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HomeMy WebLinkAbout2010-05-10 Appointment3o b Marian Karr From: WalkerCL04@aol.com Sent: Saturday, May 01, 2010 11:59 PM To: Council; Dale Helling Subject: May Day Resignation from Senior Center Commission May 1, 2010 City Council of Iowa City and the City Manager: On April 22, I attended my final meeting of the Iowa City Senior Center Commission. As some of you know, I was the first low income resident to become a member of that commission, and I will probably be the last one. It was not easy to complete that one year on the commission. In fact it has been a very unpleasant experience. I was not the kind of member that Mr. Honohan and Ms Kopping want on that commission. I took the assignment very seriously and have tried to bring things to your attention, mostly through contacts with the City Manager and the civil rights case. Since I had already endured too much unpleasantness in trying to be a responsible member, I was planning to resign at the end of last year. However, Mr. Honohan caused me to change my mind by lashing out at me in a very hostile chastisement during the recorded December Commission meeting. Instead of resigning as he advised me to do, I decided to try to stay on the commission at least to the one year anniversary of my appointment. It has been an even worse experience than I had expected. Before I got appointed, I already knew about the disgusting unspoken social class divisions that operate there. It is inexcusable how the staff and the commission focus upon the desires and opinions of the higher income elders and barely tolerate elders who are not among the retired University crowd. I also already knew that the Senior Center Commission does not operate as an advisory group like other city missions that give recommendations to the Council. Instead of giving recommendations to the council or city manager, as most of you know, the Senior Center Commission usually just gives pleasant little 5 minute presentations during public comment time at city council meetings. You have been told, often by Mr. Honohan, about how good things are going at the senior center, about things that have already been decided and money spent. I did hear Mr. Honohan give advice at a budget hearing about adding a staff member but I don't recall any other advice that he gave to council other than to invite council to this or that event that was to take place at the senior center. Even though I knew the above problems, I was willing to take part of the commission in order try to say a sort of "hey wait a minute" when things were being glossed over or information seemed avoided. It didn't matter though, did it? Actually, I didn't expect that it would. At least I did provide a meager record of -- "at least I tried". 5/3/2010 Page 2 of 2 I thank those of you who gave me the opportunity to be almost on the inside of the Senior Center commission for a while. I was well aware of how I could have been an accepted member of that commission. I know how to smile and act like the others expected me to act. But, it would have been irresponsible for me to do that. In addition to this letter of resignation, I will also send you a copy of a document that is written in a form similar to what Martin Luther did in 1517 when he posted his 95 thesis criticizing the Roman Church on the door of Castle Church in Wittenburg, Germany. I have call it "The 95 Nailed to the Wall". It will be another example of "at least I tried". I simply will not leave the Commission silently. I will make another attempt to call attention to some things that I think need the attention of the city manager and the council and the public. I first wrote the document last fall and had planned to post it on my Press Citizen blog on the anniversary of that famous historic event in Germany: Oct. 31. However, some technical changes on the blogs at the Press Citizen around that time made it impossible for me to post it on that date. So, I put it away to use at a later date. I have updated it a bit in order to include some things that have happened since October. In addition to sending it to you, I will also symbolically nail it to the wall of my Press Citizen blog. Thanks for giving me an almost inside look at the Senior Center. It sure is not my kind of senior center but it does pretty well at pleasing the upper income elders who seem to count the most. Sincerely, Charlotte Walker 5/3/2010 Page 1 of 10 Marian Karr From: WalkerCL04@aol.com Sent: Sunday, May 02, 2010 12:08 AM To: Council; Dale Helling Subject: Addition to resignation from Senior Center Commission This is the addition which is mentioned in my resignation. ... charlotte walker May Dam May Day!~~ The 95 Nailed to the wall. Posted 5/1/2010 10:40 PM CDT on press-citizen.com 1 i ~ ,i r' . , ;~ ~~- •,~1! J ~ ~~,~ ~~{_. . ~`.. ~,r ~ l~i~~ ~1 ~3_ i l l ~i 'fit ~ ! ~lft~ ,~,. . r ~' ~~a 'l~ r~~~ +. . . ~'•'" S ; ' ~-~' a' ~~- ~, ' ~;., . ~ ~,y1 j~ The 95 Nailed to the Wall Down at the Iowa City Senior Center I hereby set forth and nail up the following problems and criticisms directed at the city owned well funded Iowa City Senior Center. They are to be taken as a love manifesto of mini-theses written with the good spirited intentions of trying to lead to better oversight from city hall. Though the rather pudgy senior center's program guides are loaded with a quite overwhelming number of planned activities, a quick walk through that big historic building in the afternoon hours will give you a jolt of 5/3/2010 Page 2 of 10 reality. You will not see many people in those somber halls of that expensive to maintain building. Though the staff tries hard to bring people to the building in the afternoon, all too often the overall atmosphere is similar to a stately museum that has a high entrance fee to keep out undesirables. The building seems too big for current use. Be warned if you are easily upset by criticism or suggestions for change at the Senior Center. The following may just be a little too upsetting. I have learned how troublesome it is for some people to read an opinion that does not match their own. Too many seniors in Iowa City would rather let problems fester under the surface rather than to face them straight on. So take heed all you status quo exalters. It might be wise to not proceed further. The 95 Nailed to the wall: Remembering the example of Martin Luther. 1. Very often the large front lobby with its nice solid comfortable couches is little used and gives the first impression to people entering at the front entrance that the building might be empty. It is being used as a quiet reading area and there are nice magazines to look at. A quiet place that very few people ever use. 2. The so-called Coffee shop, with its full time staff person and thermal containers of gourmet coffees, is located at the edge of the entrance lobby. It has space for only two tables. There is not enough table space for it to be called a coffee shop and few people use it. 3. All the bulletin boards are locked and controlled by the staff. Several requests over a period of nine full years for an unlocked bulletin board have been denied. 4. The 25% discount for class costs that is available for lower income people results in costs that are still far too high for lower income seniors who might like to take part. 5. The staff will not allow free day old pastries to be distributed at the senior center. They have claimed that none are available. 6. The staff reluctantly allowed a once a week distribution of a small amount of free donated bread from the Pioneer Co-op. Donated bread could be distributed 5/3/2010 Page 3 of 10 there every day and need not just be from the co-op. 7. People are not allowed to use the big dining room except for planned events. Much of the time it is empty. They claim they do not discourage it but check it out. 8. People are not allowed to sit in the large activity room when only a small area is being used for band or small musical group practice. 9. The senior center commission has voted against having an open bulletin board for the seniors to use. They expressed fear that controversial content would be posted. 10. There is no limit on the number of years that a person can serve on the senior center commission. Jay Honohan has been on the Commission for at least ten years. He and the manager set the agenda. 11. Cards are played on the Mezzanine, out of sight. 12. Only paid members can play in the card games. 13. The pool table room is locked and only for paid members. Often the room is dark and empty. 14. The exercise rooms are locked and the sign says "Enter at your own risk". Only members can open the locked doors of those rooms where few people pass by. 15. Elderly people are often required to set up and take down table and chair arrangements for small group use. 16. The staff mostly stay isolated in their offices, rarely mingling with the people who attend. 17. The staff rarely, if ever, make public appearances in the community to 5/3/2010 Page 4 of 10 promote the senior center. 18. The staff occasionally arranges to use of the high cost Englert Theatre for senior center "intergenerational" presentations. 