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HomeMy WebLinkAbout2013-07-23 AppointmentNOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy — Five -Year Term January 1, 2012 - December 31, 2016 The powers and duties of the Airport Zoning Board of Adjustment are: 1. To hear and decide appeals where it is alleged there is an error in any order, requirement, decision, or determination made by an administrative official in the enforcement of the Airport Zoning Chapter. 2. To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which such board is required to pass under the Airport Zoning Chapter. 3. To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning Chapter as will not be contrary to the public interest, where owing to special conditions a literal enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship, and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done. Iowa City- appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets at the call of the Chairperson. Applications must be received by 5:00 p.m., Wednesday, July 17, 2013. The City 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 Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356 -5045. 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: 1 Council Announcement Date: December 6, 2011; January 24, 2012; March 6, 2012; April 3, 2012, May 1, 2012; June 5, 2012; July 31, 2012; September 4, 2012; October 23, 2012; December 4, 2012; January 8, 2013; February 19, 2013; March 19, 2013; April 23, 2013; June 4, 2013 Application Deadline: Wednesday, 5:OOp.m., July 17, 2013 Council Appointment Date: July 23, 2013 After 03/05/2012 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy — Five -Year Term January 1, 2012 — December 31, 2016 New Full Term Gender Balance Requirement: None No applications as of Wednesday, 5:OOp.m., July 17, 2013 0 Denotes applicant completed the Confidential page of the application. NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy — Five -Year Term January 1, 2009 - December 31, 2013 The powers and duties of the Airport Zoning Board of Adjustment are: 1. To hear and decide appeals where it is alleged there is an error in any order, requirement, decision, or determination made by an administrative official in the enforcement of the Airport Zoning Chapter. 2. To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which such board is required to pass under the Airport Zoning Chapter. 3. To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning Chapter as will not be contrary to the public interest, where owing to special conditions a literal enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship, and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done. Iowa City- appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets at the call of the Chairperson. Applications must be received by 5:00 p.m., Wednesday, July 17, 2013. The City 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 Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356 -5045. 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: 1 Council Announcement Date: September 23, 2008; November 3, 2008; December 16, 2008; February 10, 2009; March 10, 2009; April 6, 2009; May 19, 2009; June 16, 2009; July 28, 2009; September 15, 2009; October 20, 2009; December 1, 2009; January 25, 2010; March 2, 2010; April 6, 2010; May 10, 2010; June 15, 2010; August 17, 2010 (Gender Balance in Effect); September 21, 2010; November 16, 2010; December 7, 2010; January 10, 2011; February 15, 2011; March 22, 2011; May 3, 2011; June 7, 2011; August 2, 2011; September 6, 2011; October 4, 2011; November 1, 2011; December 6, 2012; January 24, 2012; March 6, 2012; April 3, 2012, May 1, 2012; June 5, 2012; July 31, 2012; September 4, 2012; October 23, 2012; December 4, 2012; January 8, 2013; February 19, 2013; March 19, 2013; April 23, 2013; June 4, 2013 Application Deadline: Wednesday, 5:OOp.m., July 17, 2013 Council Appointment Date: July 23, 2013 After 11/15/10 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy - Five -Year Term January 1, 2009 - December 31, 2013 Term expires for Dennis Keitel Gender Balance Requirement: None No applications as of Wednesday, 5:OOp.m., July 17, 2013 [H] Denotes applicant completed the Confidential page of the application. NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING COMMISSION One vacancy — Six -yr Term January 1, 2010 - December 31, 2015 Duties of the Airport Zoning Commission are: 1. To recommend amendments to the current Iowa City Airport Zoning regulations, including the repeal thereof. 2. To recommend the adoption of new Airport Zoning regulations. Iowa City- appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets as required. Applications must be received by 5:00 p.m., Wednesday, July 17, 2013. 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 Airport Zoning Commission should be directed to Michael Tharp, Airport Operations Specialist at 356 -5045. 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: 1 Council Announcement Date: September 15, 2009; November 2, 2009; December 1, 2009; January 25, 2010; March 2, 2010; April 6, 2010; May 10, 2010June 15, 2010; August 17, 2010 (Gender Balance in Effect); September 21, 2010; November 16, 2010; December 7, 2010; January 10, 2011; February 15, 2011; March 22, 2011, May 3, 2011; June 7, 2011; August 2, 2011; September 6, 2011; October 4, 2011; November 1, 2011; December 6, 2011; January 24, 2012; March 6, 2012; April 3, 2012, May 1, 2012; June 5, 2012; July 31, 2012; September 4, 2012; October 23, 2012; December 4, 2012; January 8, 2013; February 19, 2013; March 19, 2013; April 23, 2013; June 4, 2013 Application Deadline: Wednesday, 5:OOp.m., July 17, 2013 Council Appointment Date: July 23, 2013 After 11/15/10 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. AIRPORT ZONING COMMISSION One Vacancy - Six -year Term January 1, 2010 - December 31, 2015 Term expires for Brian Sponcil Gender Balance Requirement: None (F) Christine Douglas ❑x 1965 Meadow Ridge Lane (M) Robert Powers ❑ 3 Melrose Circle x❑ Denotes applicant completed the Confidential page of the application. City of Iowa City r l Advisory Board /Commission /Committee; -'� • ,,r„N ®R Application 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 Airport Zoning Commission Term NAME Christine Douglas HOME ADDRESS 1965 Meadow Ridge Lane Is your home address (listed above) within the corporate limits of Iowa City? W✓ Yes F-I No How long have you been a resident of Iowa City? 30 years Gender: Male 11 FemaleQ OCCUPATION Executive Administrator EMPLOYER CIVCO Medical Solutions PHONE NUMBER: HOME (319)621-7366 BUSINESS (319) 248 -6510 EXPERIENCE AND /OR ACTIVITIES WHICH YOU. FEEL QUALIFY YOU FOR THIS POSITION: I am a current plane owner and student pilot and have had a love of aviation for 20+ years. I have studied the FAA airspace regulations related to potential development around this airport and I believe my knowledge could prove to be helpful. I personally developed and led a diverse group of 40+ owners (and adjacent property owners) to complete a $400,000, 5 -yr capital improvements plan (which required initiative, creativity, accountability, decisiveness, and follow- through). I believe I am respectful of others, can listen and communicate effectively, and I don't mind asking questions to gain better understanding. I believe all of this is good experience for this role. 4HAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? My understanding is that this Commission helps ensure that airspace, as is required to protect instrument and visual flight operations, will be adequately maintained by mitigating existing hazards and by preventing the establishment or creation of future airport hazards. Additionally, this Commission will help define and recommend adoption of zoning laws (within reason) to restrict the use of land adjacent to or in the immediate vicinity of the airport to activities or purposes compatible with normal airport operations. I have a good understanding of how city governments, budgets, and regulations work (and, more specifically, the role of advisory boards), I have knowledge of FAA regulations and airspace requirements, I understand what it means to operate an aircraft, and I have been witness to the effects of proper and/or poor airport zoning. I'm appying because a need has been identified and I'm happy to serve (even if it's a very limited role). - Not Applicable - IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes No. a c DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION:?: Qes QNo (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. veneral Application October 2012 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES CU. i0 BUSINESS LISTING_ ' CITY OF IOWA CITY Name of City Board /Commission /Committee Airport Zoning Commission Date Name Christine Douglas 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, 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. NOTE: A new form must be completed if the above information changes or an ownership interest is acquire Applicant Address 1965 Meadow Ridge Lane 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. _,eneral Application October 2012 Page 3 of 7 City of Iowa City _ r 1 Advisory Board /Commission /Committee h oplication 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 41,64W T � ©NiN � cc1�1ff1,: 51 Term %�3f �O j$ NAME X0,8 �'� 740 6V,6,2 S HOME ADDRESS 3 Ae- IA4a,5X iSZZ46` 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? Y"—'o S Gender: Male Q FemaleF] OCCUPATION 64C51C ,1—" -A EMPLOYER PHONE NUMBER: HOME 3f C?'-,3345- ?6SI BUSINESS ,,7/5 ?-2( 7-(;Z3-3 EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ""'..,� �� /� f �•C ®.l ^ � .L �i�s(✓% � �/!rz/i/��`I /'�iP /�..% ,�ilc'J f�1Q /AV T�/ 14:-. f G'%i- / 7-1ie' -s 4. aAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? eZo6,0 WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING_ )? LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest /VaN06 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 QNo (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. General Application October 2012 Page 2 of 7 I r i ®4 BOARD, COMMISSION AND COMMITTEES ""01'� %`, BUSINESS LISTING .,,�,,,__ CITY OF IOWA CITY Name of City _ Board /Commission /Committee XIVW 7 ,7119W11J4 G 0,oVIW S.S%oN Date Name /`r���'Q .