Date: Aug 28, 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) Are you 18 years of age or older? r Yes r No David J Davies First Name Middle Last Name Initial First Name (Phonetic spelling) James (I go by my middle name) Last Name (Phonetic spelling) 119 Potomac Dr Home Address Suite or Apt Iowa City IA _ 52245 City 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? 39 years Home: (319) 330-3303 Primary Phone Alternate Phone d.james.davies@gmail.com Email Address Pre-Construciton Project Manager Occupation Boards & Commissions David J Davies Which Boards would you like to apply for? Public Art Advisory Committee Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Question applies to Public Art Advisory Committee Board Member Information Public Art Advisory Committee Category W Art or Design Professional Interests & Experiences Experience and/or activities which you feel qualify you for this position: I work in the commercial construction sector as a preconstruction project manager. My primary role is managing the planning stage of commercial construction projects by providing expertise in design management, cost estimating, and scheduling. Prior to my work in the construction field I earned a Bachelors of Fine Art with a studio focus in Drawing & Painting from the University of Iowa. After college I worked for 8 years as a freelance art and design professional in a wide variety of media including graphic design, illustration, photography, videography, contributor to arts publications Little Village & Bread & Butter, among others. I also have a deep passion for the Iowa City community. I was born and raised in this great community and have experienced living, learning and working in many different areas. I recently completed the Community Leadership Program through Greater IC and had the privilege of discovering an even deeper understanding of the many sectors within the Iowa City community. Through the CLP program I have been encouraged to participate and engage more fully within my community. I believe serving on the local government Committee or Board would be a great way to serve my community by bringing my professional knowledge and personal passion for the vibrancy, resilience and sustainability of Iowa City. What is your present knowledge of each advisory board you are interested in? Since my involvement in the CLP program I have made a concerted effort to better understand and participate in the local government functions. I regularly watch City Council meetings and read transcripts and agendas from various Boards and Commissions. Regarding the Public Art Advisory Committee I have watched previous meetings and have read the Public Art Strategic Plan and the Management Plan. 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. David J Davies 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: I currently work for Russell, a construction and development company headquartered in Davenport, IA. I would not expect any overlapping interests with the work of the Public Art Advisory Committee. I would expect to recuse myself in the event any conflicts did arise. 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 (.- 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: David J Davies Gender I•J Male Age 40 Country of Origin USA Sexual Orientation Religion Do you have a disability No 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. David J Davies Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree David J Davies Advisory Board/Commission Application Form Submit Date: Aug 16, 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) Are you 18 years of age or older? r Yes r No Seth E Hadenfeldt First Name Middle Last Name Initial First Name (Phonetic spelling) Seth Last Name (Phonetic spelling) Hadenfeldt 426 Brown St Home Address Suite or Apt Iowa City IA 52245 City 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? 1 year 2 months Mobile: (402) 853-4409 Primary Phone Alternate Phone shadenfeldt@opnarchitects.com Email Address architectural designer Occupation Boards & Commissions Seth E Hadenfeldt Which Boards would you like to apply for? Public Art Advisory Committee Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Question applies to Public Art Advisory Committee Board Member Information Public Art Advisory Committee Category W Art or Design Professional Interests & Experiences Experience and/or activities which you feel qualify you for this position: Hi there! My name is Seth Hadenfeldt and I am an architectural and interior designer with an interest in art and urban design. I have an undergraduate degree in interior design and a Master's degree in Architecture, both from the University of Nebraska Lincoln. I am both passionate about art and urban space and feel that this advisory committee is a great intersection of these interests. I have a growing passion for public service and understand that committees such as this one are why Iowa City has a vibrant built environment and is able to attract and keep talented professionals to live in its city. Outside of work I love to travel and do "Urban Sketching" which is a practice of sketching and water coloring existing urban spaces. Through study abroad and personal travel I have visited and studied from cities such as Seattle WA, London UK, and Zurich Switzerland. This practice has given me great insight into why these are great cities and is where my interest and passion for urban space has developed. Thank you for considering my application! What is your present knowledge of each advisory board you are interested in? I understand that compromise, teamwork, commitment, communication, and the celebration of "small wins" are a vital aspect of being a part of public service. I understand the public arts commission is vital to Iowa City and its identity of an active cultural destination. 