HomeMy WebLinkAbout2012-07-10 Appointment14a
Dear City Council and members of the Youth Advisory Commission,
I am writing to formally resign from my position as the West High representative on
the Youth Advisory Commission. This resignation will be effective immediately as I
will be leaving to attend camp and will then begin my college career at Hope College.
Thank you for the opportunity to learn and grow while being part of this engaging
environment.
Sincerely, Leah Murray
j
Marian Karr
From:
Kasra Zarei <kasra.zarei @gmail.com>
Sent:
Thursday, June 28, 2012 2:14 PM
To:
Marian Karr
Subject:
Re: Youth Advisory Commission
Hello Mrs. Karr,
Thank you for your reply. I would greatly appreciate it if you could forward my email to them. Once again, I
think I deserve to be considered, especially if there aren't any other applicants so far. Thank you for letting me
know.
Best,
Kasra
On Thu, Jun 28, 2012 at 2:08 PM, Marian Karr < Marian- Karrgiowa- cit".org> wrote:
Thank you for your email and interest in the Youth Advisory Commission. You must be a City resident to apply for all
City Boards and Commissions, including Youth Advisory. With your permission I can forward your letter to the City
Council and see if they are interested in changing that requirement. Please let me know if you'd like me to forward this
email to them or if you'd like to write another. Feel free to send the email back to me and I can include in the next
packet going to Council. Thanks again for your interest and 1 hope you stay active in the community.
Marian Karr, MMC
City Clerk
From: Kasra Zarei [mailto:kasra.zarei @ amail.com]
Sent: Wednesday, June 27, 2012 10:33 PM
To: Marian Karr
Subject: Youth Advisory Commission
Hello Mrs. Karr,
Sorry to bother you. My name is Kasra Zarei and I am going to be a senior at West High School. I am the
president of my school's student senate and I am very involved in many clubs, organizations, and activities in
my school and in the community. I am also friends with Leah Murray who is an alumni of the youth advisory
commission. Earlier this year (during the winter time), she told me about this commission and I was really
interested in doing it. However, since I am not a resident of Iowa City, I am unable to apply despite the fact that
I attend West High. Well I understand the Leah is still searching for someone to take over for her from West
High now that her term is done. I have aided her by trying to get qualified, hardworking people we know to
apply. However, It seems like there aren't any Iowa City residents at West that would like to apply.
I am still interested in applying for this position if possible. I have a deep interest in these types of activities. I
have been part of student senate and the student senate execboard for all four year and I have loved it. I really
enjoy all the activities I do, and I wouldn't be interested in applying if I didn't think I would be great for the
position. I technically live in Coralville but I can assure you many of my daily activities (community service,
work, etc.) take place in Iowa City and I have a lot of familiarity with all the issues the residents of Iowa City
face. Also, I think that since the position is specific for a West High student, with all the respect I believe that it
is a little unfair to exclude residents of the Coralville like myself that are very involved in West High School.
I really appreciate your time, and I would greatly appreciate it if you would allow me to apply for the West
High position. You will not regret your decision. I take everything I do seriously and I can assure you that I am
a great leader that can contribute a lot. Thank you again for your time. Please let me know what you think.
Best regards,
Kasra Zarei
15a
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
HOUSING & COMMUNITY DEVELOPMENT COMMISSION
Three Vacancies — Three -Year Terms
September 1, 2012 — September 1, 2015
Duties of the Housing and Community Development Commission include assessing and
reviewing policies and planning documents related to the provision of housing, jobs, and
services for low- and moderate - income residents; reviewing policies and programs of the Public
Housing Authority and Community Development Division and make recommendations
regarding the same to the City Council; reviewing and making recommendations to the City
Council regarding the use of public funds to meet the needs of low- and moderate - income
residents; housing policies and programs, and seeking public participation in assessing needs
and identifying strategies to meet these needs; recommending to the City Council from time -to-
time amendments, supplements, changes, and modifications to the Iowa City Housing Code.
Iowa City- appointed members of boards and commissions must be eligible electors of the
City of Iowa City. When possible, Council will appoint persons with expertise in construction
and /or finance, a person receiving rental assistance, and a member of the Local Homeless
Coordinating Board. The Housing and Community Development Commission will have monthly
meetings.
Applications must be received by 5:00 p.m., Wednesday, June 27, 2012. The City of Iowa
City encourages diversity in the appointment of citizens to boards and commissions. Persons
interested in being considered should contact the City Clerk at City Hall, 410 E. Washington
Street. Application forms are available from the Clerk's office upon request or on the City
website at www.icgov.org.