19. There is a big problem with the use of the Gift Fund by the senior center commission. Recent legal changes arranged by Mr. Honohan has drastically reduced city oversight of those funds. 20. The contents of the suggestion box is only viewed by the staff. The contents are never shared with the commission members. 21. The suggestion box bulletin board for posting a few selected suggestions is very tiny. 22. The gift shop is in an area where few people go. Few people go in there either. 23. Parking is difficult. 24. Few snacks are available. 25. The large somber lobby could be used for coffee house type table and chairs arrangement, instead of the large overstuffed furniture that is not often used. 26. Elder Services is given a very large free office on the main floor but few people enter that room except for two Elder Service employees. 27. Seniors cannot use empty rooms without permission. 28. Most day time exercise classes have high costs and only for paid members. 29. The membership fee is unfair since membership is not required at other city facilities. 5/3/2010 Page 5 of 10 30. Most things at the senior center are only for paid members, even some that are without any cost to those who attend. 31. The computer room is locked and only for members. 32. Only members can use the ceramics studio which is now locked. 33. The kiln is in the art room. That art room cannot be used when the kiln is operating. Volunteers have been operating the kiln. 34. Only members can use the locked exercise rooms. 35. You can lose membership privileges if you allow anon-member to enter any of the locked rooms. (I have a photo of the staff sign posted on the exercise room.) 36. There is a long involved written disciplinary policy for bad behavior. 37. The empty somber quiet halls in the afternoons seem like meditation areas. 38. Jay Honohan and Linda Kopping set the agenda for the senior center commission. 39. Jay Honohan has been on the senior center commission for over 9 years. 40. It is very difficult for outsiders to get anything on the agenda for the senior center commission. 41. Only a very few seniors use the ceramics studio but the staff just installed a security locking system that cost around $1,000. 42. Some exercise classes have more UI student volunteers in them than senior participants. 5/3/2010 Page 6 of 10 43. Very little income is received from the membership fees. That income must be off set by the cost of all the advertising and costly events for the members only. 44. Staff rarely ever come into the dining room during the time for the senior meals. Some seniors only come to the senior center for the noon meal. Its like a taboo area for the senior center staff. 45. The too large historic building is very expensive to maintain. The need for a large senior center is much less than in previous years. 46. Several recent large costly building renovations have ended up with big problems. 47. The new heating system does not work in some rooms. 48. Few lower income elders are included in planning. 49. Only a small percentage of area seniors are paid members of the senior center. 50. There is almost no planning done for things that might interest lower income elders. 51. Legal action, written by Commission chairman Jay Honohan, was approved by the Senior Center Commission to further remove city control over the gift fund. 52. People who make suggestions or criticisms are made to feel unwelcome. 53. The Council of Elders, an advisory committee that was not selected by the city council, was eliminated. Recently a very complex set of committees was started supposedly to increase volunteer participation. 5/3/2010 Page 7 of 10 54. Mostly upper income members are selected by staff for some extra committees that work with the staff. 55. The city does not offer any assistance toward the skimpy food budget of the meals program which could help make the meals better, especially for holidays. 56. There is a very odd way, and some say a very deceptive way, of counting volunteers at the senior center. 57. There is too much effort to lure people in their 50s to become members. It doesn't work. Most people in their 50s and early 60s are still working and do not need or want a senior center at that age. 58. There is a rather sick paranoia among some staff and some commission members regarding using the word "Senior". 59. Though the name of the senior center has never been officially changed, the staff insists on calling the Senior Center "The Center". 60. The staff has begun to use TV advertising and other expensive advertising, often slick color ads, without discussing that with the commission. 61. The name chosen for the new non-profit group that controls the Senior Center gift fun is "Friends of the Center". 62. The policy for room rental needs attention. Barter for room use seems very questionable. 63. It is suspected that more money is spent on expensive advertising each year trying to get new members than the yearly memberships bring in. 64. Most of the large budget for the senior center goes to staff salaries and benefits. 65. There are few things planned during the time immediately after the noon 5/3/2010 Page 8 of 10 meal making it necessary to either make two trips to the senior center or lurking around at the senior center for a couple of hours waiting for some afternoon program or class. 66. There are few things planned immediately before the noon meal in order to do more than just attend the noon meal. 67. The senior center is closed on holidays when other city owned facilities are open. 68. When the senior center is closed that also closes the kitchen. Consequently the isolated home bound people who depend upon Meals on Wheels will not get a hot meal. 69. There are no free exercise classes or supervised exercises. 70. It is necessary to be a paid member in order to be a senior center volunteer. 71. There is an unwritten policy for giving free memberships. 72. The manager's salary is extremely high. 73. The locked exercise rooms with heavy duty high cost new equipment are usually empty. It is unwise to have Seniors exercise in those locked rooms. 74. Some classes that are held only have a few people attending. 75. Members who don't use the exercise rooms or exercise classes must also sign a very harsh waiver of liability when they join the senior center. 76. Non-members and visitors do not have to sign a waiver of liability but members do. 77. Minutes of the senior center commission are posted on a bulletin board in an 5/3/2010 Page 9 of 10 area where few people ever go. 78. The Art classes are very costly. Only paid members of art classes get to use the art room. 79. The fees for classes is often paid directly to the teacher on the first day of class instead of being paid at the reception desk and run through the city books. It is hard to see in the revealed financial charts what is being paid to the teachers or the payments to the senior center. 80. The periodic program guides are confusing and contains entries about things that are not happening at the senior center and some that just filler. The cost including the mailing are not revealed to the senior center commission. 81. There is no effort to encourage participation of minority group elders. It is rare to see a person of color at the senior center. 82. There is no volunteer room, only the small office for the volunteer director that is barely big enough for her office desk and her couch. 83. There is too little oversight of the management of the senior center by the city manager or the city council. 84. There has been only one lower income person to serve on the senior center commission during the past 9 years and perhaps from when the senior center commission began. 85. Most of the members of the senior center commission for the past 9 years have had some type of connection with the Univ. of Iowa. 86. The overall atmosphere of the senior center is quiet and somber, class divided, and highly controlled. 87. The job descriptions for all of the staff need to be reviewed and revised. 5/3/2010 Page 10 of 10 88. The current job description for the coordinator of the senior center does not reflect a position worth over $90,000. per year. 89. There seems to be an effort to run the senior center like amini-junior college. 90. Most of the commission members rarely come to the senior center to talk with the seniors who come there, especially during the lunch time. 91. The agenda for the senior center commission does not reveal what the director is going to cover when she gives her report. Consequently things get discussed that are not on the agenda. She also does not provide a written report. 92. The meeting date for the senior center commission is not stable. 93. The stats that are given on Participation reports appear to be inflated. 94. The financial chart that is given to the commission members seems very inadequate. 