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. Seth E Hadenfeldt 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: OPN Architects 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: Gender TJ Male Seth E Hadenfeldt Age 27 Country of Origin United States Sexual Orientation Straight Religion n/a Do you have a disability n/a Ethnicity Swiss German - white 1 Swiss German - 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. Seth E Hadenfeldt Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Seth E Hadenfeldt Advisory Board/Commission Application Form Submit Date: Sep 30, 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) Are you 18 years of age or older? r Yes r No Rachel H Kinker First Name Middle Last Name Initial First Name (Phonetic spelling) 3194001170 Last Name (Phonetic spelling) Kinker 10 Spring Valley Dr. NE Home Address Suite or Apt Iowa City IA 52240 City 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? 11 months Home: (319) 400-1170 Primary Phone Alternate Phone rhecklund@gmail.com Email Address Education and Outreach specialist at UI Occupation Boards & Commissions Rachel H Kinker Which Boards would you like to apply for? Public Art Advisory Committee Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) public art Question applies to Public Art Advisory Committee Board Member Information Public Art Advisory Committee Category 17 At-Large Interests & Experiences Experience and/or activities which you feel qualify you for this position: My previous education and experience is in Art Education (BA from UI-2008) and then I recieved my MPA from Drake (2016). I grew up in Iowa City and attended University here, I recently moved back to the area this past year with my family. I have a background in art and I currently create my own, although as more of a hobby. I love seeing the improvements that have been made while I lived outside of Iowa City and the additions of new art works throughout the city. Having lived in several other cities and countries I would like to build on our existing strong foundation as an arts community and pursue additional projects and funding that could expand our public art projects throughout the city and attract artist utilizing a variety of media and from a variety of backgrounds to participate. What is your present knowledge of each advisory board you are interested in? I have reviewed the previous agendas and the work of the current committee as well as the landing page for the committee. I have followed the current projects. I am currently serving on the PAAC with a term ending in December 2024 and would like to apply for another term. 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. Rachel H Kinker 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: University of Iowa (employed) 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: Gender W Female Rachel H Kinker Age 39 Country of Origin United States Sexual Orientation heterosexual Religion not religious 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. Rachel H Kinker Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Rachel H Kinker Advisory Board/Commission Application Form Submit Date: Oct 03, 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) Are you 18 years of age or older? r Yes r No Aaron R Moseley First Name Middle Last Name Initial First Name (Phonetic spelling) Error in Last Name (Phonetic spelling) Mose Lee 821 E Market street Home Address Suite or Apt Iowa city IA 52245 City 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? 11 years Home: (319) 361-0871 Primary Phone Alternate Phone moseleypottery@gmail.com Email Address Art Education _ Occupation Boards & Commissions Aaron R Moseley Which Boards would you like to apply for? Public Art Advisory Committee Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Question applies to Public Art Advisory Committee Board Member Information Public Art Advisory Committee Category W Art or Design Professional Interests & Experiences Experience and/or activities which you feel qualify you for this position: I am a professional ceramic artist, working with various communities in the past to create art in many different capacities. From being an apprentice potter, to teaching classes, and currently working with adults with special needs at Systems Unlimited, working to create artwork with clients. I work to create artwork to share with the Systems Unlimited community, done by individuals or small groups of people. We work to integrate individuals into the larger community using artwork as the means to do so. What is your present knowledge of each advisory board you are interested in? The board decides how to allocate funds to support public art around Iowa City, creating new public works and maintaining current pieces installed around town. I am interested in giving an inside perspective as to process, and time invested to complete projects. I intend to spread awareness of the impact of public art and its need to speak up when given the space. artwork the doesn't need a statement attached. I intend to keep Iowa City the art hub that it is in Iowa. 