Boards and Commission Application Amendment Copyrighted
December4, 2017
City of Dubuque Consent Items # 7.
ITEM TITLE: Boards and Commission Application Amendment
SUMMARY: City Manager recommending approval of a revised
application for the Boards and Commissions program that
includes a page for tracking demographics information.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
Boards and Commission Application and New City Manager Memo
Demographics Page-NNM Memo
Staff Memo Staff Memo
Application Supporting Documentation
Demographics Page Supporting Documentation
THE CITY OF Dubuque
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TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Boards and Commission Application and New Demographics Page
DATE: November28, 2017
City Clerk Kevin Firnstahl recommends City Council approval of the revised Boards and
Commissions application with the addition of a new demographics information page.
The applicant responses on the demographics page will provide valuable data to the
City Clerk's Office in tracking whether it is reaching a diverse audience through vacancy
notifications and help identify marketing opportunities for the boards and commission
program. The City Clerk's Office will report this information through its Performance
Measures and Outcomes during the annual budget process with the City Council.
The demographics data received will not be attached to applicants' names or used in
the City Council's membership selection purposes. Completing the demographics
information page is optional and confidential. The demographics information page is
removed from the application, data is compiled separately and housed independent of
applications. Information identifying the applicant is not included on the demographics
page.
By broadly seeking out and appointing qualified board and commission members with
diverse perspectives and life experiences, the City Council can appoint individuals that
represent the Dubuque community consistent with the City's goals and priorities.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
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Mic ael C. Van Milligen �� �
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Attachment
cc: Crenna Brumwell, City Attorney
Kevin Firnstahl, City Clerk
Teri Goodmann, Assistant City Manager
Cori Burbach, Assistant City Manager
2
THE CITY OF Dubuque
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2013•2017
DATE: October 30, 2017
TO: Michael C. Van Milligen, City Manager
FROM: Kevin Firnstahl, City Clerk
RE: Boards and Commissions Application and New Demographics Page
PURPOSE
The purpose of this memorandum is to request City Council review and approval of the
attached revised Boards and Commissions application with the addition of a new
demographics information page.
BACKGROUND
As City departments move to Socrata Open Data to better inform their departmental
outcomes, the City Clerk' s Office partnered with the Human Rights Department, City
Attorney's Office and the Public Information Office on the creation of a revised Boards
Commissions application and demographics information page.
DISCUSSION
City staff worked to create an application process that would provide a more robust
membership profile through additional questions and the collection of demographics
data.
Applicants are now asked to identify experiences that qualify them to serve on a specific
board or commission beyond traditional education. Applicants now have a chance to
describe their ideas, interests, and soft skills that they can bring to a specific board or
commission. Soft skills are defined as the cluster of personality traits, social graces,
communication, language, personal habits, interpersonal skills, managing people,
leadership, etc. that characterize relationships.
The applicant responses on the demographics page will provide valuable data to the
City Clerk's Office in tracking whether it is reaching a diverse audience through vacancy
notifications and help identify marketing opportunities for the boards and commission
program. The City Clerk's Office will report this information through its Performance
Measures and Outcomes during the annual budget process with the City Council.
The demographics data received will not be attached to applicants' names or used in
the City Council's membership selection purposes. Completing the demographics
information page is optional and confidential. The demographics information page is
removed from the application, data is compiled separately and housed independent of
applications. Information identifying the applicant is not included on the demographics
page.
By broadly seeking out and appointing qualified board and commission members with
diverse perspectives and life experiences, the City Council can appoint individuals that
represent the Dubuque community consistent with the City's goals and priorities.
ACTION REQUESTED
The requested action is for the City Council to review, edit and/or approve the revised
Boards and Commissions Application and Demographics Information page.
KF/tlg
cc: Crenna Brumwell, City Attorney
Kelly Larson, Human Rights Director
Randy Gehl, Public Information Officer
THH CITY OF DUUULiUe
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BOARDICOMMISSION APPLICATION
Individuals serving on Boards and Commissions play an important role in advising the City Council on
matters of interest to our community and its future.
