HomeMy WebLinkAbout1999-11-23 AppointmentNOTICE
THE CITY COUNCIL OF IOWA
CONSIDERING APPOINTMENT
FOLLOWING BOARD:
CITY IS
TO THE
BOARD OF ADJUSTMENT
One vacancy - Five-Year Term
January 1, 2000 - January 1, 2005
Duties: In appropriate cases and subject to
appropriate conditions and safeguards, the
Board may make special exceptions to the terms
of the Zoning Chapter in harmony with the
general purpose and intent of the ordinance and
in accordance with general or specific rules
contained therein. The Board may grant
variances to the Zoning Chapter only in the case
of "unnecessary hardship." The hardship must
be substantial, serious, real, and of compelling
force, as distinguished from reasons of
convenience, maximization of profit or caprice.
The Board may also hear and decide appeals
where it is alleged there is an error in any order,
requirement, decision, or determination made by
a City official in the enforcement of the Zoning
Chapter.
Iowa City appointed members of boards and
commissions must be eligible electors of the City
of Iowa City. The Board meets the second
Wednesday of each month at 5:00 p.m.
This appointment will be made at the
November 23, 1999, meeting of the City Council
at 7:00 p.m. in the Council Chambers. The City
of Iowa City encourages diversity in the
appointment of citizens to boards and
commissions. Persons interested in being
considered should contact the City Clerk at the
Civic Center, 410 E. Washington Street.
Application forms are available from the Clerk's
Office upon request.
9/28/99
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father-
in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother,
step-child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 1
November 23, 1999
BOARD OF ADJUSTMENT
One vacancy - Five Year Term
January 1, 2000 January 1, 2005
NO APPLICATIONS AS OF NOON 11/10/99
Dennis J. Keitel []
1696 Ridge Road
(has also applied for Parks & Recreation Commission)
[] Denotes applicant completed the Confidential page of the application.
NOU-11-1999 15:11 HALL & HALL ENG.
CITY 'OF IOWA CITY
ADVISORY BOARD/COMMISSION
[ ?PLICATION FORM
5193629548 P. 05/0?
----- ~
O~-, co
Individuals serving on Boards,/Commissions play an important role in advising the Counc~n ma~'ers of interest
to our community and its future. Applicants must reside in Iowa City,
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBUC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL' THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME,
ADVISORY BOARD/COMMISSION NAME
Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes
How long have you been a resident of Iowa City?
PHONE NUMBER:
No
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
T, or
WHAT I~ YOUr PRE~ENT KNOWLeDgE OF THIG ADVISORY BOARD? ~CC~ o~
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON
NOU-11-1999 15:11 HALL & HALL ENG. 3193629548 P.06/07
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~_YES _.__NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION?
YES ~/~ NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same rime.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointment.
i;," "k%iiOCm~rn3D~,dOC
r]J. anuary 3998
,r---'--'
NOTICE
THE CITY COUNCIL OF IOWA
CONSIDERING APPOINTMENT
FOLLOWING BOARD:
CITY IS
TO THE
BOARD OF APPEALS
One Vacancy - Five-Year Term
[Building Design Professional]
January 1,2000 - December 31,2004
It is the duty of members of the Board of
Appeals to hold appeal hearings on matters
concerning the Uniform Building Code, Uniform
Plumbing Code, National Electric Code, Uniform
Mechanical Code, Uniform Fire Code, the
Dangerous Building Code, and the Iowa City
Housing Code. Members must be qualified by
experience and training to pass upon matters
pertaining to building construction.
Iowa City appointed members of boards and
commissions must be eligible electors of the City
of Iowa City. The Board meets the first Monday
of each month at 4:30 p.m. or at the call of the
Building Official.
This appointment will be made at the
November 23, 1999, meeting of the City Council
at 7:00 p.m. in the Council Chambers. The City
of Iowa City encourages diversity in the
appointment of citizens to boards and
commissions. Persons interested in being
considered for this position should contact the
City Clerk at the Civic Center, 410 E.
Washington Street. Application forms are
available from the Clerk's Office upon request.
9/28/99
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father-
in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother,
step-child, aunt, or uncle. (Resolution 85-354)
Males: 5
Females: 1
November 23, 1999
BOARD OF APPEALS
One vacancy Five Year Term
(Building Design Professional)
January 1, 2000 - December 31, 2004
NO APPICATIONS AS OF NOON 11/10/99
NO APPLICATIONS AS OF NOON 11/18/99
[] Denotes applicant completed the Confidential page of the application.