95. The high cost for membership for people who live outside of Iowa City seems very unfair and unnecessary. Signed: Charlotte Walker 5/1/10 Comments (0) ~ Permanent Link 5/3/2010 Page 1 of 1 #~~ ~ Marian Karr From: Jay Honohan [honohan@hebblaw.com] Sent: Thursday, May 06, 2010 10:51 AM To: Council Cc: helling@iowa-city.org; Linda Kopping Subject: Walker resignation The Honorable Mayor Matthew J. Hayek and City Council Iowa City, Iowa 410 E. Washington Iowa City, IA 52240 Dear Mayor Hayek & Council: have read Charlotte Walker's resignation and the accompanying material. I do not intend to engage in a response, however, I want the council to understand that my lack of response does not indicate that agree with any of the items that she has listed. Jay Honohan Notice: This E-mail (including attachments) is covered by the Electronic Communications Privacy Act, 18 U.S.C. 2510-2521, is confidential and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. Although this e-mail and any attachments are believed to be free of any virus or other defect that might affect any computer system in to which it is received and opened, it is the responsibility of the recipient to ensure that it is virus free and no responsibility is accepted by Honohan, Epley, Braddock & Brenneman LLP or the author hereof in any way from its use. If you have received this communication in error, please immediately notify us by return e-mail. 5/6/2010 31a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: AIRPORT COMMISSION One Vacancy -Unexpired Term Effective Upon Appointment -March 1, 2012 Duties: To exercise all the powers granted to cities and towns under Chapter 330 of the Code of Iowa, except the power to sell said airport. To annually certify the amount of taxes within the limitations of the Statutes of the State of Iowa to be levied for Airport purposes. All funds derived from taxation or otherwise for airport purposes shall be under the full and absolute control of the Airport Commission, deposited with the City Treasurer, and disbursed only on the written warrants or order of the Airport Commission. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Airport Commission meets the second Thursday of each month at 5:45 p.m. Applications must be received by 5:00 p.m., Wednesday, May 5, 2010. 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 Commission should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Airport Commission April 29, 2010 AIRPORT COMMISSION ATTENDANCE RECORD YEAR 2010 TERM 1/21 2/18 3/18 4/15 4/29 NAME EXP. Greg Farris 3/1/13 X X X O/E X Minnetta Gardinier 3/1/15 X X X O/E X Howard Horan 3/1 /14 X X X X X Janelle Rettig 3/1/12 X X X X O/E Steve Crane 3/1/14 --- --- --- X X NAME TERM EXP. Greg Farris 3/1 /13 Minnetta Gardinier 3/1/15 Howard Horan 3/1 /14 Janelle Rettig 3/1/12 Steve Crane 3/1/14 KEY: X = Present 0 = Absent O/E = Absent/Excused NM = No meeting --- = Not a Member Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: Council Announcement Date: March 23, 2010 Application Deadline: Wednesday, 5:00 p.m., May 5, 2010 Council Appointment Date: May 10, 2010 AIRPORT COMMISSION One Vacancy -Unexpired Term Effective Upon Appointment -ending March 1, 2012 Janelle Rettig resigned Jose Assouline ~ 814 Camp Cardinal Rd Nolan Klouda ~ 309 Finkbine Ln Apt 9 ODenotes applicant completed the Confidential page of the application. City of Iowa City _ ~ r i ~~`~.®~ Advisory Board/Commission/Committee ~,,.,~'~~ '' ~plication Form CITY OF IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name ,Assea}+ee-- Q,=r-port- ',~-n,w~~~ion Term 6 Years 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: c~ Signature of parent/guardian: ~ r~ ~ ~~ NAME Assouline ~ ,lvse. =-iL-~ '~' =~ ~ r, HOME ADDRESS 814 Camp Cardinal Rd ~~p ~246~ Is your home address (listed above) within the corporate limits of Iowa City? Q -''17es c~ No How long have you been a resident of Iowa City? 32 years OCCUPATION Professor of Engineering/Scientist EMPLOYER Uof I PHONE NUMBER: HOME 319 338 7423 BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: As a professor and engineer I have experience in the administration of technical entities. I have been involved in a number of committees on the welfare of the University. I have also been involved in city and state issues. I am currently the president of a couple of condominium associations and the Iowa City Jewish Federation. 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 December 2008 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I believe that the Airport is an important element in our community both in terms of economy in commercial opportunities. As a result members of this committee ought to be knowledgeable in public affairs and have some t~~hnical knowledge. I think I fulfill both criteria. I have been peripherally in this airport during my involvement eriment on the flight simulator and in collaboration with Prof. Tom Schnell. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I think I could participate positively in discussions concerning the airport's financial and public reports. I might be able to understand the technical aspect of the demands/needs of the airports day-to-day activities. I will always try to provide a fair and balance opinion. In addtion, because of my interest in the community and the well beefing of the economy of our city, I have been involved in various aspects of the city's activities. At the Univers~, I am usually recongnized as a good adminstrator. o c-j ~, R~ ~.; ~ ~~ N -~4 C') ~,~_ o ~' ~, POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. ' articular, if you are applying to be a member of a board or commission which makes recommendations tothe 1,,.~r Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthatSection 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ Yes ~ No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application December 2008 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING 1 ~ i ~r ~~~®t~7 ,!~ ~~IIIi~~ ~- ~..~_ CITY OF IOWA CITY Name of City Board/Commission/Committe~ssee- >~:1 ~ i~or~- C.o rn rri-- ss; 01"1 Date Nam@~ssouline ~ ~-J e~,,~ 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 6). List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS Jose and Susan Rental Inc. 814 Camp Cardinal Rd, Iowa City 52246 ECG Academy Inc POB 2976 Iowa City, IA 52244 N Q ; ~..~ ^~ ~ •. ; T . ~ Y .~..; r cs~a e .~ ^ ~ N f~ .. U~ NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. ~ _ Applicant Signature Signature of parent/guardian (Youth Adviso Address 814 Camp Cardinal Rd 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. ssion only): General Application December 2008 Page 3 of 7 individuals serving on Boards/Commissions/Committees play an important rale in advising the C;ouncrl an o7-tattei-` or' interest to our comrn:.rnity and its fut!?re. A,pp!icants rr~trst reside iti !ova City. After a vacancy Ip~v been announced, ti;e Cour:ci! rev;etrvs a!i applications during the vvor!c session. -i he c1pJaC1i3"iti"ne-?~$ is i"6 :caC~e ~$ t!ie nenf farrrral CtJ~inCil m~'~tltlCt. Appointees Serve ~~ unr~aid volunteer",mss. This form may `ate fii!Gd oLrt rr~anr<ral!y (please use a blac~ int: laerrl, ty;~ewritten; cr electr-o=~ically (I,DF). l~.eturn tht/ application to City C!erl<., ~~~(3 E. ~~ashir~gtan St., laws City, Iowa. THIS APPLICATIONv 1S A PUBLIC DOCUivIENT AND AS SUCH CAN BE REPRODUCi~D AND DiSTRIBUTF_D FOR THE PUBt_IC; Wi-fH THE EXCEPTION C3F THE LAST" PAGE MARKED "~CaNFIbENTIAL." THIS APPLICATION ~Nit..i_ BECOIUSII~ERFD FOR THREE iViONTHS ONLY AID AIJTOi~iATIGAI_.t_Y CONSIDERED FOR ANY VACANCY DURING THAW TIMF_. Teri~~ ~A~ .,,,.: A ACI\/!S!J~/ (r'C~?iC's/~v?r~EYI~SiOn~~.~fl1li'Y'iit`~~ i~lc',°i1~ ':_._ _ ~ `_'_ ----'__=_- -- ----- Y~?~~tt~ Advisor°y Con~rri`~issiora (shirt!I r;c°t !~e mare ti7an 'i~ }/ears of ache art rile fiin~L of a~rlication) I~J,~<<ie of IaaA~~t City I--iic,!~ ~c!sool or t-{ic~h sc!~cca! equivalent: ~,~.~. ° .~,.~....,~,,,,._. •~ ~ 4 .~,® Sigr~at~rre c,f parerrtlguardian: NCartE{?QDRESS ~,~~ t^ L Y± c --t c-~ -~r- r-~- o o ,;., !t fs !F~'-'r I"ra!7Re ai~!dreSS (!rste~:! al~oldr~) V.rt!~ir ttae corpCrate !rmrts of to+ah~G CitJ/~ ~; Yes I-lo~r long Dave ya;~ beers a resident of laws City? ~ === _== CiC~,aJPAT!UN r~;is~;~r~er Se'~~rUe A~~:t~-t, r-r~e;;,~s,ra;~/t ~ EsvrPLU1'I~R~= s- --._- °!-I O t~l E [J U Pot BE(-~: >-I U ~./; ~ ~ ---- -- E~'L~uINESS EXPERIENCE AND/UE~ /~C"i-I!/!-i~!ES lfkfHlCH YUU FEEL UUALII=Y YUU !=UR ~!-HIS PUSI~f~ION: __..._._.._. ._. - 4" ~ ~ zt~~°~ Ti~fYY~G {iS ~'a it {~;it, f1.1<t14 ~ii~ii ~L: i_1e~{ s. l~~r (.~wyra.{!~{r{r..r~4 "l (1S`ls:=~i`:krct;C)e4 6 ~r-;~~co ~ J _ y: +~ c i . rvtll Ct{:?~°tl ~'Cbie=~ie ~g=t, tS 4•~ ~:*-/ - , t - ~ e m ~? C^.~. i,° t~ ~^ rrr ~°c~E-.,t ,fit :"1~~=, ii Jr`l:rl ~. ~i,~i)iE.(:~t=rrC~ {if i.c.r1.~._-.., ~rit~t tl-i~ :~`11V.~.'iSPty C}I „~.r?~ct~, ani ~rl,~s 2 y 3, °Cil`4S, ~ rs~? at ~ i'v+~r1 ti; , e ` iz st~rnntC'€?~. c.?t~vri~- tt=a f~3ti?tsf ~I~} Q~t?~ ~~ ~ rl~recist~i rsi ~.ilT iit ~%~i%i~a`i. Fr'i ('i~,'I ilc~ve i;Jii~ is~C1 wit i~tc".,iti--~~ .. .- - °- - ~'`-:Cli:~'i,~'`~~~- i(t~`~`(i~?:Ed~i;.'si rc';"~°r°'.)~i ~.cTifs"~' rciirli'€~ As cz Ccti`1Cii:.v[ze `'~a ~(it-.' ~:!?,~„+ '~ ~-L?%~tls,~i.i}33 ,~3f7~>t ci ~r`~'~ll ~~s4~}e ~:i;=e, i~c=%'ji''=~ :e;[i%sl`vf:~1`;° 1~:3~)i`~`r;tj'~;~?~ r ca":~..,~~eiil~ti ~~ N°isi" 'sgS~~{~ -~ c ",~„~ rat,-.:,., .-.-,~y:~~• ~~?! ~ vl;l;SkC2Ci'~n, .f ,.;~.