- letq W"4 ,e -S 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, 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.. NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. business. Applicant Signature /�/ Address -3 /%%���!1,5� �i,,�C�.� , O 1.U�9 617-,Y -Z"O et/ /1 2 Z 4- 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 October 2012 Page 3 of 7 M 07 -23 -13 9d NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HISTORIC PRESERVATION COMMISSION One Vacancy — Three Year Term March 29, 2013 - March 29, 2016 (1) Jefferson St Representative Duties of the Historic Preservation Commission include: conducting studies for the identification and designation of Historic Districts; reviewing and acting upon all applications for Certificate of Appropriateness; cooperating with property owners and city agencies regarding remedy of dangerous conditions; furthering the efforts of historic preservation in the City by making recommendations on preservation issues, when appropriate, by encouraging the historical, architectural or cultural value, and by encouraging persons and organizations to become involved in preservation activities. This Commission meets the second Thursday of each month at 5:30 p.m and, if necessary, the fourth Thursday of each month at 5:30 p.m. Iowa City appointed members of the boards and commissions must be eligible electors of the City of Iowa City. Applications must be received by 5:00 p.m., Wednesday, July 17, 2013. 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 Historic Preservation Commission should be directed to Bob Miklo, Sr Planner at 356 -5240. 6/5/2013 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: 6 Females: 5 Council Announcement Date: February 5, 2013; March 19, 2013; April 23, 2013; June 4, 2013 Application Deadline: Wednesday, 5:00 p.m., July 17, 2013; Council Appointment Date: July 23, 2013 After 05/06/2013 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. HISTORIC PRESERVATION COMMISSION One Vacancy - Three Year Term March 29, 2013 — March 29, 2016 Gender Balance Requirement: 1 Female Jefferson St District Representative (New District) No applications as of Wednesday, 5:OOp.m., July 17, 2013 El Denotes applicant completed the Confidential page of the application. 9e NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: PARKS AND RECREATION COMMISSION One Vacancy — Unexpired Terms Effective Upon Appointment - January 1, 2017 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. Applications must be received by 5:00 p.m., Wednesday, July 17, 2013. 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 Parks and Recreation Commission should be directed to Mike Moran, Parks & Recreation Director at 356 -5110. PARKS AND RECREATION COMMISSION April 10, 2013 Page 6 of 6 PARKS AND RECREATION COMMISSION ATTENDANCE RECORD NAME N N N N N N C4 C4 M M °f co O C �' M M O TERM r ° ^ `0 as N r � V. T- EXPIRES David 1/1/15 X X X LQ X LQ X X O/E O/E X X Bourgeois Clay 1/1/14 X X X LQ X LQ X X X X X X Claussen Maggie 1/1/13 X X O/E LQ X LQ X X X X X O/E Elliott Allison 1/1/14 X X X LQ X LQ X X X X X X Gnade Cara 1/1/16 X X X LQ X LQ X X X X X X Hamann Aaron 1/1/13 O O ** X LQ X LQ O O Krohmer Lucie 1/1/15 X X O/E LQ X LQ X X O/E O/E O/E O/E Laurian Alex 1/1/16 * * * * * * X X X X Taylor John 1/1/14 O/E X X LQ X LQ X X X X X X Westefeld Joe 1/1/16 O/E X X LQ X LQ X X X X X X Younker KEY: X = Present O = Absent O/E = Absent/Excused NM = No meeting LQ = No meeting due to lack of quorum * = Not a member at this time Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards J 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: 4 Council Announcement Date: June 4, 2013 Application Deadline: Wednesday, 5:00 p.m., July 17, 2013 Council Appointment Date: July 23, 2013 After 09/02/2013 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. PARKS AND RECREATION COMMISSION One Vacancy - Unexpired Term Effective Upon Appointment — January 1, 2017 Alex Taylor resigned Gender Balance Requirement: None (F) Suzanne Bentler rx-1 520 S Governor St [R] Denotes applicant completed the Confidential page of the application. City of Iowa City I r I Advisory Board /Commission /Committee g -I� , Form �pplication 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. UAey yj Fe Advisory Board /Commission /Committee Name Parks and Recreation Term -te f NAME Suzanne Bentler HOME ADDRESS 520 S Governor St 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? approx. 20 years Gender: Male 11 FemaleQ OCCUPATION Research Specialist EMPLOYER University of Iowa PHONE NUMBER: HOME 319.321.5157 BUSINESS 319.384.4414 EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I am an avid user of many of the city parks including City Park, Hickory Hill, Terry Trueblood (from the time when it was just Sand Lake!), both dog parks, and College Green. I am also a regular at the Farmers' Market and miss it in the off - season. I have experience hiking, biking, kayaking, gardening, composting, wildlife habitat restoration, and being a cheerleader for all things Iowa City. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? III have_sQme� limited-- kl to ledge of the vror k of thlJ. ad'v 1;soi y` board' but a1 very in to re�ted'iti-icari �i City's parks, recreational activities, and farmers' market. THIS ADVISORY BOARD bout its C= -1C, Z FORYI )? I want to be sure that Iowa City continues to be a leader with regard to providing excellent parks arWrecreational activities. I want to work with the other board members to further encourage sustainable practices and promote recyclying /reuse opportunities within parks & rec. I am a hard worker, I work well with others, I'm an unabashed fan of Iowa City, and I am enthusiastic about maintaining and improving our parks and recreational opportunities. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest None IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 0 Yes r_J No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? F Yes 7No (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. General Application October 2012 Page 2 of 7 � r j BOARD, COMMISSION AND COMMITTEES► t BUSINESS LISTING CITY OF IOWA CITY Name of City Board /Commission /Committee Parks and Recreation Date 07/17/2013 Name Suzanne Bentler 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, 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 Tinman, LLC 520 S Governor St, Iowa City, IA 52240 SOS436, LLC 520 S Governor St, Iowa City, IA 52240 [CDC, LP 520 S Governor St, Iowa City, IA 52240 c� —4 r .� ;<rn -v � o NOTE: A new form gust be compli acquired in an addy Tonal business. Applicant Signature Address 520 S Governor above information changes or an ownership interest is 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 October 2012 Page 3 of 7 L 9f Z 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, 2013 — September 1, 2016 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 26, 2013. 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. ooxr(D m II II II II Z>> o��� � :3 M x 070 CD CD C. >N n a D = n D n� N 0 c G) 3 'Do 0 m r3 z 0 0 _ Z o Z cn z r- n n cn n r 3 Z v m = z m r M m m r r m N 0 N 0 N 0 N 0 N 0 N 0 N 0 N 0 N 0 N 0 m cn cn p w cn w w -p Ul x T X X X X X 0 m 0 m o m X et m X X X m X X X X y m x m X X m X X X o CD X m X X X x x X X co o X X X m x m X X x co m X x X X m x x x m X X X m m X X X W X X X m X X X X X X X X X X x x x X x X m X X X X m y x x X X m m X x X rn o a m z o � N Z N n o m w m 0 0 v c 0 Z mmc ci) 00 N Z 0 00 0 Z wo 0 0 c _z 0 m r- 0 m z -I 0 O cn cn 0 z 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: 2 Females: 4 Council Announcement Date: May 14, 2013 Application Deadline: Wednesday, 5:00 p.m., June 26, 2013 Council Appointment Date: July 23, 2013 After 08/12/2013 (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, 2013 — September 1, 2016 Term expires for Scott Dragoo, Holly Jane Hart, Charles Drum Gender Balance Requirement: 2 Males, 1 None (M) Peter Matthes 0 1077 Tamarack Trail (F) Laurie Finn El 3334 Hanover Ct (F) Susan Murty M 1907 F St (M) David Hacker 0 55 Denbigh Dr (F) Dorothy Persson El 14 Gallup Place (M) Charles Drum 0 (Currently serving 2nd three -year term) 1136 Franklin El Denotes applicant completed the Confidential page of the application. City of Iowa City r _4 Advisory oard /Commission /Committee zi , "not � ry 't ! plication 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 9/1/13 - 9/1/16 NAME Peter Matthes HOME ADDRESS 1077 Tamarack Trail Is your home address (listed above) within the corporate limits of Iowa City? R] Yes 0 No How long have you been a resident of Iowa City? 16 years total Gender: Male ✓1 Female❑ OCCUPATION Director of Federal Relations PHONE NUMBER: HOME 383.8978 EMPLOYER U of I BUSINESS 335.3714 EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: was the lead staffer on the Health and Human Services Approprations Subcommittee anu numan rxoauu1%lua standing Committee for 8 years while working in the Iowa Senate. VHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY t3UAMLJ feel as though I am knowledgeable about the intent and scope of the board. VHAT CONTRIBUTIONS CAN YOU MAKE TO THIS j Till bring a state and federal perspective to the board. POTENTIAL CONFLICTS OF INTEREST: See 1 BOARD IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Dyes R]No (It has been Council policy not to permit an individual to serve on two Boards or Commissio n at the e 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 Page 2 of 8 March 2013 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commissi on /Committee Housing and Community Development Name Peter Matthes 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). 