NOTICE
THE CITY COUNCIL OF IOWA CITY IS
CONSIDERING APPOINTMENT TO THE
FOLLOWING COMMISSION:
HUMAN RIGHTS COMMISSION
Three Vacancies - Three-Year Terms
January 1,2000 - January 1, 2003
The duties of the members of the Human
Rights Commission are to receive and to
determine the merits of human rights
complaints alleging unfair or discriminatory
practices in the area of employment, credit,
public accommodation, education, and
housing. The Commission shall provide
conciliation and the enforcement necessary to
further the anti-discriminatory goals of the
Human Rights Ordinance and to protect
citizens from unfounded charges of
discriminatory practices.
The Iowa City Human Rights Commission
has an obligation to investigate and study the
existence, character, cause, and extent of
discrimination in Iowa City in order to eliminate
discrimination by education, conciliation,
and/or enforcement. It is also the duty of the
Human Rights Commission to draft revisions
to the Human Rights Ordinance if necessary to
eliminate prejudice, intolerance, bigotry, and
discrimination.
Iowa City-appointed members of boards
and commissions must be eligible electors of
the City of Iowa City. The Human Rights
Commission meets once a month at 7:00 p.m.
Appointment will be made at the
November 23, 1999, meeting of the City
Council at 7:00 p.m. The City of Iowa City
encourages diversity in the appointment of
citizens to boards and commissions. Persons
interested in being considered should contact
the City Clerk at the Civic Center, 410 E.
Washington Street. Application forms are
available from the Clerk's office upon request.
September 28, 1999
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father-
in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother,
step-child, aunt, or uncle. (Resolution 85-354)
Males: 1
Females: 5
November 23, 1999
HUMAN RIGHTS COMMISSION
Three Vacancies - Three-Year Terms
January 1, 2000 - January 1, 2003
Colette Brodersen []
904 #rd Avenue
Jan Warren [] (has served one full term)
815 N. Johnson Street
AS OF NOON 11/10/99
Charles A. Major []
7 Blue Stem Court
Mettie Th0m0pul0s []
75 Shagbark Court
Tammy Spies []
1121 Ash Street
(has served an unexpired term)
(has served an unexpired term)
Maureen Howe []
411 Reno Street
[] Denotes applicant completed the Confidential page of the application.
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father-
in- law; ~brother, sister, brother- in- law, sister- in- law, step-father, stepmother,
step-child, aunt, or uncle. (Resolution 85-354)
Males: 1
Females: 5
November 23, 1999.,~
HUMAN RIGHTS COMMISSION
Three Vacancies - Three-Year Terms
January 1, 2000 January 1, 2003 ,.,.
Colette Brodersen []
904 #rd Avenue
Jan Warren [] (has served one f~{Lterm)
815 N. Johnson Street
AS OF NOON 11/10/99 \~.
Charles A. Major []
7 Blue Stem Court
Mettie Thomopulos []
75 Shagbark Court
(has served an unexpired~"~erm)
(has served an unexpired term)
[]/D no applicant completed the Confidential page of the application.
, e tes
/
/
CITY OF IOWA CITY
ADVISORY BOARD/OOMMISSiON
' PPLICATION FORM
"'~ .... c~ E"
Individuals serving on Boards/Commissions play an important role in advising the Co¢c~n ~atteE~f interest
to our community and its future. Applicants must reside in Iowa City. ~) ~ .~.
After a vacancy has been announced, the Council reviews all applications during~.'e wo~ session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Is your home address (listed ab e) within the corporate limits of Iowa City? V'~es ~ No
How long have you been a resident of Iowa City?
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
~ .c. (.~.~ ~.,~,~J~-lL
jr's-
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? YES _~_NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? .~(ES "'~' NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointment.
cclerk%bdcomapp.doc
January 1998
ATTACHMENT TO APPLICATION FOR HUMAN RIGHTS COMMISSION
It is the mission of the Iowa City Human Rights Commission to protect citizens of the city
from discrimination as defined in the Human Rights Ordinance. In order to further this goal,
the city strives to ensure the Human Rights Commission is representative of the community
and the groups which it serves. Therefore, "[a]ppointments shall take into consideration men
and women of various racial, religious, cultural, social, and economic groups in the city. (Ord.