Questions about the Iowa City Housing and Community Development Commission should
be directed to Tracy Hightshoe, Community Development Planner at 356 -5244.
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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: 3
Council Announcement Date: May 15, 2012
Application Deadline: Wednesday, 5:00 p.m., June 27, 2012
Council Appointment Date: July 10, 2012
After 08/13/2012 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
HOUSING & COMMUNITY
DEVELOPMENT COMMISSION
Three Vacancies - Three -Year Terms
September 1, 2012 — September 1, 2015
Term expires for Andrew Chappell, Jarrod Gatlin, Rachel Zimmerman Smith
Gender Balance Requirement: None
(M) Andrew Chappell 0
911 Rider Street
(F) Rachel Zimmerman Smith rx-1
1240 Teg Drive
El Denotes applicant completed the Confidential page of the application.
City of Iowa City
Advisory Board /Commission /Committee
pp
lication Form
CITY OF IOWA CITY
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 /Committee Name Housing and Community Development Term Starting 9/1/12
Youth Advisory Commission (shall not be more than 18 years of age at the time of application)
Name of Iowa City High School or high school equivalent:
Signature of parent/guardian:
NAME Andrew B. Chappell HOME ADDRESS 911 Rider street, Iowa City
Is your home address (listed above) within the corporate limits of Iowa City? ❑✓ Yes F No
How long have you been a resident of Iowa City? August of 1994 Gender: Male ❑✓ Female F
OCCUPATION [-a=Pr EMPLOYER Johnson County Attorney's Office
PHONE NUMBER: HOME 319.354.7073 BUSINESS m9 339 s ion
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
am a lawyer who represents Johnson County, Iowa, and through that employment have experience with and
owledge of numerous local non - profit organizations that work with HCDC. I also am HCDC,s current chairperson.
in that role I have been through several rounds of funding and have worked to improve the funding application
process.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
HCDC provides funding recommendations to the Iowa City City Council for a variety of'CDBGand Hd iib programs.
In conjunction with doing so it serves as an outlet for public participation and also helps recommend,, policies related
to these same programs.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)?
I believe I help make HCDC an efficient and effective Commission while at the same time helping ensure the general
public, the applying organizations, and other Commission members have adequate opportunities to participate.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
I have no likely financial conflicts of interest but may occassionally have a conflict, real or perceived, through my
employer.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑✓ Yes F] No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ❑ Yes [�]'No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
HCDC Application
June 2012 Page 2 of 8
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BOARD, COMMISSION, & COMMITTEES
BUSINESS LISTING CITY OF IOWA CITY
Name of City
Board /Commission /Committee Housing and Community Development Date 06/25/2012
Name Andrew B. Chappell
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member
of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5
is attached (see page 8).
List all businesses in which you or your spouse /domestic partner have an ownership interest (for
example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there
are none.
BUSINESS NAME BUSINESS ADDRESS
N/A
r7 .s
+, l
NOTE:
Signature
A new form must be completed if the above information changes or an ownership interest
is acaUred immn additionat bainessA/
Address 911 Rider Street, Iowa City
Misrepresentations on this application will constitute just cause for removal of an appointee.
If you fail to answer all the questions, Council may not consider your application.
HCDC Application
June 2012 Page 3 of 8
TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY
Effective February 9, 2012
Household
Size
30% Median Income
(Poverty Level)
50% Median
Income
60% Median
Income
80% Median Income
(low income)
Median
Income
1
$16,900
$28,150
$33,780
$45,000
$56,300
2
19,300
32,150
38,850
51,400
64,300
3
21,700
36,150
43,380
57,850
72,300
4
24,100
40,150
48,180
64,250
80,300
5
26,050
43,400
52,080
69,400
86,800
6
28,000
46,600
55,920
74,550
93,200
7
29,900
49,800
59;760
79,700
99,600
8
31,850
53,000
63,600
84,850
106,000
ATTACHMENT TO APPLICATION FOR THE
HOUSING AND COMMUNITY DEVELOPMENT COMMISSION
IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS
REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, PLEASE INDICATE IF YOU
ARE A MEMBER OF EITHER OF THE FOLLOWING CATEGORIES:
Lower Income (see table) Receive Rental Housing
Assistance
Your response is voluntary, and you may wish instead to elaborate on or indicate ,areas in which
you can make a special contribution to the Commission in another section of this form. ,,
When possible, Council will appoint a person or persons with expertise in construction, finance and /or
a person receiving rental assistance.
If you have expertise in construction or finance, please describe your experience and /or training.