1 � � A �oOlq �l CITY OF IOWA CITY Date 04/29/2013 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. BUS NESS NAME B SINESS ADDRESS NOTE: A new form must be completed if the above information changes or an ownership interest is acquj, ed in an additional business. Signature Address lr --) s^ j 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 Page 3 of 8 March 2013 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 Household 30% Median Income Size (Poverty Level) 50% Median Income 60% Median Income 80% Median Income Ilow income) Median Income $16,050 18,350 20,650 22,900 24,750 26,600 28,400 30,250 $26,750 30,550 34,350 38,150 41,250 44,300 47,350 50,400 $32,100 36,660 41,220 45,780 49,500 53,160 56,820 60,480 $42,750 48,850 54,950 61,050 65,950 70,850 75,750 80,600 $53,500 61,100 68,700 76,300 82,500 88,600 94,700 100,800 1 2 3 4 5 6 7 g ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION R ORDER TO TIIVE OF HE COMMUNITY AND HOUSING HE GROUP(S) WH CHI IT SERVES, PLEASE INDICATE IIF YOU REPRESENT 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. HCDC Application March 2013 page 4 of 8 City of Iowa City —J- Advisory r 1 Board /Commission /Committee� *6 COT `r )plication Form -n-�- 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 & Community Development Term through 2015 NAME Laurie A. Finn HOME ADDRESS 3334 Hanover Court, IC, 52245 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? nearly 24 yrs Gender: Male ❑ Female OCCUPATION editorial manager EMPLOYER ACT, Inc. PHONE NUMBER: HOME 319- 321 -5345 (cell) BUSINESS 319- 341 -2847 EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I believe the combination of my experience in this community and my academic background qualifies me for the commission. I have been active in the community over the years, including being involved with school and extracurricular activities when my now -adult daughters were younger, volunteering as an advocate with the Rape Victim Advocacy Program, and actively participating in community outreach /social justice efforts of two area faith cnmmunities. I also hold a bachelor's degree in business economics, with an emphasis in public sector economics, 1 a master's degree in servant leadership. The master's program taught me to focus on helping,ojhers reach their potential and discover their own gifts, and on building community within and among diverse groups- df people. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? My knowledge of the board is based on my review of meeting minutes and agendas. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYING)? I am applying because I want to help ensure that Iowa City continues to foster positive quality of life for all residents even as the community grows. By asking questions and gathering information from people living in this community, I believe I can contribute to ensuring that housing and community development decisions address /consider the needs of all Iowa Citians. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest none 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 to answer all the questions, Council may not consider your application. HCDC Application October 2012 Page 2 of 8 I. t 1 =z6a.& t� BOARD, COMMISSION, & COMMITTEES — •�.,s__ BUSINESS LISTING CITY OF IOWA CITY Name of City Board /Commission /Committee Housing & Community Development Date 04/03/2013 Name Laurie A. Finn 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 none NOTE Signature A new form must be completed if the above information changes or an ownership interest is acquired in an additional business - %/I Address 3334 Hanover Court, Iowa City, Iowa 52245 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 October 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 1 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) F-1 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. HCDC Application October 2012 page 4 of 8 City of Iowa City W U 4—m Advisory Board/Commission/Committee S�� - �� 50 W Aeplication Form CITY 1 F OVVA CITY THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, VA TH THE EXCEPTION OF THE LAST PAGE MARKED "WNFIDENTIAL.;" THiS APiPLICATTION'\VVII-L BE CONSIDERED ,FQRTHREr= MONTHS ONILYANDA, t=1 AT1,CAUYCOt4SlDJ=-REDFORANI YVACAt4CYiDUPJNGTHATTI:MF-. Advisory Board/Commission/Committee Name Housing and Community Development Corn Term 9/1/13 NAME Susan A. Murty HOME A, DDR ESS 1907 F Street Is your home address (listed above) within the corporate limits of Iowa City? 7 Yes F-1 No How hong fieveymu been a.iresident of Iowa Cfty? 19 years Gejwer, Malle ❑ FernmeWl OCCUPATION Professor (retired as of June 2013) EMPLOYER Univ. of Iowa PHONE NUMBER., HOME 319-338-7814 BUSINESS 319-335-3628 EXPERIENCE ANDIOR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION., My experience as a social worker and professor of social work have given me opportun'ities to learn about housing and community development programs and to understand the importance of housing in communities. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Very little L WHAT PST 110110 CM YOU MME TO TM AVVIISORY BO MW 0aEASON FOR AWKYING)? I would like to contribute to commurifty deve.lopment in Iowa City and to making affordable housing accessible to residents of the city. I I[-J, 6;;*) f� P F i F-1 W�C-L19 9 1rq f -IKJ ;: 1, 1 :�ct ':*�J' JF'YOUARE NOT SELECTED, DO YOU W, ANTTO ENO FIE Y No B -n oo F7 es R DO YOU CURRENTLY SERVE ON ANOTHER, IOWA CITY BOARD OR COMMISSION? ❑-Yes FV]Rio (11 ,has been Coun-dil pofir, yn not -to pwmd an, 7individu M to sew ant two Boandsar Camm*Is:ions at the awn a # m,, e.) MWqxesentabons on Wo aoicallion Will consfflute just cawse for removal of an appointee, Ifyou fa answ all ftquestions Cound may notconsideryour appricarm, Hi Cole Apprication, October 2012 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commission /Committee city of Iowa city Name Susan A. Murry CITY OF IOWA CITY Date 04/03/2013 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. NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature Address 1907 F Street, Iowa City, IA 52240 Misrepresentations on this application will constitute just cause for removal of an appointee. I you fail to answer gall the questions, Council may not consider your application, HCDC Application October 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 79J00 99,600 8 31,850 1 53,000 1 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) a 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. HUDC Application October 2012 page 4 of 8 City of Iowa City .61viso . ry Board /Commission /Committee Application 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 & Community Development Term 10/ 2013 -16 NAME David Hacker HOME ADDRESS 55 Denbigh Drive Is your home address (listed above) within the corporate limits of Iowa City? 0 Yes r_J No How long have you been a resident of Iowa City? 40+ Years Gender: Male ✓1 Female ❑ OCCUPATION retired attorney (of counsel status) EMPLOYER Simmons Perrine Moyer Bergman PLC PHONE NUMBER: HOME 319 337 -4602 BUSINESS EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: F ong term residency as a renter and then as a homeowner in various neighborhoods in Iowa City, with three ildren (two home owners, one renter) living in Iowa City. years as an attorney representing diverse clients (from litigation for major corporations to litgation, and problem ng for Voluntary Lawyer Project clients)- I was selected State Bar Association Pro Bono attorney of the year in ing the parent of a disabled adult son who lives independently in Iowa City on a limifed mcorge. T IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? can be gathered from published matterial on the Iowa City webcite WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISUKY tsvAKU Imcm2wil .- ..--- I believe that I have the following useful skills and /or attributes - analytical and practical skills developed as a teacher and attorney - perspective developed representing clients ranging from large corporations to individuals with no resourses - empathy developed working with (and for) individuals in need of help OF Of My son presently recieves housing support. The law firm (Simmons Perrine Moyer Bergman PLC, where I remain of counsel, but for whom I am not required to do any work) may represent or oppose the City or ineterested parties. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 0 Yes No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes ✓F --4. +„ nermi+ n inrliviA, gal to serve on two Boards or Commissions at the same time.) Ahas peen Count-Al P01­y ..Vl <- r......., �....._.- - -- - - 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. Hr r)C Application C Page 2 of 8 I per 2012 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commissi on /Committee Housing & Community Development Name David Hacker CITY OF IOWA CITY o-4/i a /2,013 Date n„ 48 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 NONE NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature Address 55 Denbigh Drive 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. H. 0 Application October 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 211700 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 ....E -• �.: 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 ttiisform. 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. I have considerable experience in drafting and litigation contracts, some were related to real estate, most were not. I was occasionally involved in litigating construction issues, but that is not a specialty area. 1 was sometimes involved in contract negotiations and litigations concerning finance. Most of these cases involved corporate finance (venture capital) or cleaning up after failed or disputed transactions. I was fairly frequently involved in litigation that involved the determination of damages in commercial cases (such as distributor /franchise termination damages, patent or copyright infringement damages). This required some skill in dealing with both accounting data and the various tools for analysis and projection employed by experts. HCDC Application O ^sober 2012 page 4 of 8 City of Iowa City r Advisory Board/Commission/Committee�~�;'� Pnplication 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 911/13 - 9/1/16 NAME Dorothy M. Persson HOME ADDRESS 14 Gallup Place, Iowa City, IA 52246 Is your home address (listed above) within the corporate limits of Iowa City? 0 Yes ❑ No How long have you been a resident of Iowa City? 41 years Gender: Male ❑ Female❑✓ OCCUPATION academic librarian EMPLOYER UI Libraries PHONE NUMBER: HOME 319- 337 -3347 BUSINESS 319- 335 -5232 EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ubject expertise as an academic librarian. Community activities using subject expertise. Please see my attached irriculum vitae WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Only what I read online and in the newspaper. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYING)? Given my experience with Big Brothers Big Sisters, Shelter House, and my subject expertise, I think that I bring some understanding of issues facing lower income individuals and families. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for infonnation regarding Conflict of interest I currently serve on the Lodge Advisory Committee for Shelter House. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Q Yes ❑ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ❑Yes WINO (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 March 2013 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commissi on /Committee Housing and Community Development Name Dorothy M. Persson t L Al CITY OF IOWA CITY Date 06/10/2013 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 None NOTE: A new form must be completed if the above information changes or an ownership interest is anuired in an additional businessun Address 14 Gallup Place, 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. HCDC Application March 2013 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,050 $26,750 $32,100 $42,750 $53,500 2 18,350 30,550 36,660 48,850 61,100 3 20,650 34,350 41,220 54,950 68,700 4 22,900 38,150 45,780 61,050 76,300 5 24,750 41,250 49,500 65,950 82,500 6 26,600 44,300 53,160 70,850 88,600 7 28,400 47,350 56,820 75,750 94,700 8 30,250 50,400 60,480 80,600 100,800 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) F-1 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. HCDC Application March 2013 page 4 of 8 Dorothy Marie Persson Librarian Education/Psychology Librarian 14 Gallup Place EPLS -COE Iowa City, Iowa 52246 (319) 335 -5232 (319) 337 -3347 EDUCATION 1987 -1988 Administrative Intern, Dean's Office, College of Business Administration, The University of Iowa. Quarter -time appointment. 1985 Ph.D., Higher Education, College of Education, The University of Iowa. Dissertation title: Nonacademic Staff Participation in University Governance: A Faculty Perspective. 1972 MLS, Library Science, Indiana University, Bloomington, Indiana 1971 BA, Political Science and Economics, Ohio University, Athens, Ohio HONORS Graduated summa cum laude from the Honors College, Ohio University. Elected to Phi Beta Kappa, Beta Phi Mu, Phi Kappa Phi, and Pi Gamma Mu. Received the University of Iowa Staff Achievement Award for Meritorious Contribution to the University and the Community, June, 1989. EMPLOYMENT 2010- present Psychology/Education Liaison, The University of Iowa Libraries 1992 - present Adjunct Assistant Professor, Educational Policy and Leadership Studies Department, College of Education 2001 -2004 Mentor and supervisor of Mathematical Sciences and Physics Interim Librarian 1989 -1999 Head Librarian, Physics Library, The University of Iowa and Collection Development Specialist for physics and astronomy 1 materials. 1981 -2009 Head Librarian, Psychology Library, The University of Iowa and Collection Development Specialist for education and psychology materials. Promoted to Librarian IV on July 1, 1985. 1994 -1995 Acting Science Division Coordinator, The University of Iowa. 1979 -1981 Librarian III, Acting Head Librarian, Education - Psychology Library, The University of Iowa. 1973 -1979 Reference Librarian, Education - Psychology Library, The University of Iowa. Promoted during this period from Librarian I to Librarian II and from Librarian II to Librarian III. 1972 -1973 Librarian I, General Reference Librarian, Reference Department, The University of Iowa. 1971 -1972 Graduate Assistant, School of Library Science, Indiana University. Graded papers, proofread manuscripts, and helped with the Research of Dr. Charles Busha. PROFESSIONAL American Library Association MEMBERSHIPS & Association of College and Research Libraries ACTIVITIES Education and Behavioral Sciences Section. Psychology/Psychiatry Committee Member, 1984 -1988 Chair, 1986 -1988 1998 Program Planning Committee Chair Membership and Orientation Committee Member, 2008 -2012 - - University Libraries Section Policy and Planning Committee Member, 2004 -2005 Library Administration and Management Association : LAMA Membership Committee - Member, 1986 -1990 LAMA Budget and Finance Committee Member, 1996 -2000 LAMA National Institute Planning Committee Member, 1999 -2003 LAMA Endowment Task Force Member, 1999 -2003 LAMA Awards Committee W Library of the Future Award Committee, Member, 2000 -2001 LAMA Program Committee Member, 2004 -2008 LAMA MASS Using Measurement Data for Library Planning Assessment Committee, Member, 2007 -2009 LAMA/Library Organization and Management Section Executive Board, Member, 1992 -1997 Risk Management and Insurance Committee Member, 1986 -1990 Member & Chair, 1991 -1993 Member, 1993 -1994. LOMS Chair- Elect, Chair and Past Chair, 1994 -1997 LOMS 1998 Nominating Committee Member, 1997 -1998 ALA Constitution and Bylaws Committee Member, 2004 -2005 ALA Lippincott Award Jury, Member, 2011 -2012 Iowa Library Association ILA/ACRL Membership Committee, 1984 ILA/ACRL Chapter Secretary/Treasurer, 1985 ILA/ACRL Chapter Vice President/President Elect, 1986 ILA/ACRL Chapter President, 1987 ILA/ACRL Ex Officio Member, Executive Board and Chair, Scholarship Committee, 1988 ILA Conference Planning Committee, Coordinator, 1988 -1989 ILA Executive Board Member, 1990 -1992 ILA Vice President/President Elect, 1992 ILA President, 1993 ILA Past President, 1994 ILA Governmental Affairs Committee, member, 1995 -1998 ILA's Chapter Councilor, American Library Association, 1999 -2002 ILA Bylaws & Organization Manual Committee, 1999 - 2007, Chair, 2007 ILA Leadership Institute Committee, Member, 2007 -2009. -- Institute of Physics Library Advisory Council Member, 1997 -1998 Phi Beta Kappa Member, Alpha of Iowa Chapter, 1972- < Eligibility Committee Member and helper with initiations, 1972- 1978 Secretary- Treasurer, Alpha of Iowa Chapter, 1976 -1978 American Association of University Women Life Member, 2000 3 Member, Iowa City Chapter, 1986 -2001 Vice President/President Elect, 1986 -1987 President, 1987 -1989 Member, Iowa Division Membership Committee, 1988 -1990 American Psychological Association, Library Advisory Council Member, 2004- present Member, APA Excellence in Librarianship Award Committee, 2011 -2012 ACADEMIC University Library SERVICE Numerous committees as assigned or volunteered including but not limited to the User Needs Assessment Committee, various search committees, Collection Management Committee, Personnel and Diversity Advisory Committee, Preservation Advisory Committee, User Services Department Heads Committee, staff representative to ExCo, Organizational Review Committee and Travel Committee University Staff Council At4arge representative, Professional & Scientific Staid 1981- 1984 Vice President, 1983 -1984 Member, Executive Committee, 1982 -1984 Chairperson, Committee on Committees, 1981 -1984 Chairperson, P & S Policies Committee, 1982 -1983 Member, P & S Policies Committee, 1983 -1984 Member, Elections Committee, 1982 -1983 Associated Professional and Faculty Women Secretary- Treasurer, 1982 -1983 Chair, 1983 -1984 Ex Officio Member, Executive Board, 1984 -1985 Member, Executive Board, Fall, 1986 Council on the Status of Women Member, Wages and Salaries Subcommittee, 1983 -1985 Member of the Council, 1984 -1989 Member, Sexual Harrassment Subcommittee, 1986 -1989 Member, Affirmative Action Subcommittee, 1986 -1993 Co- chair, Affirmative Action Subcommittee, 1986 -1987 Member, Unwanted Sexual Behaviors Survey Subcommittee, 2004 -2007 ; Funded Retirement and Insurance Committee z Member, 1984 -1990 and 2001 -2008 : Member, 1984 -1990 of Disability Insurance, - - Education /Communication, Archives, and Retirem_ ent' Subcommittees Chair, Archives Subcommittee, 1986 -1987 4 Secretary, 1986 -1987 Human Rights Committee Member, 1990 -1993 Chair, 1992 -1993 Office of Equal Opportunity and Diversity Member, Climate Survey Committee, 2004 - present Women in Science and Engineering Board Member, 2004 -2008 OTHER SPECIAL Member, Staff Interview Group to fill position of ACADEMIC Vice President for Finance and University Services, 1987 SERVICE Representative of Council on the Status of Women to the Open Interview Sessions for the position of Assistant Vice President for Finance and University Services, 1987 Member, Multiconstituent Search Committee for the University Librarian, 1985 -1986 Member & Chair, Women's Interview Group to fill position of Director of Affirmative Action, 1985 Member, University Staff Award Committee, 1984 -1987 Member, Advisory Committee for Professional and Scientific Staff Comparable Worth (in conjunction with S.F. 2539), 1984- 1986 Member, Multi- Constituent Search Committee to screen candidates for the position of Vice President for Finance and University Services, 1983 Member, Staff Interview Committee to fill position of Vice President for Academic Affairs, 1982 Member & Treasurer, Student Advisory Committee, College of Education, 1981 -1982 Community Member, Resources Conservation Commission, City of Iowa City, Service 1987 -1988 Member and Secretary, Executive Board, Memorial Society of the Iowa River Valley, 1989 -1990 Member, Housing Commission, City of Iowa City, 1990 -1991 ELCA Lutheran Campus Ministry Board. Appointed by the Southeast Iowa Synod Bishop = =' Member, 1993 -1999 i- Secretary, 1994 -1996 President, 1996 -1999 - Emma Goldman Clinic Member, Public Issues Committee, 1995- 1996 Vice President of the Board, 1996 President of the Board, 1997 Big Brothers, Big Sisters of Johnson County Couples match with spouse, 1994 -2004 Johnson County Juvenile Court, Circle Program Match with a young woman in mentee- mentor relationship, 1999- 2000 Shelter House Board, Iowa City, 2001 -2011 Member, 2001 -2011 President of Board, 2002 -2010 Shelter House Lodge Committee, 2011 -2012 Zion Lutheran Church Sunday School teacher, 2000 -2002 Member, Board of Education, 2002 -2004 Member, Altar Guild, 2000 -2004 DISSERTATION Nonacademic Staff Participation in University Governance: A Faculty Perspective. University of Iowa, Ph.D., 1985. PUBLICATIONS Psychology/Psychiatry Committee (Dorothy Persson, chair). "Psychology and Psychiatry Serials: A Bibliographic Aid for Collection Development," Behavioral and Social Sciences Librarian, 9 (2), 1990. Henkin, Alan B. and Persson, Dorothy. "Faculty as Gatekeepers: Non - academic Staff Participation in University Governance," Journal of Educational Administration, 30 (2), 1992, 52 -64. Clougherty, Leo; Forys, John; Lyles, Toby; Persson, Dorothy; Walters, Christine; and Washington - Hoagland, Carlette, "The University of Iowa Libraries' Undergraduate User Needs Assessment," College and Research Libraries 59 (6), 1998, 572 -584. Barton, Hope; Cheng, Jim, Clougherty, Leo; Forys, John; Persson, Dorothy; Walters, Christine; and Washington - Hoagland, Carlette, "Identifying the Resource and Service Needs of Graduate and Professional Students," portal: Libraries and the Academy 2 (1), 2002, 125 -143. Barton, Hope; Cheng, Jim; Clougherty, Leo; Forys, John; Hammond, Ellen; Persson, Dorothy, Walters, Christine; and Washington - Hoagland, Carlette, "Faculty and Staff Use of Academic Library Resources and Services: A University of Iowa Libraries' Perspective," portal: Libraries and the Academy 2 (4), 2002, 627 -646. Persson, Dorothy and Washington - Hoagland, Carlette, "PsycINFO Tutorial: A Viable Instructional Alternative," Reference & user 31 Services Quarterly 44 (1), 2004, 67 -77. Clark, L. A., Hauserman, N., Persson, D., & Washington - Hoagland, C. (2006). Sexual harassment and umvelcomed behavior at the University of Iowa: Results of a campus wide survey. Iowa City, IA: Council on the Status of Women. Retrieved October 18, 2006 from The University of Iowa Office of the President's Web site: httv://www.uiowa.edu/president/task- forces/sexual harass survey /index.html Buckley, S. C., Fick, N., Geist, L., Holland, J., Johnson, S., Joyce, C., Kenner, P., LeBlond, R, Leventry, D., Mills, M., Modestou, J. Moore, J., Persson, D., Reed, L., Schnoebelen, H., Warren, J., Washington - Hoagland, C., & Zimmerman, B. (2006). Working at IOWA survey results, September, 2006 Retrieved September 27, 2006 from The University of Iowa, Human Resources Web site: http://www.uiowa.edu/hr/workingisurvgy report.pdf Modestou, J., Paetzold, R., Persson, D., Robinson, J., Simpson- Taylor, D., Washington - Hoagland, C. (2007). The University of Iowa's diversity climate: Results of the Spring 2005 undergraduate student survey. Iowa City, IA: Office of Equal Opportunity and Diversity. Retrieved May 30, 2007 from The University of Iowa, Office of Equal Opportunity and Diversity Web site: htta:/ /www.uiowa.edu /--eod/diversity climate survevs/PDF/Full %20Reaort %20(with %20apuendices).udf Modestou, J., Paetzold, R., Persson, D., Robinson, J. Simpson- Taylor, D., Washington - Hoagland, C. (2007). The University of Iowa's diversity climate: Results of the Spring 2005 graduate /professional student survey. Iowa City, IA Office of Equal Opportunity and Diversity. Retrieved December 10, 2007 from The University of Iowa, Office of Equal Opportunity and Diversity Web site: httD://www.uiowa.edu/—eod/diversity climate survevs/PDF /Grad ProPFull%20 Report%20(with 0/o20 app endices). p df Cully, Myntha, and Persson, Dorothy. (2012). Instructional design in library settings: designing effective and efficient training prokrams. In C. Zsuyla, A. Stewart, & C. Washington - Hoagland {Eds.), S(aff , development: a practical guide (4" ed.). Chicago, IL:--Anerican Library Association. - 7 PAPERS/ PRESENTATIONS Participation in University Governance: Faculty Designation of Roles for Nonacademic Employees, Eastern Educational Research Association Conference, February 25 -26, 1988, Miami Beach, Florida "The Library of the Future: Customer Based Diversification", ILA/ACRL Spring Conference, May 7, 1999, University of Northern Iowa, Cedar Falls, Iowa, Leo Clougherty and Dorothy Persson for the User Needs Assessment Group. "User Needs Assessment Implications for User Education and Outreach", Powerful Learning, Powerful Partnerships Symposium, November 11 -12, 1999, University of Iowa, for The User Needs Assessment Group. Clougherty, Leo; Forys, John; Lyles, Toby, Persson, Dorothy; Walters, Christine; and Washington - Hoagland, Carlette. "University of Iowa Libraries' Undergraduate User Needs Assessment Study." Iowa City, IA: University of Iowa, User Needs Assessment Group, 1998. Unpublished manuscript. Report presented to the University Librarian. Barton, Hope; Cheng, Tim; Clougherty, Leo; Forys, John; Lyles, Toby; Persson Dorothy; Walters, Christine; and Washington - Hoagland, Carlette. "University of Iowa Libraries' Graduate and Professional Student Study." Iowa City, IA: University of Iowa, User Needs Assessment Group, 1999. Unpublished manuscript. Report presented to the University Librarian. "University of Iowa Libraries' User Needs Assessment Project, Phase I The Undergraduate Assessment, Fall, 1998 to library staff, Leo Clougherty, Dorothy Persson, and Carlette Washington - Hoagland for the User Needs Assessment Group. "Basing the Future on Our Users: Final Results of the UI Libraries' User Needs Assessment Project, ILA/ACRL Spring Conference, May 19, 2001, Leo Clougherty and Dorothy Persson for the User Needs Assessment Group. "Classroom Shock: Librarians, Graduate Students and Infofm'ation.. Literacy," ILA/ACRL Spring Conference, May 19; 2001, Saint Ambrose University, Davenport, Iowa, Rebecca. L; Johnson; Mary McInroy, and Dorothy Persson. "The University of Iowa Libraries User Needs Assessment Wbject= 8 Phase III: The Faculty and Staff Analysis," poster session at the American Library Association Annual Conference, June 17, 2001,San Francisco, Dorothy Persson and Carlette Washington - Hoagland for the User Needs Assessment Group. "The University of Iowa and Kirkwood Community College PsycINFO Tutorial Project: A Library Instruction Partnership," ILA/ACRL Spring Conference, May 2, 2003, University of Dubuque, Dubuque, Iowa, Dorothy M. Persson and Carlette Washington- Hoagland. "Sharing Our Worth: Reaping the Benefits," ILA/ACRL Spring Conference, March 23, 2007, Grinnell College, Grinnell, Iowa, Dorothy M. Persson and Carlette Washington - Hoagland. TEACHING 21:232 The College and University Library, Spring, 1989, School EXPERIENCE of Library and Information Science, The University of Iowa. 7B:202 Information Resources, Spring, 2000 to present College of Education, The University of Iowa (graduate course). DISSERTATION Davis, Nedra Jeannine. A study of the impact of a science COMMITTEES symposium designed to influence middle school females toward further study in science. University of Iowa, Ph.D., 2001. Member of committee. Hardy, Linda Joyce. An investigation of the relation between middle school students' self report of being victimized and being a victimizer at school. University of Iowa, Ph.D., 2002. Member of committee. Marlborough, Ken. Development and validation of an instrument to assess student satisfaction with community college internships. University of Iowa, Ph.D., 1999. Member of committee. Ryan, Marianne. Raising the stakes: support for the establishment of a National Library of Education. University of Iowa, Ph.D., 2003. Member of committee. Defense September 5, 2003. Drozdz, James M. Managing risk in campus law enforcement and security departments: an analysis of the caselaw. University--of Iowa, Ph.D. Member of committee. Defense May 17 2004 Mishak, Debra A. An investigation of early career and- veterpi -; Iowa elementary school counselors and their classroom=guidance - 9 programs. University of Iowa, Ph.D. Member of committee. Defense May, 2007. Vivian, Anna M. Counselor meaning - making: Working with childhood sexual abuse survivors. University of Iowa, Ph.D. Member of committee. Defense April 20, 2011. Hevel, Michael S. "Betwixt brewings ": A history of college students and alcohol, 1820 -1933. University of Iowa Ph.D. Member of committee. Defense May 11, 2011. Lin, Yu -Hsin. Principal hiring practices: Stories the principals tell. University of Iowa Ph.D. Member of committee. Defense March 7, 2013. Stoner - Harris, Tiffany Danette. Counseling graduate students' multicultural preparation: a response to the dual diagnosis of childhood sexual abuse and substance abuse among African American women. University of Iowa Ph.D. Member of committee. Defense March 8, 2013. AWARDS Improving Our Workplace Award, April, 2006 for work on the sexual harassment survey. Reception held May 24, 2006, Atrium of the Medical Education and Biomedical Research Facility, The University of Iowa. Arthur Benton Excellence in Reference Services Professional Development Award, 2010. Reception held October 5, 2010, Main Library. A $1,000 professional development stipend for 2010/2011 accompanies the recognition. United Way of Johnson County, Woman of Conviction Award, 2011 for 10 years of service to Shelter House and leading the Board of Directors in building a new homeless shelter for Johnson County. Reception held June 22, 2011, Brown Deer Golf Course, Coralville, Iowa. 03/29/2013 10 City of Iowa City r j Advisory Board /Commission /Committee M'Eh 3"Mm 'application 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 2013 -2016 NAME Charles Drum HOME ADDRESS 1136 Franklin Is your home address (listed above) within the corporate limits of Iowa City? 0 Yes ❑ No How long have you been a resident of Iowa City? 43 years Gender: Male 0 Female ❑ OCCUPATION Retired EMPLOYER PHONE NUMBER: HOME 319 -594 -4589 BUSINESS EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Have been a Commission Member for three terms and would like to make it four. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FOR APPLYING)? would bring my extensive experience W t6 the several processes the board manages. +0 LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest No potential conflicts of interest are apparent to me. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? U 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 to answer all the questions, Council may not consider your application. .CDC Application March 2013 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commissi on /Committee Housing and Community Development Name Charles Drum I i =_.. ®4, "m Al CITY OF IOWA CITY Date 06/202013 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 None NOTE: A new form must be mpleted if the above information changes or an ownership interest is ailm ired in an-a0cf1tio6aI business. Signature. Address 11WFranklin Street Iowa City, Iowa 52240 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 March 2013 Rage 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,050 $26,750 $32,100 $42,750 $53,500 2 18,350 30,550 36,660 48,850 61,100 3 20,650 34,350 41,220 54,950 68,700 4 22,900 38,150 45,780 61,050 76,300 5 24,750 41,250 49,500 65,950 82,500 6 26,600 44,300 53,160 70,850 88,600 7 28,400 47,350 56,820 75,750 94,700 8 30,250 50,400 60,480 80,600 100,800 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: EJLower Income (see table) 71 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. '-ICDC Application Aarch 2013 page 4 of 8 NMI NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION One Vacancy — Unexpired Term Effective Upon Appointment - January 1, 2016 Duties of the Commission include: 1) 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; 2) making recommendations to the City Council for such further legislation concerning discrimination as it may deem necessary and desirable; 3) 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) and; 4) 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. Iowa City- appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Human Rights Commission meets the third Tuesday of each month at 6:00 p.m. in the Lobby Conference Room at City Hall, 410 E. Washington Street. Applications must be received by 5:00 p.m., Wednesday, June 26, 2013. 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 Human Rights Commission should be directed to Stefanie Bowers, Human Rights Coordinator at 356 -5022. Human Rights Commission ATTENDANCE RECORD YEAR 2012/2013 lMeetinu Date) NAME TERM EXP. 7/17/1 2 8/21/1 2 9/18/1 2 10/16/ 12 11/20/ 12 12/18/ 12 111511 3 1/28/1 3 2/19/1 3 3/19/ 13 4/16/1 3 5/21/1 3 6/18/1 3 Diane Finnerty 1/14/14 O/E X O/E O/E X X O/E X X X O/E X X Orville Townsend, Sr. 1/1/14 X X X X X X X X X x X X X Dan Tallon 1/1/14 - X X X O/E X X X X O/E X X X Kim Hanrahan 111115 X O/E X X X X X X X X WE X X Shams Ghoneim 111115 X X X O/E X X O/E O/E X X X O/E X Jessie Harper 111115 X X O/E X O/E X X X X X R R R Katie Anthony 1/1/16 - - - - = - X X X X X R R Joe D. Coulter 1/1/16 - - - - - - X X X X X X X Harry Olmstead 1/1/16 X X X X X X X X X X X X X Connie Goeb 1/1/13 X X X X X X - - - - - - - Howard Cowen 1/1/13 O/E X O/E X O/E O/E - - - - - - - David B. Brown 1/1/14 R R R R R R R R R R R R R Henri Harper 1/1/14 R R R R R R R R R R R R R KEY: X = Present O = Absent O/E = Absent/Excused NM = No meeting -- = No longer a member R = Resignation 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: 4 Council Announcement Date: May 14, 2013 Application Deadline: Wednesday, 5:00 p.m., June 26, 2013 Council Appointment Date: July 23, 2013 After 08/12/2013 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. HUMAN RIGHTS COMMISSION One Vacancy — Unexpired Term Effective Upon Appointment - January 1, 2016 Katie Anthony resigned Gender Balance Requirement: None (F) Ann Munzenmaier 0 2006 Hannah Jo Ct (F) Andrea Cohen I] 1327 Foster Rd (F) Rachel Graber 0 1408 Prairie du Chien Rd (F) Rachel Campbell I] 2036 Bever Ave SE ( *See letter regarding residency) (F) Heidi Galer D 1749 West Benton (F) Annika Bergstrom ED 172 Broadmoor Ln 0 Denotes applicant completed the Confidential page of the application. City of Iowa City i r ! Advisory Board /Commission /Committee pplication 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 Human Rights Commission Term through 1/1/16 NAME Ann Munzenmaier HOME ADDRESS 2006 Hannah Jo Ct. 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? 2 Years Gender: Male ❑ Female ❑✓ OCCUPATION Teaching Assistant EMPLOYER University of Iowa PHONE NUMBER: HOME 319 - 333 -0555 BUSINESS n/a EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I have taken graduate classes and been involved in multiple trainings related to multiculturalism, privilege, and oppression. Some examples of this include: Cultural Competency Training, National Coalition Building Institute: Leadership for Equity and Inclusion Workshop, Multiculturalism in Higher Education (graduate class), and Diversity Dialogue Circle Training. I serve as a facilitator for the Safe Zone Project at the University of Iowa, helping to educate faculty, staff, and students in regard to creating inclusive environments for people who identify as LGBT. I '`9ve also been selected to serve on the University -wide Diversity Committee (2013 -2014, tentative). Overall, I feel I lve a strong knowledge base related to human rights concerns, and I have a strong desire to serve my community. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I have an average knowledge of this advisory board; I have read the minutes from previous meetings, and I have an understanding of the type of complaints they may deal with and the kinds of events they may organize. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)? I have knowledge about privilege and oppression, and I have a desire to help eradicate discrimination (in all forms) in Iowa City. I am also a lesbian, and this helps me empathize and understand others who may face discrimination. Iowa City is a great place, and I want to help make it even better for every individual who resides he'r_e; LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict:ofInterest have no conflicts of interest 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 WJNo (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. Human Rights Commission Application March 2013 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commission /Committee Human Rights Commission Name Ann Munzenmaier —J- ®�7 N V :III `�� =Ila CITY OF IOWA CITY Date 06/10/2013 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 NONE NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature�� Address 2006 Hannah Jo Ct. Iowa City, IA 52240 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. Human Rights Commission Application March 2013 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,060 $26,750 $32,100 $42,750 $53,500 2 18,350 30,550 36,660 48,850 61,100 3 20,650 34,350 41,220 54,950 68,700 4 22,900 38,150 45,780 61,050 76,300 5 24,750 41,250 49,500 65,950 82,500 6 26,600 44,300 53,160 70,850 88,600 7 28,400 47,350 56,820 1 75,750 94,700 8 1 30,250 1 50,400 1 0,480 1 80,600 1 100,800 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments 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) naTInnie1 PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. 33 Age Female Gender 60 %median Income (see table) Lesbian Sexual Orientation F7Other (Please explain below) .,uman Rights Commission Application March 2013 page 4 of 8 Christian Religion None Disability White Race, color or ethnic group National origin City of Iowa City I r 1 � = fir Advisory Board /Commission /Committee A- "'+� )plication 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 Human Rights Term 2013 -2015 NAME Andrea Cohen HOME ADDRESS 1327 Foster Road, Iowa City 52245 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? 1 year Gender: Male ❑ Female ❑✓ OCCUPATION Teacher EMPLOYER n/a PHONE NUMBER: HOME 319 - 333 -9540 BUSINESS n/a EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I am a Civics (History and Social Studies as well) teacher with many years of experience teaching all grade levels. I covered topics such as government, law, the multicultural society, and human rights. In addition, I am the Regional Representative of Human Rights Educators (HRE) USA which seeks to promote human dignity, justice, and peace by cultivating an expansive, vibrant base of support for Human Rights Education (HRE) in the United States. I have taught human rights in schools (all levels) and to community groups, covering topics such as discrimination, �iudice, and how to report and resolve such issues on the individual and community level. I have also arheaded civic engagement projects, worked with immigrant women, and refugees /asylum seek6rs as they (integrate into a new culture and society. ......•r .w vwuM un Lr%^rf f%f• mrtA C% A r%11IC%f1MV E2f%A nMJ2 VVr7H1 io TUUM I-Mr-oC1141 nIVVVVLGVVG Vr I F-1 %a f11JV1%7V1\ I Ovflnv: I have followed the Board via the meeting minutes. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)? I am applying because I am passionate about Human Rights and believe respect, justice, and dignity begin with early exposure and education. While the Commission has a broader mandate, I beleive I can make valuable contributions in the area of education and civic engagement programs. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest None. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑✓ Yes ❑ 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 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. Human Rights Commission Application March 2013 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commission /Committee Human Rights Name Andrea Cohen � r CITY OF IOWA CITY Date 05/18/2013 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 None NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature Address 1327 Foster Road, Iowa City 52245 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. Human Rights Commission Application March 2013 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,060 $26,750 $32,100 $42,750 $53,500 2 18,350 30,550 36,660 48,850 61,100 3 20,650 34,350 41,220 54,950 68,700 4 22,900 38,150 45,780 61,050 76,300 5 24,750 41,250 49,500 65,950 82,500 6 26,600 44,300 53,160 70,850 88,600 7 1 28,400 1 47,350 56,820 75,750 94,700 8 1 30,250 1 50,400 60,480 1 80,600 100,800 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments 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) naTiniuei PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. 