94-3647, 11-8-94) ~.
Please indicate if you are a member of any of the following categories es~on_s
voluntary):
62 years or older
~ Handicapped or Disabled
~/~acial or Ethnic Minority
Male
L/-'/~emale
Lower Income
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
[ PLICATION FORM
.-~c.:; ,'> ["
Individuals serving on. Boards/Comm[.ssions play an !mp.ortant role. in advising the Coun~;?~)~'~ ma~rs ~nterest
to our community and ~ts future. Apphcants must remde ~n Iowa C~ty. ._~ _~-
After a vacancy has been announced, the Council reviews all applications during t~ worl~ession. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.co
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME Human Rights Commissioner
TERM 2000-200B
NAME Charles A. Major HOME ADDRESS 7 Blue Stem Ct. ,Iowa Citv,IA 52240
Is your home address (listed above) within the corporate limits of Iowa City? x~x~ Yes No
How long have you been a resident of Iowa City? 76-86,90-94,97-present
Or'CUPATION Respiratory Therapist,Pulm. Funct Lab EMPLOYERVeterans Affairs Medical Center
PHONE NUMBER: HOME 319 337-3563
BUSINESS 319 338-0581 ext 6328
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:Previous Human Rights
Commissioner 98-99,Served on County Mental Health Board 96-97,Resp Therapist VAMC 28 yrs
Army Reserve 13yrs,Raised 2 sons n~ 18,22.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I am aware of Human Rights ordinance
because of my serving on human rights commission 98-present. I have read findings & case material
in my commissioner position. Participated in all city and national traininR on human rights over
2 yrs.
W R
HAT CONT IBUTION$ DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON
FOR APPLYING)? With my prv~o-q knnwlpdgp fi nWOrpnpq~ nF hnmnn rlgh~ ~n~v~ip~ T hope Co be an
advocate for human rights & fight along with others discriminaSion per city ordinance & state
~ws.I hope to better educate the Iowa City area about human rights & the Iowa City Hunam Rights
Commission. I hope to participate in future state human rights & civil rights training- to m~kP
myself a better commissioner.
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
No conflicts nf inrerP~r
T knn~ nf.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? xxxxYES __NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? )YES xxx NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointment.
cclerk~bdcornapp,doc
January 1998
ATTACHMENT TO APPLICATION FOR HUMAN RIGHTS COMMISSION
It is the mission of the Iowa C. ity Human Rights Commission to protect citizens of the city
from discrimination as defined in the Human Rights Ordinance. In order to further this goal,
the city strives to ensure the Human Rights Commission is representative of the community
and the groups which it serves. Therefore, "[a]ppointments shall take into consideration men
and women of various racial, religious, cultural, social, and economic groups in the city. (Ord.
94-3647, 11-8-94)
Please indicate if you are a member of any of the following categories (your response is
voluntary):
__ 62 years or older
xxx Handicapped or Disabled
Racial or Ethnic Minority
~ Male
Female
Lower Income
Service Connected Disabilty,Receive Compensation
from Veterans Affairs
ClT~ 0F'IOWA CITY ~o ~ z~ ~.
ADVISORY BOARD/COMMISSION m
APPLICATION FORM
Individuals se~ing on Boards/Commissions play an impo~ant role in advising the Coun~ on ~
m~ers of intere~
to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. Th
appointment is made at the next formal Council meeting. Appointees sere as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 43 0 E. Washington St., Iowa Cit%
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FO
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTIAL' THIS APPLICATION WIL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANC
DURING THAT TIME.
NAME (~&&UV~--Cn/-~,v~f._ HOME ADDRESS qll 7~eno ~ee-I', Io~
Is your home address (listed above) within the corporate limits of Iowa City? ~Yes No
How long have you been a resident of Iowa City? I ~
PHONE NUMBER: HOME ~l~, ~58' fibril BUSINESS ~l~' ~?'
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~
FOR APPLYING)? A~ ~o~ ~no~, ~,l,~'e~ ~ no, &~Q,~i~ ~o.~ Fo~ec~ c~{c~,~,
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED?
