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HomeMy WebLinkAbout2017-07-18 Appointment07-18 13a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy to fill an unexpired term Upon appointment - December 31, 2018 • The powers and duties of the Airport Zoning Board of Adjustment are 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. • 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. • 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. The Board meets at the call of the Chairperson. • Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, July 11, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Board of Adjustment One vacancy to fill and unexpired term Upon appointment -12/31/2018 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 6/20/2017 Application Deadline: 7/11/2017 Council Appointment Date: 7/18/2017 Date of Non -Gender Appointment: Gender Balance Requirement: Current Gender Balance: Gender None After date above Council may appoint without regard to gender Female:0 Male:1 Name and Address No Applications 13b NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy to fill an unexpired term Upon appointment - December 31, 2020 • The powers and duties of the Airport Zoning Board of Adjustment are 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. • 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. • 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. The Board meets at the call of the Chairperson. Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, July 11, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Board of Adjustment One vacancy to fill and unexpired term Upon appointment —12/31/2020 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 6/20/2017 Application Deadline: 7/11/2017 Council Appointment Date: 7/18/2017 Date of Non -Gender Appointment: After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Female: 0 Male: 1 Gender (-Name and Address None No Applications 13c NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING One vacancy to fill an unexpired term Upon appointment - December 31, 2021 Duties of the Airport Zoning Commission are: • To recommend amendments to the current Iowa City Airport Zoning regulations, including the repeal thereof. • To recommend the adoption of new Airport Zoning regulations. The Board meets as required. Iowa City -appointed members of boards and commissions must be 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions Applications must be received by 5:00 p.m., Tuesday, July 11, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Airport Zoning Commission should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Commission One vacancy to fill and unexpired term Upon appointment —12/31/2021 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 6/20/2017 Application Deadline: 7/11/2017 Council Appointment Date: 7/18/2017 Date of Non -Gender Appointment: After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Female: 0 Male: 2 Gender — _TNa and Address — — — — None No Applications 1 13d NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HISTORIC PRESERVATION One Vacancy to fill a three year term July 1, 2016—July 1, 2019 (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. Applicants for district representatives to the Historic Preservation Commission must reside in the district that is specified. City -appointed members of boards and commissions must be at least 18 years old and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, July 11, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Historic Preservation Commission should be directed to Bob Miklo, Sr Planner at 356-5240. 6/28/2017 Board/Commission Application Cover Board/Commission: Historic Preservation Commission Jefferson St. Representative One vacancy three year term 07/01/2016 — 07/01/2019 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 6/20/2017 Application Deadline: 7/11/2017 Council Appointment Date: 7/18/2017 Date of Non -Gender Appointment: After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Female: 6 Male: 5 Gender Name and Address ,None -- ---- - -—------�NoApplications ------------------_ - - - -_- — YrTrf'T 13e NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HOUSING & COMMUNITY DEVELOPMENT COMMISSION One vacancy, for an unexpired term Upon appointment — July 1, 2018 • 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. • The Housing and Community Development Commission will have monthly meetings. Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. 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. Applications must be received by 5:00 p.m., Tuesday, July 11, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org.or by contacting the Clerk's office. Questions about the Iowa City Housing and Community Development Commission should be directed to Iris Ackerson, Community Development Planner at 356-5247. Board/Commission Application Cover Board/Commission: Housing and Community Development Commission (HCDC) One vacancy for an unexpired term Upon appointment - 7/1/2018 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 6/6/2017 Application Deadline: 7/11/2017 Council Appointment Date: 7/18/2017 Date of Non -Gender Appointment: 9/4/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: none Current Gender Balance: Female: 4 Male: 4 Gender Name and Address Female Dietrich, Johanna 637 S. Johnson Street Female Johnson, Kristin 415 S. Van Buren St., Apt.1 Female Lambertz, Angela 1710 Hollywood Blvd. Male Maggos, Nikolaos 320 E. Burlington St., Apt. 6 Female McDonald, Sharon 1216 Jensen St Female Padron, Maria 410 N Scott Blvd Female Rose, Clare i 928 E Bloomington St Female Wall, Rachel 321 S. Linn Street Apt. 123 Female -- Young, Heather 502 3rd Ave HOUSING AND COMMUNITY DEVELOPMENT COMMISSION ATTENDANCE RECORD 2016-2017 Name Terms Exp. 8110 4/21 5/19 6/16 8/18 9/15 10/20 