54 Age Female Gender n/a Income (see table) n/a Sexual Orientation F-1 Other (Please explain below) r,uman Rights Commission Application March 2013 page 4 of 8 n/a Religion In/a Disability White Race, color or ethnic group USA National origin City of Iowa City r 1 Advisory Board /Commission /Committee _application 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 Human Rights Commission Term ending 1/2015 NAME Rachel Graber HOME ADDRESS 1408 Prairie du Chien Rd. 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? 1 year (and 9 previously) Gender: Male ❑ Female ❑✓ OCCUPATION Graduate Student EMPLOYER University of Iowa School of Social Work PHONE NUMBER: HOME (319)541 -7243 BUSINESS EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: 7 -12th Grade School Counselor and Diversity Coordinator, Wapello Community School District, 2008 -2012 Member, University of Iowa School of Social Work Diversity Committee Co -chair of Foreign Affairs subcommittee of Johnson County Democratic Platform Committee Organizer, Brent Multi -faith Forum 4 Volunteer, Iowa City Hate Act Rapid Response Team Board Member, Iowa City Jewish Federation Jrganizer, Homeland Care Agency (Sponsor, Gay- Straight Alliance W14 AT IC vnt IQ aRFAFNT KNOWI_FDGF OF THIS ADVISORY BOARD? The Human Rights Commission educates the community about issues related to civil rights. Particularly, it disseminates information about the legal. repurcussions of discrimination and endeavors to ensure people's human rights are being respected. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYING)? I represent a younger demographic than is usually present on city commissions and will be able to provide a different perspective on issues related to Iowa City human rights. From my previous profession, I have experience resolving conflicts based on descrimination. As a budding social worker, I am deeply committed to promoting social justice. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest None 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 W]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. Human Rights Commission Application March 2013 Page 2 of '8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commission /Committee Human Rights Commission Name Rachel Graber � r CITY OF IOWA CITY Date 05/26/2013 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 North Liberty Acupuncture and Herbs 185 Hwy 965, St. 6, North Liberty NOTE: A new form must be completed if the above information changes or an ownership interest is acquiro in,an additional business. Signature Address 1408 Prairie du Chien Rd. Iowa City, IA 52245 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. Human Rights Commission Application March 2013 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,060 $26,750 $32,100 $42,750 $53,500 2 18,350 30,550 36,660 48,850 61,100 3 20,650 34,350 41,220 54,950 68,700 4 22,900 38,150 45,780 61,050 76,300 5 24,750 41,250 49,500 65,950 82,500 6 26,600 44,300 53,160 70,850 88,600 7 28,400 47,350 56,820 75,750 94,700 8 30,250 50,400 60,480 80,600 100,800 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments 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 PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. 29 Age Female Gender Student Income (see table) Hetero Sexual Orientation Other (Please explain below) Jewish Religion None Disability Caucasian Race, color or ethnic group USA National origin Human Rights Commission Application March 2013 page 4 of 8 City of Iowa City r 1 .- -- - Advisory Board /Commission /Committee ;4 ' Application Form --- CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLI 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 Iowa City Human Rights Commission Term Summer 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 Campbell HOME ADDRESS 2036 Bever Ave SE Cedar Rapids A 52403 Is your home address (listed above) within the corporate limits of Iowa City? ❑ Yes W✓ No How long have you been a resident of Iowa City? 8/2010 - 1/2013 Gender: Male ❑ Female IV OCCUPATION Daycare Cook /Teacher EMPLOYER All Aboard Daycare PHONE NUMBER: HOME (319)310 -8111 BUSINESS (31q)644 -21oo EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I C­ -+uated from the University of Iowa with a BA in Ethics and Public Policy, a Human Rights Certificate and a minor in „iology. I have taken many classes in regards to human rights issues and advocacy. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? The Commissions goal is to eradicate discrimination. Doing so by taking complaints from people who feel they have been discriminated against and then performing a thorough investigation. It plans programs and activities designed to eliminate discrimination. Make recommendations to the city council for legislation concerning dicrimination. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYING)? As I studied at the University I learned about advocating for human rights. One thing that is very important in order to educate the public about current issues or topics at hand. I would love to exercise what I 'have Igarned 'in school and help put a stop to discrimination. "A right delayed is a right denied" - Martin Luther King Jr--:, LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict:of Interest N/A IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ✓0 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.) isrepresentations 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. Human Rights Commission Application January 2012 Page 2 of 9 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board /Commission /Committee Iowa City Human Rights Commission Name Rachel M Campbell � r 1 T CITY OF IOWA CITY Date 05/28/2013 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 011811E Signature A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Address 2036 Bever Ave SE, Cedar Rapids IA isrepresentations 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. Human Rights Commission Application January 2012 Page 3 of 9 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 9, 2012 r ousehold 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 HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments 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) OPTIONAL- PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. 25 Age Female Gender Below PovertyLevel Income (see table) Straight Sexual Orientation F-1 Other (Please explain below) Human Rights Commission Application January 2012 page 4 of 9 Religion None Disability Caucasian Race, color or ethnic group [-:'National origin Rachel Campbell (319)310 -8111 campbelluiowa(k gmail.com To whom it may concern, I know to be a part of the Human Rights Commission of Iowa City you must reside in Iowa City. I moved to Cedar Rapids after I graduated from the University of Iowa in December of 2012. With applying to the Commission I fully intend on moving back to Iowa City and have already lined up housing in Iowa City. If you choose to let me join the cause to end discrimination in the Iowa City area I will be residing there. I just wanted to clarify this; in fear you would see my current address and that would deter the commission from my application. I look forward to hopefully being able to volunteer with the commission. Best regards, Rachel Campbell Rachel Campbell 2036 Bever Avenue Cedar Rapids, Iowa 52403 Cell: (319)310 -8111 Email: campbelluiowa @gmail.com - Education — 2012 University of Iowa Iowa City, IA, United States Bachelor of Arts Ethics and Public Policy Human Rights Certificate Minor Sociology 2010 2005 Experience June 2007 to Current Qualifications Kirkwood Community College Cedar Rapids, IA, United States Associates of Arts Liberal Arts George Washington High School Cedar Rapids, IA, United States High School Diploma General All Aboard Daycare Teacher Solon, IA, United States • High integrity • Computer /technical proficient • Problem- solver • Outstanding interpersonal skills (able to relate to anyone) • Excellent communication skills (able to listen, write and speak effectively) • Team - player • Dependable • Quick learner • Work well under pressure • Tentative to detail • Analytical thinker • Highly motivated /enthusiastic City of Iowa City I r 1 Advisory Board /Commission /Committee ~I'� pplication 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 Cf J&#M4W g10 CO Term iii► 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 � Lam' HOME ADDRESS W 16OKi" l C S4tyW Is your home address (listed above) within the corporate limits of Iowa City? 50 Yes F-1 No How long have you been a resident of Iowa City? Gender: Male ❑ Female OCCUPATION JW1r[d 1>&'.�,114MI MOM EMPLOYER fiM : rccO PHONE NUMBER: HOME rBUSINESS •�'' t� EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ��i1Y, ei,.cd x�uwl A 01 t r.► ir,A ADVISORY BOARD? o.gy A.ALar cw MI �w.ryarpd.�, a*d ks...l Ow #K *tctrl, VJAy 4^94" k"uA&A4ti WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)? If 46004- 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? PfYes Q No- DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION ?. Yes �lo (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. Human Rights Commission Application January 2012 Page 2 of 9 � r �_-. 4# ! uii M BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING CITY OF IOWA CITY Name of City /J����� 94F Board /Commission /Committee 1NC i/ 7�1/ 1��IIl�W 4�'�N -Date d Name *h1c Al zev- 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. NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. SignatureL���� - n LF Address' 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. Human Rights Commission Application January 2012 Page 3 of 9 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 HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments 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) nDTInNAI PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. Age AM44 Gender �rIM� Income (see table) 61111640049- "4/P %!d k Sexual Orientation fta Other (Please explain below) ..man Rights Commission Application January 2012 page 4 of 9 Ae*WdZit I Religion 4L Disability Race, color or ethnic group National origin City of Iowa City Advisory Board /Commission /Committee,.;' 'T application Form �t-�-- 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 lower Ghi Hgmam RirAWs Cow,11s5ioo Term e0464� IN 16 NAME AKyiikoL f3ua4mm HOME ADDRESS 1Z2 Aroad_Iti oor L L*te 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? Gender: Male ❑ Female 0 OCCUPATION S# uJ&& Whiy. o� 10wo PHONE NUMBER: HOME (31q)33-7-3-12-7- EMPLOYER BUSINESS EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: As a J uxior /Sev►ior iw 1,t4 s ikooi, I S�fVed R, a Yow�'i, Aet"6er on �� Inge, juvev►ile, Jusfi cz A�1,.Iso; Co ww, C, l , I So/ 0.S a S em' 0 V 1 WAS a rn ber � At sh -AeA+ ry c e Executive CDMKiOtt- - w % w: Mil e^l•uT vunuln Cn/+c Ac TMj 0% Ar%1110ACV OnA0rV3 VVr7P11 10 i UUR I-RCa7C11 I nlvvvVL_GUVG vrr I nw rw V fV V:%: I'VZ �ecA o� e � M ric�j�iS vrr�incunLC! wn� c- o�nnw+uwl �Kwi ri�N ...ctw S. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)? 1 sw orl 4,rk,l,4,;5 ;r &II Peale c.J wish 4-o ridvoc4k 0-Sioaci4l� for Mkol -f� i�. I hope_ -10 PoSi h✓'0 iVK fCJ IOWA, C i. l sigw_ I `Cvti��c c(i ✓�3�� ;s So ir��nri�ik+ }o CG 1Pr�r�i2, I 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? ❑X Yes U No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ❑Yes F> 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. Human Rights Commission Application - March 2013 Page 2 of 8 cmurz BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING CITY OF IOWA CITY. Name of City Board /Commission /Committee (owck- C;-hi 44mc -% A i a 1&5 frovkwuss i o n Date 6/21/6 Name !60kVt;J1A 13U-%s Mw► 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 NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature &,Ay " !�Pcn / � Address 112 13rb ",oir LAwnP 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. Human Rights Commission Application March 2013 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,060 $26,750 $32,100 $42,750 $53,500 2 18,350 30,550 36,660 48,850 61,100 3 20,650 34,350 41,220 54,950 68,700 4 22,900 38,150 45,780 61,050 76,300 5 24,750 41,250 49,500 65,950 82,500 6 26,600 44,300 53,160 70,850 88,600 7 28,400 47,350 56,820 75,750 94,700 8 1 30,250 50,400 1 60,480 80,600 100,800 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments 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) riT y iiTilkl ", W PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. 00 Gender Income (see table) Sexual Orientation Other (Please explain below) Human Rights Commission Application March 2013 page 4 of 8 Religion Disability Race, color or ethnic group National origin 0 Marian Karr From: Matthew J. Hayek <mhayek @hhbmlaw.com> Sent: Monday, July 22, 2013 8:56 AM To: Marian Karr Subject: FW: Iowa City Human Rights Commission vacancy From: Matt Hayek [mailto:Matt- Hayek @iowa- city.org] Sent: Monday, July 22, 2013 8:46 AM To: Matthew J. Hayek Subject: FW: Iowa City Human Rights Commission vacancy From: Andrea Cohen [mailto:andreacoh(&gmail.com] Sent: Sunday, July 21, 2013 2:17 PM To: Matt Hayek; Rick Dobyns; Terry Dickens; Susan Mims; Michelle Payne; Jim Throgmorton Subject: Iowa City Human Rights Commission vacancy Dear Members of the Iowa City Council, My name is Andrea Cohen. I received a call on Friday that there was a second vacancy on the Human Rights Commission and that the City Council would vote on Tueday, July 23 to fill the vacancy. I have been unsuccessful in reaching Council members by phone and have chosen to contact you by email to further stress my interest and desire to fill the vacancy. I have been involved in Human Rights issues and education both in schools and in the community since grade school. I am the Regional Representative of Human Rights Educators (HRE) USA, an organization whose mission is to promote human dignity, justice, and peace by cultivating an expansive, vibrant base of support for Human Rights Education in the United States. The 2 areas I focus on are the integration of HRE into formal and non - formal educational settings, such as schools, universities, and organizations that work with youth; and empowering educators and learners. I am a Social Studies and Civics teacher who has successfully integrated human rights principles in class as well as in community activities. I have worked with refugees and asylum seekers, and have given presentations and workshops to various community groups. I moved to Iowa City last year and will be enrolling at the University in the PhD program in Social Studies Education with a focus on human rights and global education under the supervision of Dr. Greg Hamot. I will also be actively involved in the Center for Human Rights. I understand that the Commission has approached the Center in order to find ways to work together in the community. I look forward to being part of that initiative. I am very committed to finding ways in which the community and schools can integrate a framework of human rights thinking and action that provides benefits at the individual, local, national, and international levels. As Eleanor Roosevelt said, 'unless these rights have meaning in small places close to home, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.' How do I see myself contributing to the Commission? The Commission has 4 major duties. Given my background and expertise, I would like to focus on the first (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) and the 4th (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). I have both an educational and business background which I feel would be beneficial in taking on the duties. I have lived and worked both in the US and abroad. Please see my attached resume. I would be happy to discuss my interest and qualifications further. I can be reached at 319- 333 -9540. I look forward to the opportunity of serving the Commission, the City, and the cause of Human Rights. Sincerely, Andrea Cohen NOTICE 9h THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: POLICE CITIZENS' REVIEW BOARD Two Vacancies — Four Year Terms September 1, 2013 — September 1, 2017 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 26, 2013. 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. 5/15/2013 u u n u u y y eD OD 7 eD Aa p QtQ yeD ■s eD O. y y d eD � o n H d N W N ry O �+ n W Q `-J y� n FBI y ICI o x o o o C 4 CD i CD fb b A C�7 O N a I� a a la ~ [17 Ci7 00 ITV /V ✓� /V � N C7 A W y y d eD � o n H d N W N ry O �+ n W Q `-J y� n FBI y ICI 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: 2 Council Announcement Date: May 14, 2013 Application Deadline: Wednesday, 5:00 p.m., June 26, 2013 Council Appointment Date: July 23, 2013 After 08/12/2013 (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, 2013 — September 1, 2017 Term expires for Joseph Treloar, Kingsley Botchway II Gender Balance Requirement: 1 Male, 1 None (M) Joe Treloar EI (Currently serving 1St four -yr term) 741 Alpine Dr 0 Denotes applicant completed the Confidential page of the application. City of Iowa City Advisory Board /Commission /Committee``'' t -iplication 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 Pot Cc (21 rxt n1 S' rat= V-t6h! 0044'/% Term NAME �/dr HOME ADDRESS 75r/ Al &A16 J74-f- W Is your home address (listed above) within the corporate limits of Iowa City? Yes FJ No How long have you been a resident of Iowa City? Gender: Male ® FemaleEl OCCUPATION /�i�'Ue3A %U /�A�OIC ff Jtcr/< EMPLOYER6i// ilvaxeC-01C 2✓ PHONE NUMBER: HOME (.314) L13 D - i f 9 3 BUSINESS (31,72 G9 - 91y .3 EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: 1$ )IMA 3 L A k1 F Nfo,--- C FM E411— --Vc e . 1 .AT IC VnI IR PRFCFMT KMr)WI Fnr.l= CIF THIS AnVISCIRV RnARn? A4VE .s(--19YCR dA-7 7'11r-J a' ®ARfJ /=dam reAC -&- )'C' A25 1JNO )Jwf QV rAI7'ZI- C HA-z4 lf4ltN. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYIIVG)? C one r�Nv s�2 vac C -ro -fW e z7,Y- LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest N0 N� IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? R] Yes n No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? nYes FNo (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 answer all the questions, Council may not consider your application. General Application October 2012 Page 2 of 7 �r BOARD, COMMISSION AND COMMITTEES`�� BUSINESS LISTING .,,�,,i_ -i- CITY OF IOWA CITY Name of City , Board /Commission /Committee V, ' I J �I PDate 3 / Name . Z gQf l= ( cl19,00C, 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, 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 1 �( 717 r ; % zzz Y NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signatu r:r_rr, 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 October 2012 Page 3 of 7 From: Marcia Bollinger Sent: Monday, July 01, 2013 4:26 PM To: Kellie Tuttle; Marian Karr Subject: FW: Resignation From: Melissa Mitchell [mailto:melissakay.mitchell @gmail.com] Sent: Saturday, June 29, 2013 7:55 AM To: Marcia Bollinger Subject: Re: Resignation Dear Marcia, I am regretfully writing to let you know that I must resign from the Public Arts Advisory Committee because we are moving to Des Moines. I have enjoyed my time working with the PAAC over the years, and i am greatful for the opportunity. Best wishes, Melissa Mitchell Marian Karr From: Marcia Bollinger Sent: Monday, June 24, 2013 8:34 AM To: Marian Karr Subject: FW: here you go- - - - -- Original Message---- - From: Susie Thurmond [ mailto: Thurmond.Susie @iccsd.kl2.ia.us] Sent: Friday, June 21, 2013 2:41 PM To: Marcia Bollinger Subject: here you go- Marcia- This is my official resignation from the Public Art Advisory Committee, effective June 21, 2013 as I will be moving out of town. Thank you for everything, I enjoyed being a part of the PAAC- Susie Thurmond NOTICE: All email communications to and from the District's email server are archived in accordance with District policy and procedures. This email communication, including attachments, contains information which may be confidential and /or legally privileged, and may otherwise be exempt from disclosure under applicable law. The information is intended solely for the use of the addressee. If you are not the intended recipient or believe you received this communication in error, please reply to the sender indicating that fact and delete the copy you received. In addition, if you are not the intended recipient or believe you received this communication in error, any unauthorized retention, copying, disclosure, distribution, or other use of the information is strictly prohibited. Thank you.