N/A
;DC Application
June 2012 page 4 of 8
City of Iowa City r 1
Advisory Board /Commission /Committee,Ai�
N C-!n-
t -1plication Form �-�--
CITY OF IOWA CITY
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 /Committee Name HCDC Term 2012 -2015
Youth Advisory Commission (shall not be more than 18 years of age at the time of application)
Name of Iowa City High School or high school equivalent:
Signature of parent/guardian:
NAME Rachel Zimmermann Smith HOME ADDRESS 1240 Tea Drive
Is your home address (listed above) within the corporate limits of Iowa City? ❑✓ Yes F-1 No
How long have you been a resident of Iowa City? Since 5th grade Gender: Male F-1 Female 17
OCCUPATION attorney EMPLOYER Johnson County
PHONE NUMBER: HOME 319 - 621 -2298 BUSINESS
FxPFRIFNrF ANMOR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHAT IS YOUR PRESENT MNUwLtUGt Ur I t'11, AUV WUKT 13UAMW f
have been through several funding cycles on HCDC.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)?
I love Iowa City and am re- applying for this commission because I want to serve my community and I have an
interest in many of the topics that the commission addresses.HCDC plays a vital role in helping to direct community
development.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑✓ Yes U No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes [Z]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
�o answer all the questions, Council may not consider your application.
HCDC Application
June 2012 Page 2 of 8
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BOARD, COMMISSION, & COMMITTEES - •�.,�
BUSINESS LISTING CITY OF IOWA CITY
Name of City
Board /Commission /Committee HCDC
Name Rachel Zlmmermann Smith
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member
of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5
is attached (see page 8).
List all businesses in which you or your spouse /domestic partner have an ownership interest (for
example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there
ara nnna
BUSINESS NAME BUSINESS ADDRESS
NOTE: A new form must be completed if the above information changes or an ownership interest
is acauAd in a"- cldtGjR�siness.
Signature
Address 7 O� �%� /� V,
Misrepresentations on this application will constitute just cause for removal of an appointee.
if you fail to answer all the questions, Council may not consider your application.
HCDC Application
June 2012 Page 3 of 8
TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY
Effective February 9, 2012
Household
Size
30% Median Income
(Poverty Level)
50% Median
Income
60% Median
Income
80% Median Income
(low income)
Median
Income
1
$16,900
$28,150
$33,780
$45,000
$56,300
2
19,300
32,150
38,850
51,400
64,300
3
21,700
36,150
43,380
57,850
72,300
4
24,100
40,150
48,180
64,250
80,300
5
26,050
43,400
52,080
69,400
86,800
6
28,000
46,600
55,920
74,550
93,200
7
29,900
49,800
59,760
79,700
99,600
8
31,850
53,000
63,600
84,850
106,000
ATTACHMENT TO APPLICATION FOR THE
HOUSING AND COMMUNITY DEVELOPMENT COMMISSION
IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS
REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, PLEASE INDICATE IF YOU
ARE A MEMBER OF EITHER OF THE FOLLOWING CATEGORIES:
E] Lower Income (see table)
FReceive Rental Housing
Assistance
r ?
Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which
you can make a special contribution to the Commission in another section of this form.
When possible, Council will appoint a person or persons with expertise in construction, finance and /or
a person receiving rental assistance.
If you have expertise in construction or finance, please describe your experience and /or training.
HCDC Application
June 2012 page 4 of 8
15b
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
POLICE CITIZENS' REVIEW BOARD
Two Vacancies — Four -Year Terms
September 1, 2012 — September 1, 2016
Duties of the Police Citizens' Review Board include reviewing Police Department investigations into
allegations of misconduct lodged against police officers, conducting further investigation of the complaint
when the Board deems it necessary, and issuing a public report which explains why and the extent to
which the complaint is sustained or not sustained; maintaining a central registry of complaints against
sworn police officers and issuing annual reports regarding the disposition of the complaints to the City
Council; reviewing police policies and practices from time -to -time and recommending changes to the City
Council when the Board deems it appropriate.
Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa
City. However, the City Council reserves the right to waive the residency requirement for good cause
shown. The City Council also reserves the right, for good cause shown, to waive the requirement that the
Board include one current or former "peace officer" as that term is defined by State law.
Applications must be received by 5:00 p.m., Wednesday, June 27, 2012. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Police Citizens' Review Board should be directed to Marian Karr or
Kellie Tuttle at 356 -5041.
5/17/2012
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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: 0
Council Announcement Date: May 15, 2012
Application Deadline: Wednesday, 5:00 p.m., June 27, 2012
Council Appointment Date: July 10, 2012
After 08/13/2012 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
** Appointments to the Board shall include one current or former "peace officer"
as that term is defined by State law. The City Council reserves the right, for
good cause shown, to waive the requirement that the Board include one
current or former peace officer.