/
YES
NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? __YES '~NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointment.
ccterk\bdcornapp.doc
ATTACHMENT TO APPLICATION FOR HUMAN RIGHTS COMMISSION
It is the mission of the Iowa City Human Rights Commission to protect citizens of the city
from discrimination as defined'in the Human Rights Ordinance. In order to further this goal,
the city strives to ensure the Human Rights Commission is representative of the community
and the groups which it serves. Therefore, "[a]ppointments shall take into consideration men
and women of various racial, religious, cultural, social, and economic groups in the city. (Ord.
94-3647, 11-8-94)
Please indicate if you are a member of any of the following categories (your response is
voluntary):
__ 62 years or older
__ Handicapped or Disabled
__ Racial or Ethnic Minority
Male
~'/Female
~/' Lower Income
N0v-t-8-99 02:21pm From-CITY OF IOWA CITY +3193565009
T-180 P.03 F-269 2_~ c
CiTY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
Individuals serving on Boards/Commlsslons play an important role in advising the Coun~m~rs o~nterest
to our community and its future. Applicants must reside in Iowa City. ;;--: "
After a vacancy has been announced, the Council reviews all applications during t~e world:rSession. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME ~tt~,rfi~r~k"'R,~,.5. h~5 .......... TER&Z-~r~o- ~n,~
Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes __ No
How long have you been a resident of Iowa City? }'~ ~/CS.
OCCUPATIOi~.C~-'i~L S-i-
PHONE NUMBER: HOME~,~q :~ [~SLI
... EMPLOYEFeff.,~I.
BUSINESS
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~2:
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON
N0v-iB-gg 0Z:2Tpm Fr0m-CITY OF 10WA CITY +3193585009 T-iS0 P.04 F-ZEtl
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY, OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARb OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? .,~YES __NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES .~ .NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this al3plication will constitute just cause for removal of an appointee.
!f you fail to answer all questions on the application you may not be considered for appointment.
; cletld, D(3comlpO.doc
January 1998
.Nov-iS-g9 02:22pm Fr0m-CITY OF 10WA CITY +3193565009 T-180 P.06 F-Zag
ATTACHMENT TO APPLICATION FOR HUMAN RIGHTS COMMISSION
!t is the mission of the Iowa C. ity Human Rights Commission to protect citizens of the city
from discrimination as defined in the Human Rights Ordinance. In order to further this goal,
the city strives to ensure the Human Rights Commission is representative of the community
and the groups which it serves. Therefore, "[a]ppointments shall take into consideration men
and women of various racial, religious, cultural, social, and economiC' groups in the city. (Ord.
94-3647, 11-8-94)
Please indicate if you are a member of any of the fo]!owing categories (your response is
voluntary}:
years or older
Handicapped or Disabled
Racial or Ethnic Minority
_Z~Lower Income
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, 2000 - January 1, 2004
The duties of the members of the Parks
and Recreation Commission are to
recommend and review policies, rules,
regulations, ordinances, 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.
Iowa City-appointed members of boards
and commissions must be eligible electors of
the City of Iowa City. The Parks and
Recreation Commission meets the second
Wednesday of each month at 5:00 p.m,
Appointment will be made at the
November 23, 1999, meeting of the City
Council at 7:00 p.m. The City of Iowa City
encourages diversity in the appointment of
citizens to boards and commissions. Persons
interested in being considered should contact
the City Clerk at the Civic Center, 410 E.
Washington Street. Application forms are
available from the Clerk's office upon request.
September 28, 1999
-23-99
23d
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father-
in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother,
step-child, aunt, or uncle. (Resolution 85-354)
Males: 4
Females: 3
November 23, 1999
PARKS AND RECREATION COMMISSION
Two Vacancies Four-Year Terms
January 1, 2000 - January 1, 2004
Allen Stroh []
3023 Cornell
(has served one full term)
AS OF NOON 11/10/99
Dennis J. Keitel []
1696 Ridge Road
James W. Moxley []
2040 Waterfront Drive
(has also applied for Board of Adjustment)
[] Denotes applicant completed the Confidential page of the application.
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
/' ' PLICATION FORM o m....