11/17 12115 1/19 1 219 1 2116 Byler, Peter 711/17 X X X X X X X X X X 01E X Conger, Syndy 7/1/18 0/E X 0/E O/E X X 0/E X X X 0/E X Harms, Christine 7/1/19 -- -- X X X X X X X X X X Lamkins, Bob 7/1/19 X O/E X O/E 0/E X 01E X 01E X O/E X McKinstry, John 7/1117 -- X X O/E O/E X X X X X X Ohnstead, Harry 7/1118 X X X X X X 01E X X X X X Persson, Dottie 7/1117 X O/E X X X X X X X X X X Seiple, Emily 7/1118 X X X X X X X X X X X X Vaughan, Paula 7/1/19 -- X I X 0/E X X X X X Key. X = Present O =Absent O/E = Absent/Excused --- = Vacant I A Advisory Board/Commission Application Form `1 This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CUN Of NTEMMU NOTE: Must be 18 years of age and live within city limits of lowa City to apply Date of Application 211 612 01 7 First Name* Johanna Last Name Dietrich Home Address* 637 S. Johnson Street city IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 5077794207 Email Address* johanna-dietrich@uiow.edu Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City? A year and a half 3. Occupation:* Student and Camubs Driver 4. Gender:* Female 5. Experience andlor activities which you feel qualify you for this position:* I was active in rry high school apart of the student council and Vice President of my senior class. I Has introduced to this position from my human rights class. I Hant to bring positive change to the community and be actively engaged with the Iowa city citizens. I am a student at the University of lova studying enterprise leadership, minor in human relations and certification in human rights. My goal is to become a social entrepreneur. I think being apart of the board will help me understand more about the community needs. 6. What is your present knowledge of each advisory board you are interested in? * I understand that the commission works to make affordable and sustainable housing across Iowa City. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-ir-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency if reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No B. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 19 10. Country of Origin USA 11. Sexual Orientation straight 12. Religion NA 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down t Advisory Board/Commission Application Form rY � : ' uliP:f?y This application is a public document and as such can be reproduced and distributed for m �� r the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNES CnT OF LITERATU11E NOTE: Must be 18 years of age and live within city limits of lowa City to apply Date of Application 4/5/2017 First Name Kristin Last Name Johnson Home Address* 415 S. Van Buren St., Apt.1 City IOWA CITY State IA Tip Code* 52240 1. Is your home address (listed above) within the corporate limits of fowa City?* Yes Contact Phone Number* 319-594-1032 Email Address* sunshineariel9g@grriail.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Human Rights Commission Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 22 years 3. Occupation:* volunteer 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* I am active in some support groups which help me stay connected to the community and help me to take good care of myself, and interact with an interesting and diverse population in this city. 6. What Is your present knowledge of each advisory board you are Interested in?* I am avare that the library board term is a period of 6 years and helps determine policies and practices. I am avare that the Community Police Review Board is designed to help those concerned with criminal justice in this community. And I am aware that the Human Rights Commission is designed to help protect people with disabilities to be treated fairly in this community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in arty contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. 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. City Council Resolution If 15-300 established a policy that the following persons shall riot be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and hall -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is rat to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin USA 11. Sexual Orientation heterosexual 12. Religion Episcopal 13. Do you have a disability? Yes Please explain: I have a mental health condition which I manage with medication and social activities and healthful activities. For example, I volunteer at a local peer support recovery center, volunteer for New Pioneer Co-op,& garden in the city garden. I also advocate with letters and phone calls to our elected representatives for a combination of issues I am concerned about, such as mental health parity, the environment and social justice.) also receive rental assistance. 14. Ethnicity Caucasian `NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* �OQ.A<0"JI-ar Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down gg CITY OF IOWA CITY UNESCO CITY OF LITERATURE Date of Application 2/22/2017 First Name* Angela Last Name Lambertz Home Address* 1710 Hollywood Blvd. City IOWA CITY State IA Zip Code* 52240 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196219837 Email Address* ca4ee73@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 3 years 3. Occupation:* Content Specialist I, Technical 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have lived in various unsafe buildings because of lack of funding for affording safe housing. I am an LGBTQ activist who would like to participate more directly in the government of my community. 6. What is your present knowledge of each advisory board you are Interested in?* I have attended a couple City Council meetings and keep up to date on local news through social media outlets and the local newspaper. I have read through the Duties descriptions of each advisory board on the iovd- city.org website. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerelly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract City Council Resolution # 15-300 established a policy that the following persons shall not be eligible appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. lf reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following 9. Age 43 10. Country of Origin United States 11. Sexual Orientation Bisexual 12. Religion Wiccan 13. Do you have a disability? Plo 14. Ethnicity Caucasian "NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* C3A"O A66&A :?- Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down City of Iowa City Advisory Board/Commission/Committee Application Form THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR TWELVE MONTHS AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/CommitteeName o-aS•-'Term $pilo -ZMJ NAME M3100S %' Io ci 3 HOMEADDRESS 3Zo f �—If JCt1-cp Is your home address within the corporate limits of Iowa City? Yes No _ How long have you lived in Iowa City? VCS Gender: Male 1C Female Contact# W-59341\2 Email Address �Sn"hq�^SG'gr�si•ce^ti CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS pwtesopa.' P�� Skvdu-:- wer4.: 5 un trSt s 6 S b5:�4ent+. r,. y4.4c_ As ..-..l 'y trxuR.la iv.b u<:�+- =n ye,,, Yr+`o<(ront�, aI Xt-.r:^j tn:,:.n•vall7 r,,.CC'a�.l- awx5 i -e vw•-s. �_r Fnca, :nW r•^Er �� �i v1( Qco4la.. 3 o-r5c bo�'t. � �;�t,-� Einax3e-1 �.r��iY.1i.rt. t�cu-uc2 e.i-� he.1=J 70% F ��4 (.:y •.s N.ed;n.. :n�erk, � enty �-+ •l Kur "'J° t-el.3e� a<. s1-,-6,.r4� 1t�s k+ ply +Ge 1o',\ls, r �FA.-r In....e. baN^ nco-a.,--�� o�L }.e„�c ;�V•ecn4 o„S e�Qes:,,.ez. Uattt+. .Aw <Y�\V'�f- it.2:r� ea�a�d.bV, �i,�-s,� 4 be.\i..•t. sk,&- l% ire. by 1-4 bXW <xgerdn.,.s v;N.. v,ma. b,:s.n/;n,_orf�..e. w >•orr+ a r..,,.f.,-t\t,� ,.J lo..a�o,a WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? yL {tc 1 sLtti<5 o- b CAc s gro\f;c:<s .mac b[b 4v us, c. r &c rc�t a 1 tow jruN`t. ;r-�1 v; du.h �n�'C aCt<tj �, rs}Fo�r�a-tO �L �ow5:�` t c5 weii e.t �,rgeo�•^S LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest T �1k �*r,.•t a.s o.� vC -6k, prc5ws. "A. D^^b simlrt aewriwt' L11 DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? LYes ^ &No (If yes, please indicate which board would be your first choice to serve on.) V". v (Ti Misrepresentations on this application will constitute just cause for removal of an alipomtge. If Tou fail to answer all the. questions, Council may not consider your application. - - 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 $16,700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 1 46,150 1 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63,000 84,000 105,000 ' ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, PLEASE INDICATE IF YOU ARE A MEMBER OF EITHER OF THE FOLLOWING CATEGORIES: Lower Income (see table) Receive Rental Housing Assistance Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint 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. ill ,:re.c n. c. N'st-sk-b Vv 44-,,. U, o O� (.Nk(i Qct .l C4. vrs, 11 �I (ant cs4o1-e. dea,•clopr.lwl- loons - we- 4,u��, ac.i; HCDC Application February 2015 page 4 of 8 l � r BOARD, COMMISSION AND CORiHITTEES �, BUSINESS LISTING � M ,,,moi CITY OF IOWA CITY Name of City Board/Commission/Committee Nvsn b �� w,4 el�p wG l c� M cS,o� Date -7/Z5(u Name Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, 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 I BUSINESS ADDRESS —1 NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional busjpess.,, Applicant 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. N General Application April 2015 Page 3 of 7 Marian Karr From: Maggos, Nikolaos S <nikolaos-maggos@uiowa.edu> Sent: Wednesday, July 27, 2016 11:38 AM To: Council Subject: Housing and Community Development Commission Hello City Council members, My name is Nik Maggos and I am applying for a position on the Housing and Community Development Commission. I wanted to send an email introducing myself to all of you with the hope that we will soon be working together towards improving access to employment opportunities and affordable housing for Iowa City's at -risk citizens. To give a little information about myself, I am entering my third year in the Philosophy Ph.D. program at UI and serve as the Political Action Chair for COGS (UI's graduate student union). Academically, I'm most interested in philosophical issues surrounding human rights. Non -academically, I love playing sports (especially basketball, soccer, and tennis), hiking, camping, and spending time with my girlfriend and friends. I also love thinking about spending time with a puppy, because I can't actually spend time with one until I move to a new apartment that allows pets. I look forward to meeting all of you and hearing about your interests as well. I hope to be seeing you all soon! Best, Nik Nikolaos S. Maggos Philosophy Ph.D. Candidate University of Iowa EPB 252 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for wy� the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CRY Of LRERANRE NOTE: Must be 18 years of age and live within city lirnits of Iowa City to apply Date of Application 3/31/2017 First Name Sharon Last Name McDonald Home Address'" 1216 Jensen St City IOWA CITY State IN Zip Code 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number" 3196318270 Email Address* snicdonald2l28@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 29 years 3. Occupation:* child care center director 4. Gender:* Female S. Experience and/or activities which you feel qualifyyou for this position:* I have been interested in this topic for a tong time. I live quite dose to the Pheasant Ridge complex 1 worked at the Fareway store on kbrmon Trek for 14 years and got to know many of the residents of PR. I also used to live in the yellow townhouses behind the Kwik Trip on MT. I was the 2016 precinct captain for these two neighborhoods and canvassed them personally and by phone quite often. I know that getting into these units is difficult and I also know there are significant challenges for those that do. 6. What is your present knowledge of each advisory board you are Interested in?