** The City Council also reserves the right to waive the residency requirement for
good cause shown.
POLICE CITIZENS' REVIEW BOARD
Two Vacancies — Four Year Terms
September 1, 2012 — September 1, 2016
Term expires for Melissa Jensen, Royceann Porter
Gender Balance Requirement: 2 Females
(M) Mike McKay
1105 Keokuk St
(F) Melissa Jensen Fx1
830 Elliott Ct
El Denotes applicant completed the Confidential page of the application.
City of Iowa City ► r 1
Advisory Board /Commission /Committee
Application Form
CITY OF OF IOWA CITY
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 /Committee Name Citizens Police Review Board Term 2012 -2016
Youth Advisory Commission (shall not be more than 18 years of age at the =#" c --supplication)
Name of Iowa City High School or high school equivalent: ='
Signature of parent/guardian:
NAME Mike McKay HOME ADDRESS 1105 Keokuk §t''
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? 23 Years Gender: Male ❑ Female
OCCUPATION Owner /Officer EMPLOYER Keystone IT, Inc.
PHONE NUMBER: HOME 319- 337 -6185 BUSINESS
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
While in charge of administration at Systems Unlimited, I was in charge of all internal investigations regarding child
ai !dult abuse claims and corporate policy infractions. I then decided the appropriate courses of action. While
perrorming this function I learned the importance of gathering information, sorting out facts, cross checking, etc. I am
a follower of current events in the area and am interested in seeing that Iowa City is a great(er) place to live.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I know when and why it was founded. I know that it is a board for citizens to approach with unresolved issues
regarding treatment by the force or perceived unfair policies and practices of the force. I know that it has no direct
power, but is a good communication vehicle for the citizenry as well as the police force.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FOR APPLYING)?
I think that my years of experience in positions where I interacted with the powerful and the powerless has given me
good basis for this advisory board. I have served on juries and thus have seen that process in action. I also
recently served as the Chair of the Housing and Community Development Commission which gave me insights into
some of the tools the city has to improve the lives of the citizens. I would draw on all of this as a member.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
I resigned form the HCDC because of potential conflicts of interests between my computer business and the
recipients of city funds for IT projects. I do not see the possibility of a conflict with this board.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? R✓ Yes ❑ No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? RYes F✓ No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
.Aisrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
January 2012 Page 2 of 8
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
CITY OF IOWA CITY
Name of City
Board /Commission /Committee Citizens Police Review Board Date 05/30/2012
Name
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 7).
List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission
applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's
stockholdings). Please indicate if there are none.
BUSINESS NAME
BUSINESS ADDRESS
Keystone IT, Inc.
365 E.College St.
CD
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business.
Applicant Signature,
%,Jj
Signature of parent/guardian (Youth Advisory tDn4n*si3ion only):
Address S/-- jA— G7`,
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
answer all the questions, Council may not consider your application.
General Application
January 2012 Page 3 of 8
J u n. 27. 2012 11: 27AM No. 7826 P. 2
City of Iowa City �,► r 1
Advisory Board/Commission/Committee;,'I'�,
,,application Form
CITY OF IOWA CITY
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRI13UTED FOR THE PUBLIC,
WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL SE CONSIDERED
FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME.
Advisory Board /Commission /Committee Name Police Citizen Review Board Term
Youth Advisory Commission (shall not be more than 18 years of age at the time of application)
Name of Iowa City High School or high school equivalent:
Signature of parent/guardian:
NAME Melissa A. Jensen _ HOME ADDRESS 830 Elliott Ct, Iowa City. Iowa 52246
Is your home address (listed above) within the corporate limits of Iowa City? ❑✓ Yes n No.
How long have you been a resident of Iowa City? 12 years Gender: Male F-1 Female
OCCUPATION Director, Emergency Segtices EMPLOYER Kirkwood CQmmunity Collecie
PHONE NUMBER: HOME 319- 354 -5047 BUSINESS ���- BAR -5aa1
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
-rent PCRB member. I have also attached a resume. I am used to managing multiple priorities, making difficult
udcisions, and am highly organized.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? --
Current PCRI3 member.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYINO)l
Because of my backgrou id and experience, I belleve I have an understanding of the issues that may arise, but also
have the ability to be inbiased and fair.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
NA 7
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ✓Z Yes r] No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? nYes QNo
(It has been Council policy not to permit an individual to serve on two Boards or Comnilssions at the same time.)