Individuals serving on Boards/Commissions play an important role in advising the Coun_~'~ m~<~ers of interest
to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees sere as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 4.10 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
NAME'~/I,q~"',,.,C [~2/4q~)XLE~2' HOMEADDRESS~-0'~'(~TM M/'~--~F~/~/Y~'
Is your home address (listed above) within the corporate limits of Iowa City? K Yes __ No
How long have you been a resident of Iowa City? EL~"'//~"/J ~'~
Or'r:.UPATION G~D~~ ~ T~0~) T~m'To~ EMPLOYER ~ Q Fy ~b'c U~
VHON~ NUMBER: HOME 33/-22 ~o BUS~NESS 3~ -- ?~O~ ~./~
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~ ? ,~
WHAT CONTRIBUTES DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE ASON
FOR APPLYING)?
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST, PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? .. YES .,X NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES .,~NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointment.
cclerk\bdcomapp .doc
January 1998
(2)
NOV-11-1999 15:10 HALL & HALL ENG. 3193629548 P.02/07
CITY 'OF IOWA CITY
ADVISORY BOARD/COMMISSION
: ?PLICATION FORM _
Individuals serving on Boards,/Commissions play an important role in advising the CoLOn ~at~e~of interest
to our community and its future. Applicants must reside in Iowa City. 3> ~
After a vacancy has been announced, the Council reviews all applications during the w~ session. The
appointment is made at the ne~ forma( Council me~ing. Appointees sere as unpaid volunteem.
PL~SE USE A B~CK INK PEN. R~urn the application to Ci~ Clerk, 410 E. Washington St., Iowa City,
Iowa.
ADVISORY BOARD/COMMISSION NAME
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONRDENTIAL' THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
!s your home address (listed above) within the corporate limits of Iowa City? :~. Yes No
How long have you been a resident of Iowa City?
PHONE NUMBER: HOME ~> ,~' '/F' ' I cf ~ c~
SUreNESS 2~ 6 '~ - '=/
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD {OR STATE REASON.
NOU-11-1999 15:10 HALL & HALL ENG. 3193629548 P.03/07
Src~CIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Y',,YES NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION?
YES ~ NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fa~ to answer all questions on the application you may not be considered for appointment.
cclefk~,dcomapg,doc
NOTICE
THE CITY COUNCIL OF IOWA CITY IS
CONSIDERING APPOINTMENT TO THE
FOLLOWING COMMISSION:
SENIOR CENTER COMMISSION
Two vacancies - Three-Year Terms
January 1, 2000 - December 31, 2002
The duties of members of the Senior Center
Commission are to:
1. Serve in an advisory role to the City Council
with regard to needs of the Senior Center.
2. Make recommendations with regard to
policies and programs at the Senior Center.
3. Join staff and other interested persons in
seeking adequate financial resources for
operation of the Senior Center.
4. Encourage full participation by senior
citizens in the programs of the Senior
Center.
5. 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.
6. Serves in an advocacy role with regard to
the needs of senior citizens in Iowa City.
Iowa City-appointed members of boards
and commissions must be eligible electors of
the City of Iowa City. The Senior Center
Commission meets the third Tuesday of each
month at 3:00 p.m.
Appointments will be made at the
November 23, 1999, meeting of the City
Council at 7:00 p.m. The City of Iowa City
encourages diversity in the appointment of
citizens to boards and commissions. Persons
interested in being considered should contact
the City Clerk at the Civic Center, 410 E.
Washington Street. Application forms are
available from the Clerk's office upon request.
9/28/99
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father-
in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother,
step-child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 2
November 23, 1999
SENIOR CENTER COMMISSION
Two vacancies - three Year Terms
January 1, 2000- December 31, 2002
NO APPLICATIONS AS OF NOON 11/10/99
Ken Fearing []
605 Manor Drive
Harold Stager []
201 N. First Avenue #302
Robert L. Welsh []
84 Penfro Drive
Lori Benz []
201 2 Dunlap Court
Charity Rowley []
519 Park Road
[] Denotes applicant completed the Confidential page of the application.
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father-
in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother,
>-child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 2
1999
SENIOR COMMISSION
Two vacancies 'ee Year
January 1, 2000- 31
NO APPLICATIONS AS O!
11/10/99
Ken Fearing []
605 Manor Drive
Harold Stager []
201 N. First Aven
Robert L.
84 Penfro Driv
Lori Benz
201 2 Dunl~ Court
#302
[] Denotes applicant completed the Confidential page of the application.