* I follow whars reported in the newspaper. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. 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. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-ir-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is rat to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No S. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin United States 11. Sexual Orientation We 12. Religion unitarian 13. Do you have a disability? Yes Please explain: I have a bad back but I can walk fairly well with a walker. 14. Ethnicity caucasion "NOTE: The Hunan Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* c5a;O teW ' fern0)ar.v!d Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down _ r Advisory Board/Commission Application Form _ L rY `�mtpjlj�►►t� This application is a public document and as such can be reproduced and distributed for wy� the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNEWOCOY OF LUEMN0.E NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 6/28/2017 First Name Maria Last Name Padron Home Address* 410 N Scott Blvd City IOWA CITY State IA Zip Code* 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3199309528 Email Address* marialorena.pad ron@gmel.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 8 3. Occupation:* Designer 4. Gender:* Female 5. Experience and/or activities which you feel qualifyyou for this position:* I studied architecture in Argentina for five years and took urban planning classes, I have a Masters Degree in Art from the University of Iowa. I am very interested in how cities develop and how development and transportation affects low income families. I worked for many years in architecture, doing residential and commercial projects in big and small cities. 1 have been a volunteer for the CPL for seven years, and now I am a board member for the Wiled Nations Association Johnson County Chapter. 6. What is your present knowledge of each advisory board you are interested in?* This board advises the city on housing and developments. The board should advise the city on how to proceed taking into consideration the well being of its citizens and how developments will affect them. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in arty contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneralty prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. CityCouncil Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step-clrldren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase line opportunities for new applicants to serve. Council policy is not to pennit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No S. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 41 10. Country of Origin Argentina 11. Sexual Orientation heterosexual 12. Religion none 13. Do you have a disability? No 14. Ethnicity hispanic 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I ! 8 S -F!•T warms CIN OF IOWA CITY UNESCO CITY OF UTEBATUIIE Date of Application 4/4/2017 First Name Clare Last Name Rose Home Address* 928 E Bloomington St City IOWA CITY State IA Zip Code 52245 Advisory Board/Corrrnission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3192130477 Email Address* cmartin204@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* North Side 2. How long have you been a resident of Iowa City?* 26 years 3. Occupation:* Technical Project Manager 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* I have been a project manager for five years at Pearson Education. My skills as a project manager, including gathering information from stakeholders, planning processes and documenting decisions I feel would be applicable to these commissions. Previously I was a research intern at a small think tank in Washington DC called SpiritHouse, where I was tasked with gathering large amounts of research and distilling it down into easily understandable pieces for press releases. In college I worked for a development firm who built low. income assisted living facilities in lowe City, I was tasked with reviewing potential resident applications and approving income requirements. Finally, I have lived in lova City for 26 years, experiencing it as a child, a college student and finally an adult. I have the good fortune to be able to call on the perspectives of these multiple roles in considering issues that night come to the attention of these commissions. 6. What is your present knowledge of each advisory board you are Interested In?* I have limited knowledge of the specifics of each of these advisory boards. I have lived in the Northside neighborhood most of my fife and from a citizen observer perspective I am familiar with some of the duties of the Historic Preservation Commssion. Regarding the Housing and Community Development Commission, I have reviewed the agendas and notes from the last few meetings. I recognize the role this commission plays in programs such as UniverCity and it work in providing assistance in allocating funds towards affordable house in Iowa City. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to fire proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-ir-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 34 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Atheist 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* &144'e104. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I r 4J. w.r._ CITY OF IOWA CITY UNESCO CITY Of UTEMTUNE Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of love City to apply Date of Application 11/14/2016 First Name Rachel Last Name Wall Home Address* 321 S. Linn Street Apt. 123 City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 309-646-2354 Email Address* rachel.v&ill@Jbfs.