~a to it-i ~a- .. ~Sa•i`t4= ~-. , ~ ~e•_:,s,v; ss-:. „:. ;. i~rtsrel~ruse, tc~.tivilS Grb this c'~~tl~!I%:.°'tl~1n E/`ii11 Cfl~stit~ite (~+~~ C~Ll:i~ fC31' r~-;llfl~f~ti yr cs(~ ~I~~Jrni.~c"'... It ~1Cti., °c,1, tC? c€r1S~^.`~ all ti2? gt.i~5tions, Ciorrtnc!i ~,~,3° n~i Gfli1Si~~ter'/C~L'r c^. ;:7}~ll''~tiJn ~.-3en~rc~! A,:}i~!4Cw t?Ct;l -~, ; ~~ 6°"~3 V ,~~.z!' I`i o WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I know the Airport Commission exercifies stat!,tor;~ authority over the lo~va City l~~unicipa! Airpork and makes decisions regarding the aHocatian of funds. WHAT CONTRIBUTIONS D® YO'J FEED YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE R~a~nnl r=nR APPLYING? l have knowledge of, and experience in, i©cai g~~vernment admini5tratic~n thiat l can draw upon in discussions. I believe 6 can provide a fresh perspective as 4.~ell. Although 1 am fairly new to tF-ie Iowa City area, i live near the airport and take an active interest in the community. I can effectively reNretient the public interest in a fWir end equitable v~ray; 1 understand Loth the adrf~inistrative ar-rd political sixes of issues- N a 0 -n :~ c? m ~ _.,t w C'7 ~ J i'®'°'o --~ ~ ~ -a F_.. __•, PQTENTIAL CONFLICTS OF INTEREST == w Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. Ir ~yrricuiar, if you are applying to be a member of a board or cornrrrission which makes recomrr~endationstothe G. Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding fio~~t tl-~e City. "Affiliation" includes being a board rnr/mk~er or employee of the agertcy.C3iher~ types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know That Sectiarr 362.5 oft°r~e Code of Iowa generally prohibits, with certain irr~partantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict ofi interest exists or have questions about Section 362.5 of th~C;nci~ of Iowa. r3lease contact the City Attorney's office at 356-5030. IF YC~lri fi=,:?E l~!O~i SELECTED, ®O YOU 1NAt~T TO BE 1~JCC;?T!i (ED? ~~ j Yes ~ No l~3Q .1fC~.1 C:t~i~REI~;TLY SEFcVE O[~ ANOTHER {QO~IA CITY k3OARD OR CCaf~'li~rlSSlON? % ~'es .-w ~ f~io (lt has beLrs Council po=icy not to pe~~trit arr individual to se~-:de on t~,~o Boards or Cor~~rrrissions at the sarr~,e tirr~e.) "P'~~" ~ '' ~"~"u'~iC21"ts C7 i7 ti~4s u~p!€L'~~'i~! ~ ~.h`II! a C?tl~'~i%UiG f U~t Gc~USv ~o!` fenl~t~J~l Ci~t'ari ~p}.~'O';~4:Ge. if y~t.~ idii Cj ~rIU~J~.``°i' al ~!"s C- glr~strCirl~, CGL4riC`1 may rrot C~fosi~l~; yCr~~r" a~i~lrLatiC?~i. Cer ke±~ ~ ~i~~sic..-~t1C3n Jan~r~r';' `0'i0 rage :~ of ~ SC~ARDS CC}MMISSIQN ANQ CC?MMITTE~S ~USIN~SS LlSTtNG Name of City Bc+arcl/Gommissian/Committee Airpart Commissian Name i5!aiQn lF;ic;,sda Date Section 362.5 of the Gade of laws 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 6). List all businesses in which you, year spouse/domestic partner, or parent if Youth Advisory Commission a~plic~nt, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stocki~roldings). Please indicate if there are none. acquired in an additional business. /applicant Signature Signature of parentlguardian (Youth Advisory Corr:mission only): Address 309 FnkbinP Ln. Apt. lv1isrepresentations on this application wi!! constitute just cause for removal ofi an appointee. if you fail ~! to ar~,swer all the questions, Council may not consider your application. Genera! Application ,1ant~~ar\,r ~~1Q Page 3 of 7 l~lG~T~: A new farm must be completed if the above infarmatian changes or an ownership interestis Page 1 of 1 Marian Karr From: Howard Horan [hhoran@msn.com] Sent: Wednesday, May 05, 2010 2:55 PM To: Council Subject: Airport Commission Candidates Dear Friends, I think Nolan Klouda would be a good person to fill our vacancy. His interest in public administration would be an important asset to our group. It also appears that he has family experience in airport operations. I hope you will chose him. Thanks and I'll see you Monday evening. Howard Horan H Horan Studio 2711 Muscatine Ave. Iowa City, IA 52240 319 351 2813 hhoran@msn.com hhoranstudio.com 5/5/2010 05-10-10 31b NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy -Unexpired + 5-yr Term Effective Upon Appointment, ending December 31, 2011 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, May 5, 2010. 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: June 13, 2006; August 1, 2006; September 5, 2006; September 19, 2006; November 14, 2006; December 12, 2006; January 9, 2007; February 20, 2007; March 20, 2007; May 1, 2007; June 5, 2007; July 24, 2007; September 18, 2007; November 5, 2007; December 11, 2007; January 29, 2008; March 11, 2008; April 14, 2008; May 13, 2008; June 17, 2008; July 15, 2008; August 26, 2008; October 6, 2008; November 18, 2008; January 6, 2009; February 24, 2009; March 24, 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 Application Deadline: Wednesday, 5:OOp.m., May 5, 2010 Council Appointment Date: May 10, 2010 AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy -Unexpired + 5-yr Term Ending December 31, 2011 Carl Williams resigned No applications as of Wednesday, S:OOp.m., May 5, 2010 Denotes applicant completed the Confidential page of the application. 31c 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, May 5, 2010. 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. 31d NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING COMMISSION One vacancy -Six-Year Term January 1, 2006 -December 31, 2011 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, May 5, 2010. 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 20, 2005; November 1, 2005; December 13, 2005; January 23, 2006; February 28, 2006; March 21, 2006; April 18, 2006; June 13, 2006; August 1, 2006; September 5, 2006; September 19, 2006; November 14, 2006; December 12, 2006; January 9, 2007; February 20, 2007; March 20, 2007; May 1, 2007; June 5, 2007; July 24, 2007; September 18, 2007; November 5, 2007; December 11, 2007; January 29, 2008; March 11, 2008; April 14, 2008; May 13, 2008; June 17, 2008; July 15, 2008; August 26, 2008; October 6, 2008; November 18, 2008; January 6, 2009; February 24, 2009; March 24, 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 Application Deadline: Wednesday, 5:OOp.m., May 5, 2010 Council Appointment Date: May 10, 2010 AIRPORT ZONING COMMISSION One Vacancy -Six-year Term January 1, 2006 -December 31, 2011 Term expires for Mark Anderson No applications as of Wednesday, 5:OOp.m., May 5, 2010 ~ Denotes applicant completed the Confidential page of the application. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, 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 Application Deadline: Wednesday, 5:OOp.m., May 5, 2010 Council Appointment Date: May 10, 2010 AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy -Five-Year Term January 1, 2009 -December 31, 2013 Term expires for Dennis Keitel No applications as of Wednesday, S:OOp.m., May 5, 2010 D Denotes applicant completed the Confidential page of the application. ua-~ u-~ u 31e 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, May 5, 2010. 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 Application Deadline: Wednesday, 5:OOp.m., May 5, 2010 Council Appointment Date: May 10, 2010 AIRPORT ZONING COMMISSION One Vacancy -Six-year Term January 1, 2010 -December 31, 2015 Term expires for Brian Sponcil No applications as of Wednesday, 5:OOp.m., May 5, 2010 ~ Denotes applicant completed the Confidential page of the application. 31f NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF APPEALS One Vacancy- Five-Year Term January 1, 2009 -December 31, 2013 One (1) Mechanical Professional It is the duty of members of the Board of Appeals to hold appeal hearings on matters concerning the Uniform Building Code, Uniform Plumbing Code, National Electric Code, Uniform Mechanical Code, Uniform Fire Code, the Dangerous Building Code, and the Iowa City Housing Code. Members must be qualified by experience and training to pass upon matters pertaining to building construction. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets the first Monday of each month at 4:30 p.m. or at the call of the Building Official. Applications must be received by 5:00 p.m., Wednesday, May 5, 2010. 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 regarding the Board of Appeals should be directed to Tim Hennes, Sr Building Inspector at 356-5122. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 5 Females: 1 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 Application Deadline: Wednesday, 5:OOp.m., May 5, 2010 Council Appointment Date: May 10, 2010 BOARD OF APPEALS One vacancy -Five-Year Term (1) One Mechanical Professional January 1, 2009 -December 31, 2013 Term expires for Tim Fehr (Mechanical Professional) No applications as of Wednesday, S:OOp.m., May 5, 2010 ~ Denotes applicant completed the Confidential page of the application. 31 NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF LIBRARY TRUSTEES One Vacancy -Unexpired Term Effective Upon Appointment -June 30, 2013 The Board of Library Trustees is asemi-autonomous body of nine persons empowered by State Law to plan, direct, and control all affairs of the Public Library. This includes determining long-range goals of Library service, adopting written policies to govern operation of the Library, and employing a competent staff to help plan and implement the Board's service goals. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Library Board meets the fourth Thursday of each month at 5:00 p.m. Applications must be received by 5:00 p.m., Wednesday, May 5, 2010. 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 vwvw.icgov.org. Questions about the Iowa City Board of Library Trustees should be directed to Susan Craig, Library Director at 356-5200. 3/24/2010 ~ ~O m ~Z ~ O ~~~ "~ a~,m x m ~ a --i ~ ' Z; " 7 ~ ~ N ~ 3 Q p s . Q N s Q ( ~ ~ ~ ~ rn ~ ~ 1 S 4 ~ 3 Q ~ ^ ^ li ~ ~ p s m f ~ • .~ ~ ~ m o ~ ~ , ~ Q m ~ ' ~ ~ \ \ \ \ \ \ \ \ W W O W W O W W O ~ w to w c„ to w ~ x x x x x x x x x ~ 3 o ~ ~ = ~ m g p x x x x x x x N m N ~ t iY 0 x x x o x x x x x R+ .. o~ 0 x x x O x x O x x .~', ~ m ~ m N N ~_ O N V r 0 O~ ~,. A ~_ O V ~... ~' _ N; Q OD N O~ O *0 , N W O 0 -~.. N 001 .. O •~.. .+ :, 00 O N O~ O ~~ na ~o z ~ m m a~ ~o m Nn op 7D ov 00 0 D 0 n 0 ~• o~ 3 n r 00 0 c a 0 c t~ N Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 5 Females: 3 Council Announcement Date: March 23, 2010 Application Deadline: May 5, 2010 Council Appointment Date: May 10, 2010 BOARD OF LIBRARY TRUSTEES One vacancy -Unexpired Term Effective Upon Appointment -June 30, 2013 (Michael Cohen resigned) Holly Carver ~ 2301 E Washington St Lyn Hoversten ~ 29 Wolfbrook Circle D Denotes applicant completed the Confidential page of the application. r i City of Iowa City r ~.®~r Adviso Board/Commission/Committee ~;,~~"';~``'~ rY aNplication Form ~'~`-'_-- CITY Of IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Board of Library Trustees Term thru 6/30/13 Youth Advisory Commission (shall not be more than 18 years of age at the time of ap~cation) Name of Iowa City High School or high school equivalent: _~ __ ~~ ~ .~. j a Signature of parent/guardian: ~~~ ~~ - Holl Carver -~ !1_ _~ ~~~~ ~ N, - Y _ r-~~_; _ f-`' ^ '- ~.rr..~ HOME ADDRESS 2301 E. Washington Street, Iowa City _~~j"p 522'45 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? 25-plus years OCCUPATION Director, University of Iowa Press EMPLOYER University of Iowa PHONE NUMBER: HOME 319/337-4739 BUSINESS 319/335-2013 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: An addiction to books and reading would qualify me for this position in any other town, but in Iowa City there is nothing special about this addiction. Thus I will have to rely on my forty-plus years of experience as an editor and 'publisher of books, first at the University of Texas Press and then at the University of Iowa Press. I recently completed athree-year term on the board of directors of the Association of American University Presses; this experience gave me fresh appreciation for the collective energy generated by a focused, well-intentioned group of people who bring diverse experiences to bear on common problems. "Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail answer all the questions, Council may not consider your application. General Application January 2010 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? little. I count about half of the members as friends, but I have never discussed board business with them. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I've spent many years creating books--acquiring and editing and producing specialized academic books as well as works of poetry and short fiction. I've also spent many years managing the people who do all the hard work involved with creating books--not just the hundreds of authors I have worked with but the many editors, designers, etc., I have worked with. I would like to apply this experience to the end user--to the library, its collection, and the many people who take advantage of it--and work with other members of the library board to ensure that Iowa City's library continues to be a central focus of our town's literary community. Iowa City's designation as a UNESCO City of Literature has made the library even more influential and responsible for the future well-being of our town, and I would like to support the library's partnership in this significant designation. As the Iowa City Book Festival makes plans for its second year, it is good to see the library involved with this emerging annual event, and I would like to support this also. Recent contact with Maeve Clark and the amazing Eco Iowa City venture have given me even more reasons to appreciate the energy and goodwill of our city's librarians. And finally, after years of enjoying all the benefits that an Iowa City Public Library card brings, it's time for me to try to do something for the library in return! POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about ~sction 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. ~A _ ,3 ~ {~ I do not think that membership on the library board would present a conflict of interest. ~ ~--~.. .~~ ~ W y d ~,, -. ` ~ [~'~ i ~ 3 ~ 9 IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes Nod 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 ,answer all the questions, Council may not consider your application. General Application January 2010 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Board of Library Trustees Name Holly Carver r~oa~ ~~:~I~II, ~~~ -•n.a~. CITY OF IOWA CITY Date April 22, 2010 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 6). List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS NONE `3x _..„r t^a f t T' b -- ^.3 - _ ~ CrJ NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. Applicant Signature '~ ~"'`-e Signature of parent/guardian (Y ~C~~i~~ Advisory Commission only): Address 2301 E Washington Street, Iowa City "~isrepresentations on this application will constitute just cause for removal of an appointee. If you fail answer all the questions, Council may not consider your application. General Application January 2010 Page 3 of 7 Marian Karr From: Carver, Holly [holly-carver@uiowa.edu] nt: Wednesday, April 21, 2010 10:15 PM ~; Council Subject: application for board of library trustees Dear City Council Members, Following up on my application for a position on the Library Board of Trustees, I am writing to say that I welcome any questions you may have. Please get in touch at any time. And thank you for considering my application. It would be an honor to become part of this vibrant, vital group. Cordially, Holly Carver Director, University of Iowa Press 119 West Park Road, 100 Kuhl House Iowa City IA 52242-1000 319.335.2013 phone, 319.335-2055 fax http://www.uiowapress.org 1 City of Iowa City ~ r __~ Advisory Board/Commission/Committee ~.,~'`'~~ ~` ~plication Form ~'`-"- CITY OF IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Board of Library Trustees Term Youth Advisory Commission (shall not be more than 18 years of age at the time of aRplication) 0 Name of Iowa City High School or high school equivalent: Signature of parent/guardian: ~=''~ ~` ~~ CJ'1 ~ C ._ NAME Lyn J. Hoversten Hafner =tip-f~ ~ ~r~ ~.3 .1 HOME ADDRESS 29 Wolfbrook Circle Iowa City, IA -~.=SIP 346 ~""~ 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? We moved into our home 1/14/1991 OCCUPATION Secretary II/Student Services Staff for CCP EMPLOYER University of Iowa PHONE NUMBER: HOME 319-631-3823 BUSINESS 319-335-2579 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I have been an active patron of the Iowa City Public Library since I first moved to Iowa City in January 1991. Since I had two, then three small daughters, our first visits centered around the Children's Room and Toddler Storytimes. Later both Hayley and Carly volunteered with Katherine Habley and then were members of Kids Spectacular with Debbie Dunn. Carly continued with the Teen Advisory group until she graduated last May. I've purchased books at the Book End, attended book talks/signings, and enjoyed a variety of other events. My first job after staying home with our younger daughters was as a ICCSD media secretary. I've belonged to a book group for over 25 years; first in Ames, then here in town. I earned a Bachelor of Science in English from Iowa State University. In short, I'm a reader who is interested in the continued excellence of the Iowa City Public Library. 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 January 2010 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Although I've been aware of the Board of Library Trustees existence for years, probably because their picture is on display in the lobby of the lovra City Public Library, until t attended the April 22, 2010, -meeting and read the minutes, I ~~~as not aware of the scope of the programs and services that the Iowa City Public Library provides to our ~ munity. I would like to learn more about the library programs and help promote the ICPL. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE RFncnN FnR APPI YINGI? It is difficult to "toot your own horn" but in my opinion, my attention to detail is one of my strong points. Years ago, .was a technical editor for the Engineering College at Iowa State University. As a parent representative on the Iowa City Music Auxiliary, that skill was helpful when we revised the bylaws. I've worked in several libraries in my past 'including three years as a workstudy student worker for Iowa State University's Main library. I consider myself open Tito new ideas and easy to work with. I hope to be able to volunteer my time as a Board of Library Trustee. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. I~ !rticular, if you are applying to be a member of a board or commission which makes recommendations tothe C~~y Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthat Section 362.5 of the Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. ,~ ~, ' ~ ~ ~ -; $,_ ,~~ ,~. ;. ~~, ~~. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? U Yes ~_lyo co ~;_ ~,~1 DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ Yes ~ No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application January 2010 Page 2 of 7 BOARD, COMMISSION AND. COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Board of Library Trustees Name Lyn J. Hoversten Hafner _~ r ®~ °' ,~I"~~ -~c.a4_ CITY OF IOWA CITY Date 05/04/2010 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 6}. List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS none N Q ~ _ _'~^ C'3 --:. -~ ~ ~a ~... ~ NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business Applicant Signature ~ Signature of parent/guardi~f (Youth Address 29 Wolfbrook Circle, Iowa Cit Commission only): 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 January 2010 Page 3 of 7 Marian Karr From: Hafner, Lyn J [lyn-hafner@uiowa.edu] ;nt: Wednesday, May 05, 2010 2:51 PM ` , o: Council Subject: FW: Scanned Board of Library Trustees application Attachments: 20100505115144158.pdf ,f 2010050511514415 8.pdf (415 KB)... Dear City Council Members, Please find attached a scanned copy of my application for Board of Library Trustees submitted earlier today, Wednesday, May 05, 2010. If you have questions for me, I can be reached at Lyn-Hafner@uiowa.edu Sincerely, Lyn Hafner 319-631-3823 -----Original Message----- From: Hafner, Lyn J Sent: Wednesday, May 05, 2010 10:31 AM To: 'PmcCarthy@icpl.org' Subject: Scanned Board of Library Trustees application .tti, As promised, please find attached a scanned copy of my application for Board of Library Trustees. Have a great day! Lyn Hafner Student Services Center for Credit Programs 319-335-2579 Lyn-Hafner@uiowa.edu -----Original Message----- From: scanner@continuetolearn.uiowa.edu [mailto:scanner@continuetolearn.uiowa.edu] Sent: Wednesday, May 05, 2010 10:52 AM To: Hafner, Lyn J Subject: This E-mail was sent from "RNPC31CF5" (MP 7500/LD275). Scan Date: 05.05.2010 11:51:44 (-0400) Queries to: scannerCcontinuetolearn.uiowa.edu 1 31h NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: POLICE CITIZENS' REVIEW BOARD One Vacancy -Unexpired Term Effective July 1, 2010 -September 1, 2013 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, May 5, 2010. 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. 3/24/2010 O ~C zz~yro ~~ a'a'~ y "/- ~ ~ p ~- ~ r+• ~ ~ ~ ~ ~~ 0 ~ ~ 0 ~ ~ ~ y 0 - ~ ., a ~ ~ a a T ~ ~ a va ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ _ N N W w N b o ~ ~ ~ ~ i ~ 2 z z N b N i i k ~ ~ ~ ~ O ~ ~ A yC ~ O k ~< W y ~ ~d ~, y ~ ~• ~' ~ ~ o~ ~~ 0 b n n z 0 v 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 Female: 2 Council Announcement Date: March 23, 2010 Application Deadline: Wednesday, 5:00 p.m., May 5, 2010 Council Appointment Date: May 10, 2010 ** Appointments fo the Board shall include one current or former "peace officer" as that term is defined by Sfate 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 righf to waive the residency requiremenf for good cause shown. POLICE CITIZENS' REVIEW BOARD One Vacancy -Unexpired Term Effective July 1, 2010 -September 1, 2013 Vershawn Young resigned Peter Jochimsen ~ 1010 Woodlawn Ave Daniel Talton ~ 320 S. Gilbert St Angelina Blanchard-Manning D 151 Cayman Gregory Roth ^D 324 4th Ave ~ Denotes applicant completed the Confidential page of the application. City of Iowa City ~ r 1 Advisory Board/Commission/Committee ~,;~'~~, Application Form ~-~-- CITY OF IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Police Citizen Review Board Term ends 9-1-2012 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 Peter R. Jochimsen -7ME ADDRESS 1010 Woodtawn Ave. ZIP 52245 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? 35 years OCCUPATION Surgeon EMPLOYER Retired/Selfemployed consultant PHONE NUMBER: HOME 319-351-6649 BUSINESS Medical teaal consultant EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: A long career at the University of Iowa, and Chief of Surgical Services at the VA, as well as vice-chairman of the Department of Surgery for a time, provided me with ample opportunity to participate in and lead numerous committee meetings, often with multiple contentious points of view and equally strong willed persons all convinced of the rightness of their position. This was certainly true, as an example, of the Iowa City Deer Task Force. Twenty two and more years as an active Naval Reservist, as a Senior Captain, gave me the opportunity to participate in Captain's Mast, a judicial hearing involving an accused and a legal authority. My civil trial work as both a plaintiff and defendant's medical expert witness has given me great experience in trial work and in appreciation of fact gathering and of testimony. c~ o Misrepresentations on this application will constitute just cause for removal of anoir~e. If fail to answer all the questions, Council may not consider your application. ~ ~ CII neral Application ~, ~" ~ uanuary 2010 Page 1 of 7 = "~'`' w rr, WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Knowledge is based primarily on newspaper reports and other new's outlets detailing the activities of the Board and interactions with citizens of Iowa City and surrounding areas. i WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? As I am now retired from my University career as Director of Surgical Oncology and as Professor Emeritus in the Department of Surgery, I have the ability to devote more of my time to civic duties. I have served in the past on the Historic Preservation Commiission and, as well, the Deer Task Force. I am familiar with the operations of Advisory Boards, Commissions, and Committees. I appreciate that the opportunity to serve is a privilege. With recent issues raised concerning and dealing with the Police Department, and other law inforcement agencies, within the community, interacting with the members of the community, a great need exists to enhance and encourage the dialogue occurring between the two, to reach a better and more comprehensive appreciation of the difficulty experienced by the people and law inforcement. The very long time I spent acquiring credentials to practice surgery, a small rural college, medical school in Milwaukee, and more than seven years in Minneapolis for my residency, have', provided me with a good understanding of the issues related to students and many of the difficulties that seem to ', exist in a University environ. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. In particular, if you are applying to be a memberof a board orcommission which makes recommendations tothe amity Council about the allocation of City funds, please list any present affiliations you have with agenciesthat ply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthatSection 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). N If you are uncertain whether a potential conflict of interest exists or have questions abot~Section 362.5 of .~__/~_ ~_ _e ~_____ .1___. __._i_.a 1L. /1!1.. All..... ...f. .1C... _i APn PA/1A ine~oae or Iowa, please coniaat ine very Htrorney s u~rice ati oav-~vou. ~~~ m ~t -=~ I know of no conflicts of interest. c-~--~ - ~ -=-~ n :~~ ~. r~°7 ~ a~ - IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ©Yes ~ N~' DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ Yes 0/ 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. ~neral Application January 2010 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Police Citizen Review Board t.=.f.r p wr®'~~ -•~..~__ CITY OF IOWA CITY Date 02/10/2010 Name Peter R. Jochimsen 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 6}. List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please Indicate If there are none. BUSINESS NAME BUSINESS ADDRESS None r ~~ ~ ~ ..d; "" -"t C"3 C'r- ~ ..- ..T r-. -r ~' ~ NOTE: A new form must ~ completed if the above information changes or an ownership interestis acquired in an ad '~t~al b e' s. , ~. Applicant Signatur Signature of parent/guardi Youth A visory Commission only): Address 1010 Woodtawn Ave. 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. ;neral Application .-anuary 2010 Page 3 of 7 City of Iowa City ~ r 1 _~~~ Adviso Board/Commission/Committee ~'~' '~~ ~ ~ ~®~~~ Application Form ~-~-- CITY OF 10WA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Police Citizen Review Board Term Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: ° ~~ m ~.~~ Signature of parent/guardian: r-~_, oo ~,~, na NAME Daniel James Tallon HG. ;ADDRESS 320 S. Gilbert Street Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? 