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. Aaron R Moseley 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: Moseley Pottery, Systems Unlimited 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: Gender TJ Male Aaron R Moseley Age 32 Country of Origin United States Sexual Orientation Religion No Do you have a disability Yes Ethnicity White Race White Gender Identity Male *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) 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. Aaron R Moseley Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Aaron R Moseley Advisory Board/Commission Application Form Submit Date: Feb 29, 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) Amanda Stout First Name Middle Last Name Initial First Name (Phonetic spelling) 13194618911 Last Name (Phonetic spelling) 220 Amhurst Street Home Address Suite or Apt Iowa City IA 52245 City 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? 8.5 years Home: (319) 461-8911 Primary Phone Alternate Phone astoutdesigns@gmail.com _ Email Address Operations Specialist 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 Amanda Stout Boards & Commissions Which Boards would you like to apply for? Public Art Advisory Committee Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Question applies to Public Art Advisory Committee Board Member Information Public Art Advisory Committee Category P At-Large Interests & Experiences Experience and/or activities which you feel qualify you for this position: I have been involved in public art the past few years myself as an artist. I also have taught art to k-12 students for 5 years through full teaching and after school arts programs. I studied studio art in college as well. I find public art specifically interesting due to the funding, allocation, locations, employing artists, and what it brings to the community. What is your present knowledge of each advisory board you are interested in? My understanding of this board is that they determine the specifications of public art, its budget expenditures, and donations and allocations. 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. Amanda Stout 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: University of 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 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 30 Country of Origin United States Sexual Orientation Religion Do you have a disability Amanda Stout Ethnicity White Race Gender Identity Female *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) 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 Amanda Stout Item Number: 11.f. r 1 CITY OF IOWA CITY a � COUNCIL ACTION REPORT November 19, 2024 Senior Center Commission - Two vacancies to fill three-year terms, January 1, 2025 - December 31, 2027 (Terms expire for Ross Elwin Taylor & Lee McKnight). Attachments: Vacancy Notice Board Demographics Attendance Sheet Application Coversheet Mcknight, Lee W - Application Milster, Kathryn J - Application NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: SENIOR CENTER COMMISSION Two Vacancies: Three-Year Terms January 1, 2025— December 31, 2027 • The duties of members of the Senior Center Commission are to: serve in an advisory role to the City Council with regard to needs of the Senior Center. • Make recommendations with regard to policies and programs at the Senior Center. • Join staff and other interested persons in seeking adequate financial resources for operation of the Senior Center. • Encourage full participation by senior citizens in the programs of the Senior Center. • Ensure that the Senior Center is effectively integrated into the community and cooperates with organizations with common goals in meeting the needs of senior citizens. • Serves in an advocacy role with regard to the needs of senior citizens in Iowa City. • The Senior Center Commission meets the third Thursday of each month at 4:00 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, November 12, 2024. An application can be completed and submitted on the City of Iowa City website at www.ic.gov.org or by contacting the City Clerk's office. Questions about the Iowa City Senior Center Commission should be directed to LaTasha DeLoach, Coordinator at (319) 356-5225. e \ o \ \ \ ) ( y \ \\ \ / \ j / ƒ ƒ .q a / \ \ .q D � \ U) 5 } LL % \ / \ \ \ / / » 'ITco (0 k5 75 \ \ \ \ § f Mn § 2 . 