CITY OF .IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest
to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME/~24'/Z.,d:~ ~
TERM
HOME ADDRESS ~/~,~ ~~ ~
Is your home addres e) within the corporate limits of Iowa City? ~ Yes No
PHONE NUMBER: HOME ~~;~3~~ ~ BUSINESS
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE,
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? .~YES __NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES ,%d NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointmex>,t.
cclerk\bdcomapp .doc
(2)
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
Individuals serving on Boards/Commissions play an important role in advising the Council onematterS'of interest
to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been annouhced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Is your home address ( above) within the corporate limits of Iowa City? ~es ~ No
How long have you been a resident of Iowa City?
OCCUPATION
PHONE NUMBER: HOME vZ'~7
EMPLOYER
BUSINESS
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON
. --- ,,
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY,
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED?
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointment.
cclerk%bdcomapp .doc
January 1998
(2)
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest
to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME
NAME a b ff/,,
HOME ADDRESS
Is your home address (listed above) within the corporate limits of Iowa City?
How long have you been a resident of Iowa City?
OCCUPATION ~l~ir~t~/~t
PHONE NUMBER: HOME
EMPLOYER
BUSINESS
Yes No
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON
FOR APPLYING)?
ATTACHMENT TO APPLICATION
Robert L. Welsh
Senior Center Commission
EXPERIENCE AND/OR ACTIVITIES V~{ICH YOU FEEL QUALIFY YOU FOR THIS
POSITION.
I have a history of services to Seniors. I was a major force in urging the City to purchase
the Old Post Office for use as a Senior Center.
I served as one of six members of the committee to plan the Senior Center jointly with
Ecumenical Towers. I was founder and organizer of the Ecumenical Housing
Corporation. I am currently Chair of the Johnson County Nutrition Board.
I have served as Chair of the Budget, Program and Planning Committee of the Heritage
Area Agency on Aging and I am thus familiar with the program and services of many of
the agencies that serve Seniors, not only in Johnson County, but in the seven-county area.
I served the City as the first chair of the Housing Commission and the first chair of the
Cable TV Commission.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I have attended meetings of the Senior Center Commission and have read many of their
reports.
WHAT CONTRIBUTION DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY
BOARD (OR STATE REASON FOR APPLYING)
I have a strong belief in the value of co-location of services for Seniors
I would be particularly strong in assisting with "Duties and Powers" #4, #5 and #6. I am
a strong advocate for senior citizens, I would seek to help empower seniors and work
build collaborative relationships.
I am applying because I feel I can help.
November 18, 1999
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~/YES NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION?
YES L'INO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointme__nt.
cclerk\bdcomapp .doc
(2)
CITY'OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
Individuals serving on Boards/Commissions play an important role in advising the Councllrj~ _rf~_ter,~ interest
to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during woL. E; session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.>
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 4i 0 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COMMISSION NAME Senlet O~¢~r Co~mZ ~s,'~ TERM ~
Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes No
How long have you been a resident of Iowa City? ~
PHO~U~s~a: HO~S 5~q~!~S SUS~SS 555--~5~
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:?~$~~
' - '. . .
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON
FOR APPLYING)? ~ ~ ~ ~ ~ ~*~ q~,~~
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY, OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? /YES NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? __YES .,/NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appoi~:ment.
cclerk\bdcomapp.doc
~J~uary
~__
1998
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
~ CS> ~a 1
:< F' .r'r'i
.~. ""
Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest
to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. Return the application to City Clerk, 410 E. Washington St., Iowa City,
Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL
BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
ADVISORY BOARD/COM~JSSION NAME
·
A
HOME ADDRESS '5",,/z9) '~/t"'~' ?~. j T~ O'cr%:~ ,9",~
Is your home address (listed above) within the corporate limits of Iowa City? ~....... Yes ~ No
How long have you been a resident of Iowa City?
PHONE NUMBER: HOME BUSINESS
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
,
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON
SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY
PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY.
AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF
AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE.
YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN
IMPORTANT EXCPETIONS, A MEMBER OF A CITY BOARD OR COMMISSION FROM HAVING AN INTEREST IN A
CITY CONTRACT. A COPY OF SECTION 362.5 IS ATTACHED. IF YOU HAVE ANY QUESTIONS, PLEASE
CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030.
IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE
AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? / YES __NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION?
YES / NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all questions on the application you may not be considered for appointment.
cclerk\bdcomapp.doc
Jan~ 1998
(2)