3 1/2 Years OCCUPATION Soldier /Server PHONE NUMBER: HOME 563 271 9747 EMPLOYER Iowa National Guard! Atlas /Jimmy Jack's Rib Shack BUSINESS N/A EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: My biggest life experience is my nearly Four years service in the Iowa Army National Guard. Although I have a long career ahead of me, I have learned many lessons in that time, the formost being professionalism, integrity, and service. I served as a member of my Church Vestry for several years and represented my church at our diocesan convention. I donate much of my time to the political party that I am a member, and donate my time to the Central Committee. I also rely on my life experiences to from a majority of my opinions and perspectives, these expereiences include growing up in a very diverse lower income household, which has become the backbone of my view on life, and the sole reason 1 so often search for ways to serve. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail t~ answer all the questions, Council may not consider your application. -, . _ r ~- ~~ -~r~ p ~L240~ Yes -~ No eneral Application January 2010 Page 1 of 7 VVI-iHl 15 YUUK F'KtJtIV I KNUVVLCUI~t Ur 11-115 f~UV15UKY tiUHKU~! The PCRB is charged with reviewing Iowa City police policies as well as complaints against officers employed by the city. The PCRB recommends action the City Council. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I believe that I would be an excellent choice for this position because, I would carry out my duties in a professional manner and contribute my personal experiences to the board. I very likely differ from other choices in age, Socioeconomic status, and life experiences, but those difference would be my biggest contribution. N O Cr -n u~'~ c~~ t~ ~ -~ w ~'°~ ,,,~ ~ ~ Cy .r~ POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations tothe City ~uncil about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ Yes ~ No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail t~ answer all the questions, Council may not consider your application. 3eneral Application. January 2010 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Police Citizen Review Board Name Daniel James Tallon ~- ~Ill~~t'i -n..s__ CITY OF IOWA CITY Date 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 6). List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS ---- d tti ~.~ cs o •.; a.` ~ mob` "' d+.., aa t NOTE: A new form must be completed if the above information changes or an owagrship"restis acquired in an additional business. ~' ,~.- ~ . Applicant Signature ~ ~~~ d -.___~ ~$ ~= Signature of parent/guardian (Youth Advisory Commission only): Address 320 S. Gilbert Street Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail +~ answer all the questions, Council may not consider your application. General Application January 2010 Page 3 of 7 Page 1 of 1 Marian Karr ' From: Mark McCallum [mccallum_mark@hotmail.com) Sent: Tuesday, February 23, 2010 3:01 PM To: Council; Mark Subject: Police Citizens Review Board Candidate ,Dan Tallen Council Members: Dan Tallen will be making an application for a position on the Iowa City Police Citizens Review Board. I met Dan last fall during my candidacy for council and while our "World Views" are somewhat at odds. I found Dan to be very bright, alert and very capable. The characteristic that stands out in my mind about Dan , is that he is a man of his word. Whenever Dan tells you he is going to do something, he does. I think this is one of the most important things an individual can have in our society today. Dan exhibits compassion for his fellow man , is a critical thinker and it is without reservation that I recommend him for a position on the Citizen Review Board: You will find Dan of the highest integrity-conscientious, truthful, and loyal. If I can be of any further help or assistance, please do not hesitate to call. Sincerely, Mark McCallum 932 East College Street, Iowa City, Iowa 52240 Cell 1-319-430-1461 Hotmail: Powerful Free email with security by Microsoft. Get it now. 2/23/2010 City of Iowa City ~ ~~ ~ -~ Advisory Board/Commission/Committee ~~,~-"',~~ t-_,~piication Form CITY OF IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Advisory Committee - pLlz-P Term Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: ~, ° Signature of parent/guardian: `~~ * ~~ ~ c-3--~ ~ ~ 'CIE Angelina R. Blanchard-Manning ---~ -a ~~,\v(11e \Rast Zalo HOME ADDRESS 151 Cayman ~^~s ~^ ~'"~`~ c~ 545 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 OCCUPATION Program Coordinator _ EMPLOYER Comm. Correct. Impr. Assoc. PHONE NUMBER: HOME 319-471-0181 EXPERIENCE AND/OR ACTIVITIES WHICH YOU BUSINESS 319-540-4195 FEEL QUALIFY YOU FOR THIS POSITION: Currently my position as coordinating Children of Promise has put me in direct contact with at risk youth. We find rnentors for teens who have a parent using correctional services (parole, probation, or prision). We not only work to build rapport with the youth but also the family. I work closely with the department of correctional services and understand the importance of their presence in society. I also serve on the editorial board for the Press Citizen and the Program Coordinator Committee at the Housing Authority. 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 January 2010 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Reviewing cases brought up against the police dept. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? believe I can bring`~ny perspective as a young, female, minority in this community along with the insight I've gained working wn und~rreented population that are not only minority but also working to get out of poverty. ~ ~~ ~ ~~ ~~ ~ ;~~. a. N POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. 1. articular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthat Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. None that I am aware of so long as I represent myself and not the agency I work for ~, 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 ~ No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail `~o answer all the questions, Council may not consider your application. General Application January 2010 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Advisorv Committee _~ r ~~~ r~~~ ~~~~~ -•t.as._ CITY OF IOWA CITY Date 02/24/2010 Name An elina R. Blanchard-Manning 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 6). List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS None ~, ~~ ~ ~~ e ~ -D - ~ '~'. " W r NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. Applicant Signature Signature of parent/guardian (Youth Advisory Commission only): Address 151 Ca man Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail Ito answer all the questions, Council may not consider your application. General Application January 2010 Page 3 of 7 i City of Iowa City r Advisory Board/Commission/Committee ~ ~"'~"~~~ application Form ~-'s-- CITY OF IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Police-Citizen's Review Board Term 2010 Youth Advisory Commission (shall not be more than 18 years of age at the time of ap~ication) Name of Iowa City High School or high school equivalent: c> a~ ~ iF a Signature of parent/guardian: ~'~ ~' °~ -~ -,__ ~~ MME Gregory E. Roth ~ ~_ 545 HOME ADDRESS 324 4th Ave., Iowa City, IA ~" I _ 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? g:~jrears ~~ ~~~,~$:-~ OCCUPATION Assistant Professor EMPLOYER Kirkwood Community College PHONE NUMBER: HOME 319-330-7389 BUSINESS 319-398-5536 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: have a Bachelor of Arts degree in Criminal Justice Administration and a Master's of Science degree in Multidisciplinary Studies [Political Science, Sociology, Corrections, Higher Education]. I currently teach college level criminal justice courses including criminal law, constitutional law, and cultural awareness. All of these courses apply to this Board's function to provide citizens with an alternative manner to voice their complaints. I have an understanding of law enforcement, the criminal law, the constitutional rights of citizens and the limits placed on the police, the theories behind the committing of crimes, and the cultural aspects that may impact interactions between the police and various groups. All of these are often included in complaints. 