75 q - ) g f § f #f f f � \ ) ƒ ) ] k ) )co :F5 � G — ° ) \ § \ \ \ \ { ± > o 0 0 m \ c 7 » E ( ~ ~ 4 / \ o [ $ ~ ~ / J § i i i i 0 s m - § \ cEE ) 2 / / J \ 2 ( E - ) § _ f LL LL LL LL LL L LL { / \ / s 2 (t.2 - . ± \ \ \) \ / ` mI - � 0 \ \ % / k 0 / / / m k ) p } } / / ) I z \ j ƒ / | } N T y ry 3: U N N o � L L � iti i-I U � Z N Ooc II oc C z 10 � N N Q oc N � U M � N � O � N O oc z � cl N � N O N M N i- N a •� � v� � � � M � � v� I I W H � Board/Commission Application Cover Board/Commission: Senior Center Commission Two vacancies to fill three-year terms January 1, 2025— December 31, 2027 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: 10/01/2024 Application Deadline: 11/12/2024 Council Appointment Date: 11/19/2024 Name and Address Mcknight, Lee W (Currently serving an unexpired term) 86 Oberlin St Iowa City IA 52245 Milster, Kathryn J 1438 Compton PI Iowa City IA 52240 Advisory Board/Commission Application Form Submit Date: Oct 21, 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) Are you 18 years of age or older? r Yes r No Lee W Mcknight First Name Middle Last Name Initial First Name (Phonetic spelling) Last Name (Phonetic spelling) 86 Oberlin St. Home Address Suite or Apt IOWA CITY IA 52245 City State Postal Code Is your home address (listed above) within the corporate limits of Iowa City? c3 Yes 0 No How long have you been a resident of Iowa City? 5 years Home: (563) 579-7529 _ Primary Phone Alternate Phone _ranger5101mcknight@gmail.com Email Address Retired Occupation Boards & Commissions Lee W Mcknight Which Boards would you like to apply for? Senior Center Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Question applies to Senior Center Commission Board Member Information Senior Center Commission V At-Large Interests & Experiences Experience and/or activities which you feel qualify you for this position: I currently serve as the Senior Center Commission Vice Chair. and desire to re-apply for a new term as my current term expires this year. What is your present knowledge of each advisory board you are interested in? I currently serve on the Senior Center Commission as Vice Chair. 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. Lee W Mcknight 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. #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: Gender m Male Age 81 Country of Origin United States Sexual Orientation Heterosexual Lee W Mcknight Religion Methodist Do you have a disability No Ethnicity Northern European 1 Caucasion 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 Lee W Mcknight Advisory Board/Commission Application Form Submit Date: Sep 26, 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) Are you 18 years of age or older? r Yes r No Kathryn J Milster First Name Middle Last Name Initial First Name (Phonetic spelling) Kate Last Name (Phonetic spelling) Milster 1438 Compton PI Home Address Suite or Apt Iowa City IA 52240 City 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? 30 years Home: (321) 522-9229 Primary Phone Alternate Phone katemilster@yahoo.com Email Address retired teacher. Worked at ICSC in the early 1990s. Occupation Boards & Commissions Kathryn J Milster Which Boards would you like to apply for? Senior Center Commission Board Member Information: Eligible Preference on first choice (If multiple boards are being applied for.) Senior Center Question applies to Senior Center Commission Board Member Information Senior Center Commission * fJ At-Large eligible elector of Johnson County Interests & Experiences Experience and/or activities which you feel qualify you for this position: Worked as receptionist in early 1990s before online computing (under Bette Meisel, then Linda Kopping). Also worked at ICPL for a few years under Susan Craig. Am a senior citizen myself. Retired from West Branch Community Schools in 2016 from position as middle school & high school art teacher and previously high school guidance counselor. Bachelor of Fine Arts - Herron School of Art, 1976; Master of Art Education, Indiana University, 1979; Master of Science in Educational Leadership, Drake University, 2008. What is your present knowledge of each advisory board you are interested in? I worked at the Senior Center years ago and I typed up the minutes and attended several meetings as I recall. Much of the meetings at that time revolved around finances and restoration of the building (Old Post Office), staffing, and to a lesser extent, senior activities and services that were available. As I recall, there was some involvement with other city offices and entities as well. 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. Kathryn J Milster 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: I am currently retired. No conflicts of interest. 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: Gender W Female Kathryn J Milster Age 70 Country of Origin USA Sexual Orientation female Religion Protestant Do you have a disability No Ethnicity Western European ka, white - 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. Kathryn J Milster Please Agree with the Following Statement I certify that the information I have given on this application is complete and correct. W I Agree Kathryn J Milster