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 6 3. Occupation:* Insurance Agent 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* - Treasurer Ulov Student Disability Organization 2014-2016 - budgeted fiscal year eVenses and revenue - licensed to sell life, health, property and casualty insurance - lows producer - employed with Farm Bureau Financial Services as an insurance agent - volunteer at the VA Hospital in Iowa City - advocate for making my community a more inclusive environment for disabled individuals - Hawkeye Accessibility Ambassador Trained 6. What is your present knowledge of each advisory board you are interested in?* As a board member, you are obligated to serve your community in their best interest. You are also obligated to provide service and add value to your community. You are representing your community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted acfivity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prottibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-inlaw, fattier-ir-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same chili, and persons with wham the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. H reappointed, an individual would be limited to one reappointment to a full tens in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission? No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 23 10. Country of Origin U.S 11. Sexual Orientation Female 12. Religion Christian 13. Do you have a disability? W 14. Ethnicity White/ Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* IF Wa// Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Advisory Board/Commission/Committee Application Form THIS APPLICATION IS A PUBL]C DOCUMENT' WI7 H THE FXCEPTION OF THE LAST PAGE MARKED `CONFIDENTIAL." THIS APPLICATION MILL BE CONSIDERED FOR TWELVE MONTHS AND AUTOMATICALLYCONSIDERED FOR ANY VACANCY DURING THAI' TIME Advisory Board/Commission/Commitlec Name I `F7(.f t �" cz 7 enn 3 c.vt.4 NAME N p 0,4 4 - i. t HOME ADDRESS -50 Is your home address within the corporate limits of Iowa City? Yes_ No_ How long have you lived in Iowa City?_ 5' , Gender: Male ___ Female x Contact# `% - 35jf 12 ty a Email Address V—h � o csi�q CONT'RIBU'TION AND/OR ACTIVITIES WHICH YOU FEEL )QUALIFY YOU FOR THIS nnerr•r�a_ -x w cw ij cer a `d1 L, min cmMa y rn�t -" bmt� J t�a WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? LIST POTENTIAL CONFLICTS OF INTEREST: See page I for information regarding Conflict of Interest � OTS - DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? _Yes PC Plo (If yes, please indicate which board would be your first choice to serve on.) 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. June 2016 Pa2e2 of 7 r N 0 r� rn nJ r BOARD, COMMISSION AND COMMITTEES It,^—'�G� BUSINESS LISTING ria®�®0 CITY Or 10WA CITY Name of City tt� l Board/Commission/Committee floc (�„ u ., Date / / 6 Name IA -ecMLr an (-&A Section 362.5 of the Cod of Iowa gVnerally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A cop of Section 367 5 (see page 7). y . is attached 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. U' NOTE: A new form must be completed if the above information changes or an owners r tinterest is acquired in an additional business. Applicant Sig 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 April 2015 Page 3 of 7 V5- Applicant j TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 60% Median Income (low Income) Median Income 1 $16,700 $--27,850 $33,420 544,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63,000 84,000 105,000 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. ® Age e- � Gender t@� Income (see table) Sexual Orientation Other (Please explain below) iPO-T,� Religion 0O�� Disability Race, color or ethnic group u S Id"ational origin .. cc ( iman Rights Commission Application February 2015 page 4 of 8 h? ( iman Rights Commission Application February 2015 page 4 of 8 07-18T7 13f NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: TELECOMMUNICATIONS COMMISSION Two vacancies — Three -Year Terms July 1, 2017 — July 1, 2020 • The duties of the Telecommunications Commission include serving as a review board to resolve disputes between any subscriber or potential subscriber and the cablevision company • reviewing and auditing reports by the cable company to the City as required by the Cable Television Ordinance; working with the public, the media, the City, and the cablevision company for the purpose of making recommendations on various issues; • monitoring and promoting community programming and the use of the local access channels by a wide range of individuals, institutions, and organizations; • informing and educating citizens on matters related to cable TV and other communications systems; • and monitoring and reviewing State and Federal legislative and regulatory action or change. • Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. • The Telecommunications Commission meets the fourth Monday of each month at 5:30 p.m. Applications must be received by 5:00 p.m., Tuesday, July 11, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Telecommunications Commission should be directed to Ty Coleman, Media Production Services Coordinator, at 356-5454. 6/28/2017 Board/Commission Application Cover Board/Commission: Telecommunications Commission Two vacancies three year terms 07/01/2017 - 7/1/2020 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 6/20/2017 Application Deadline: 7/11/2017 Council Appointment Date: 7/18/2017 Date of Non -Gender Appointment: 6/19/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: 1 Female Current Gender Balance: Female: 1 Male: 2 Gender Name and Address None No applications