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 January 2010 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I was a member of the Board for 11/2 terms and acted as Vice-Chair for part of that time. I was on the Board with Mr. '<ing and Ms. Bravermann. Due to my experience, I know the rules by which the Board functions, its general tructure, and its operating premise through investigative reports, discussion, findings, and reporting to the City Council WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I am applying for the Board because of my philosophy. I do not feel a Board of this nature is either an advocate for the police or for the citizens. It's function is to provide the public with a way to voice concerns without going directly to the police department. The Board it to consider the information about the complaint in a neutral sense and make a decision based on the facts of the citizen-police interaction. The Board then recommends any relevant followup measures such as a change in police policy/procedure, a clarification for the complainant about police procedures, or punitive measures against an officer or supervisor. I bring to the Board the legal and constitutional knowledge of what limits are on the police and the rights of the citizens through the Bill of Rights. I neither want the police to be mislabeled through an unfounded complaint or have a citizen's rights violated without some recourse. Neither would benefit the citizen-police relationship and would tend to deteriorate the environment of Iowa City. Both the police and the citizens are dependent on each other and there must be a manner in which concerns can be resolved. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests including financial interests and your duties to an employer. _, i particular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthat Section 362.5 of the Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. ~~~~~ do not know of any conflicts of interest. MAR 1 ~ Z~)~ ', n. `{ 7~-- City Clerk Iowa Ciry, Iowa IF YOU ARE NOT SELECTED,- DO YOU WANT TO BE NOTIFIED? ~ Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ Yes ~ No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause. for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. ~ I General Application January 2010 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Police-Citizen's Review Board ~ r i ~_.:.®~~ "mom' ~ ~~~~~ ~.at.._ CITY OF IOWA CITY Date 03/17/2010 Name Gregory E. Roth 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 6). List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS None N Y ~ ~~ ~ p ~ 1 a' ~ .,~. ~ ~'-"'< q ~ ,... .~ NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. Applicant Signature ~r~x~ia' ~ ~" Signature of parent/guardian (Youth Advisory Co Address 324 4th Ave., Iowa City, IA ~_... . Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer atl the questions, Council may not consider your application. General Application January 2010 Page 3 of 7 31i NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: YOUTH ADVISORY COMMISSION One Vacancy -Two-Year Term January 1, 2009 -December 31, 2010 One (1) person -Tate High The mission of the Youth Advisory Commission is to promote understanding and awareness of Iowa City among Iowa City youth, allow a select group of youth to help make decisions concerning them and their peers, enable youth members to utilize and expand on their leadership abilities, to serve as a mechanism for communication between youth and adults in Iowa City and create a bridge whereon youth and adults can develop partnerships. Membership shall consist of seven [7J members appointed by the City Council currently enrolled in an Iowa City high school or high school equivalent. Four members shall represent City, Regina, Tate, and West high schools. The three remaining members shall be at large. All ages shall. be calculated on the date of the filing of applications, and shall not be more than 18 years of age at the time of application. All members shall be residents of Iowa City. Applications must be received by 5:00 p.m., Wednesday, May 5, 2010. 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.orA. Questions about the Iowa City Youth Advisory Commission should be directed to Marian Karr, City Clerk at 356-5041. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 2 Council Announcement Date: February 10, 2009; March 24, 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 Application Deadline: Wednesday, 5:OOp.m., May 5, 2010 Council Appointment Date: May 10, 2010 (Recommendations to be made by Council liaison) YOUTH ADVISORY COMMISSION One Vacancy -Two Year Term January 1, 2009 -December 31, 2010 One (1) person -Tate High No applications as of Wednesday, 5:OOp.m., May 5, 2010 ~ Denotes.applicant completed the Confidential page of the application. U5-1 U-1 U 31' NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: YOUTH ADVISORY COMMISSION One Vacancy -Two-Year Term January 1, 2010 -December 31, 2011 One (1) person -Regina High The mission of the Youth Advisory Commission is to promote understanding and awareness of Iowa City among Iowa City youth, allow a select group of youth to help make decisions concerning them and their peers, enable youth members to utilize and expand on their leadership abilities, to serve as a mechanism for communication between youth and adults in Iowa City and create a bridge whereon youth and adults can develop partnerships. Membership shall consist of seven [7] members appointed by the City Council currently enrolled in an Iowa City high school or high school equivalent. Four members shall represent City, Regina, Tate, and West high schools. The three remaining members shall be at large. All ages shall be calculated on the date of the filing of applications, and shall not be more than 18 years of age at the time of application. All members shall be residents of Iowa City. Applications must be received by 5:00 p.m., Wednesday, May 5, 2010. 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.orq. Questions about the Iowa City Youth Advisory Commission should be directed to Marian Karr, City Clerk at 356-5041. z~Ox ii~mnu 0 o Dam rt N y y ~D ~p ~ ~ 3 ~ ~ ~ = m 3~x ~~ c ' O N ~D A Q- 0 3 ~ < ~ ~. ~ < .-. ~ .-. ~ v ~ D 3 m .~ w ~ ~ ~ w ~ ~ ~ w ~ ~ w ~ ~ w ~ ~ ~ w ~ ~ ~ w ~ ~ m m ~ ~ 3 z 3 z 3 z 3 z 3 c x x x x N x x x x x x m x x ~. N 0 C D-1 2 ~D mo 3 mo< '* Dz0 v o m ~ oom0 ~3 vN O 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: 3 Females: 2 Council Announcement Date: September 15, 2009; November 2, 2009; December 1, 2009; January 25, 2010; March 2, 2010; April 6, 2010 Application Deadline: Wednesday, 5:OOp.m., May 5, 2010 Council Appointment Date: May 10, 2010 (Recommendations to be made by Council liaison) YOUTH ADVISORY COMMISSION One Vacancy -Two-Year Term One (1) person -Regina High January 1, 2010 -December 31, 2011 Term expires for Hannah Green Matt Lincoln D 715 Caroline Ave D Denotes applicant completed the Confidential page of the application. City of Iowa City Advisory Board/Commission/Committee N o- r c-~ t-•t.f~ -•~ . application Form =~ `~GITI~'DF Ib~!1~A CITY ~-~ ~ . s --- ~- Individuals serving on Boards/Commissions/Committees play an important role ir~~advism~ the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name ~OLLL'~ A~ U1 ~~ ~~ ~ `~~ i~~~~ Term ~u~ ~t-~ ~1 Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or igh school equivalent: ' ~+ ~ h CV-~a1 Signature of parent/guardia . ~M E M~ ~ l v; CC~I '~ HOME ADDRESS ~1 ~ C' Rv~ urn ZIP ~v`ZZi-(~ Is your home address (listed above) within the corpor~arte- limits of Iowa City? U Yes How long have you been a resident of Iowa City? /~ ~/~+~~ OCCUPATION ~7``~tC~ EMPLOYER ~ PHONE NUMBER: HOME 3~`~-` ~~'~ ~" ~ ~~~3 BUSLNESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ZGt,,,vt rn~ a"~ C~a )c!' ~cn-r W ~~0 7-~ ,. ~.,f fi7~[~ l~t.t~ ~ d ~lar'r ~i L-ear'-e~-~~ fie. S ~ct,~ ~~ ,~, l tea- , ~~~ ~ lec~.a..~ ~° ~-~ ~. ~-e! ~~~ ~~.iv,e u~-, t=,L~-e.. 5~ ~ce,~rz c,~ 1~~c vas l~~Z ~cnc~~~ 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. No General Application January 2010 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~"`L~.a~ yoea~ ~i zQ1'y C~rrh m, asrr~v- ac E3 cts ~- r lctlSwt ~fw~^ -~- ~ ~~y WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE RFA~(~N FOR APPLYINGI? i ~-e I ~l~ t :L CL ~ Cc P-2Cc~~ a.-b ,~~ 1 ~~. c~.uryC ur~+til ~ ,S~`v~ try -i'-~ Y~~~~P~ ~'~cru.tc.( +^~~-~' -~.e.stu~-~ r~~cu.~vr~c~~l y ~~ c~ Cc~nc --~r~rS "U~ 1 ~ ~7.v2r~.~ -~ Y'~R ~~ ~~ c/t s C`~ ~r ~s ~ r r~-~ crc~~ 21 cvi 1 `~ S~y-~-~-~ ~i N d POTENTIAL CONFLICTS OF INTEREST ~" ~y ~~ ` ~ .-, Please identify any potential conflicts between membership on the advisory bxrar~ a~i ~ yo:~wpersonal interests,including financial interests and your duties to an employer. ~' ~ ~-~`~~ v f-°i"~ .. ~ particular, if you are applying to be a member of a board or commission which mak~Kgcor~nen~a~ ons tothe City Council about the allocation of City funds, please list any present affiliations yosu~have_with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of-#.he agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes ^ No RRENTLY SERVE ON ANOTHER IOWA CITY. BOARD OR COMMISSION? Yes ~ No DO YOU CU ^ (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 far removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application January 2010 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City ~/ Board/Commission/Committee '7Au~-T^ ~Vt $ tiy~ Coma-„~SS~~"'t Name /V(cttf' Z-i2"~U)vt ~~~®a7 ~a.ae~ CITY OF IOWA CITY Date ~~ z `~'~~ 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 6). List all businesses in which you, your spouse/domestic.partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS N D ~ .~. a. ~:a- - t1 .~ C~ -.., ~ ~„ : ~ i~9 S~ iG NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. Applicant Signature Signature of parent/ 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. General Application January 2010 Page 3 of 7