" Misrepresentations on this application will constitute just cause for removal of ah appointee. If you fail I
to answer all the questions, Council may not consider your application.
General Application
June 2012 Page 2 of 7
Jun. 27. 2012 11:27AM
No. 7826 P. 3
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BOARD, COMMISSION AND COMMITTEES����
BUSINESS LISTING ..•t...._
CITY OF IOWA CITY
Name of City
Board /Commission /Committee Police Citizen Review Board Date 06/27/2012
Name Melissa A. Jensen
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 7).
List all businesses in which you, your spouse /domestic partner, or parent if Youth Advisory Commission
applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's
stockholdings). Please indicate if there are none.
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an addition al_business. ,
Applicant Signature CA .
Signature of parent/guardid (Youth Advisory
on only):
Address 830 EIllott Ct, Iowa City, Iowa 52246 _
Misrepresentations on- this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
June 2012 Page 3 of 7
Jun. 27. 2012 11:28AM
No. 7826 P. 8
MELISSA. A. JENSEN
830 ELLIOTT CT_ • IOWA CITY', IOWA 52246
PHONE (319) 354 -5047 • E- 1vfAIL MELYSSA JENSEN@KM<WOOD.EDU
SUMMARY
Exteiasive experience in emergency management, including campus security & fire protection.
Successful management of code compliance, including ICS, NIMS, life safety, JCAHO, FEMA, &
OSHA. Excellent background in proactive planning, 12w enforcement, physical security,
investigations, and employee training & education.
MFESSIONAL EXPERIENCE
Kirkwood Community College Cedar Rapids, IA
Director, Emetgency Services (2007 — Present)
Overall responsibility for development and management of emergency
management & response programs, including design, training, & exercises.
Direct Campus Security operations including strategic planning, budgeting,
special events, investigations, and training.
Designs, establishes, implements, & provides training for emergency mgmt,
energy & environmental compliance, hazardous materials, and other
programs.
Mercy Hospital
Safety & Security Manager (2002 -2006)
Iowa City, IA
• Design, establish, and implement emergency management programs
• Manage Safety & Security department operations, including strategic
planning, budgeting, and investigations
• Develop, author, and implement multiple training programs
Serve as Project Manager for access control and fire alarm systems
Safety & Security Officer II (2000 -2002)
Principal Financial Group Des'M6ines IA
Safety & Security Manager (1993 -2000)
• Designed, implemented, and maintained 17 major OSHA Programs;
including hazardous materials
• Established, implemented, and coordinated crisis management programs
• Managed Safety & Security Department operations, including budgeting,
contractual and proprietary services
• Served as Project Manager for million -dollar access control and life safety
projects
Iowa Methodist Medical Center
Safety & Security Manager (1988 -1993)
Des Moines, IA
• Responsible for regulatory compliance, program development, and training
for fire protection and life safety programs
• Developed, wrote, and maintained programs for emergency management
• Established, implemented, and maintained OSHA programs
J u n. 27. 2012 11: 28AM
EDUCATION
No. 7826 P. 9
Melissa A. Jensen
Page 2
Assistant Director, Safety & Security (1984 -1988)
• Managed daily operation of Safety & Security Department
• Managed Emergency Communications Center
Des Moines Area Community College Des Moines, IA
1989 Fire Science Technology Associates Degree
1980 Law Enforcement Associates Degree
PROF STONAL CERTIFICATIONS
• Incident Command /Command Post Instructor — International Association of
Campus Lave Enforcement Administrators
• Certified Healthcare Protection Administrator— International Association
Healthcare Security & Safety
• Certified Fire Protection Specialist- National Fire Protection Association
• Certified as a National Mass Fatalities Responder by the National Mass
Fatalities Institute
■ Train- the - Trainer Public Health Preparedness Certification, College of Public
Health, University of Iowa
COMMUNITY ACTIVITIES
• Appointed, Hearing Officer, Red Light /Speed Cameras - Cedar Rapids Police
Department, City of Cedar Rapids
• Appointed, Police Citizen Review Board, City of Iowa City 2011 -12
• Appointed to State of Towa Rebuild Ioxva Commission
• Selected for Community College Leadership Initiative Consortium 2008 -09
• Selected as a Johnson County Election Official for 2010 - 12 General Election
PAST PROFESSIONAL ACTIVITT
■ Elected as Chairperson (4 years), Johnson County Local Erne Plan ?ning
Committee _
Elected President (3 years), Hawkeye State Fire Safety Association
■ Appointed to Member Advisory Council, National Fire Protection ,
Association -
M Elected as Vice President, Eastern Iowa. Chapter - ASIS International
REFERENCES
■ Available upon request