The City Clerk's Office, City Hall, 50 West 13�h Street, Dubuque, IA. accepts applications for any Board
and/or Commission at any time. Applications stay active for one year from the date of receipt in the
Clerk's Office. Application to multiple vacancies and/or reappointment requests requires separate
applications.
DATE:
ADVISORY BOARD/COMMISSION APPLYING FOR:
SOME BOARDS/COMMISSIONS HAVE SPECIAL REQUIREMENTS (e.g. economic representation, years of
experience, residency, education, certifications or membership on another board or commission)
I MEET SUCH REQUIREMENTS: YES NO
PLEASE LIST SUCH REQUIREMENTS:
GENDER (choose all that apply):
❑ Man
❑ Woman
❑ Trans or transgender (please specify):
❑ Another identity (please specify):
Note: Some City Boards/Commissions are subject to the gender balance requirement in lowa Code Section
69.16A:
NAME:
STREET ADDRESS:
CITY, STATE and ZIP:
(City of Dubuque residency required)
HOME PHONE: (_) -
CELL PHONE: (_) -
E-MAIL ADDRESS(ES):
BUSINESS NAME:
BUSINESS ADDRESS:
CITY, STATE and ZIP:
BUSINESS PHONE: (_) -
OCCUPATION:
POSITION WITH COMPANY:
You may attach additional pages if necessary.
EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD/COMMISSION:
WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING:
DESCRIBE YOUR EXPERIENCE WORKING IN DIVERSE ENVIRONMENTS:
DESCRIBE YOUR EXPERIENCE ENGAGING OTHER COMMUNITY MEMBERS TO GATHER THEIR
INPUT AND OPINIONS:
Are you currently serving on a City Board or Commission: YES NO ?
If yes, which?
Have you served on a City Board or Commission before: YES NO ?
If yes, which?
Have you participated in the City Life Program: YES NO ?
If so when?
Have you participated in an Intercultural Competency Workshop: YES NO ?
If so when?
LIST TWO REFERENCES:
NAME: PHONE NUMBER:
NAME: PHONE NUMBER:
This application is a public document and as such can be reproduced and distributed for the public.
Each application for reappointment to a City Board or Commission will be considered without regard to
incumbency. Misrepresentations on this application will constitute just cause for removal of an appointee.
Specific attention should be directed to possible conflict of interest. For further clarification, if a situation
arises, contact the City Clerk's Office or the City Attorney's Office.
SIGNATURE:
INTRODUCING YOURSELF TO THE CITY COUNCIL:
Your application will be reviewed by the City Council at two if iYs meetings. The City Council
stronqlv encourages you to attend the initial meeting to introduce yourself and be available for
any questions regarding your application. The City Clerk's Office will inform you of the meeting
dates via email. During the Boards and Commissions section on the agenda, the Mayor will ask
if there is anyone present to speak to the application to the board or commission you applied for.
You will step to the podium, state your name and address and then tell the Council a little bit
about yourself and why you would like to serve on that board or commission. Please keep your
comments to less than 5 minutes. City Council meetings begin at 6:00 p.m. in the second-floor
Council Chambers of the Historic Federal Building, 350 W. 6�h Street.
If you are not able to attend the meeting to introduce yourself, please consider sending the City
Council an email regarding your introduction at http://www.cityofdubuque.orq/213/Contact-the-
Council Fill in the required sections and select "City Council" as the department. Your message
will be received by each of the council members.
The City Clerk's Office will notify you if you are/aren't chosen to serve on the board or
commission for which you applied.
Please contact the City Clerk's Office, City Hall, 50 W. 13�h St., Dubuque, IA 52001 ;
563-589-4120; ctvclerk(c�citvofdubuque.orq if you have questions.
Thank you for your interest in the City of Dubuque Boards and Commissions.
THE CITY OF
Demographic Information ]�UB E
OPTIONAL
Macterpiece on Nie Mississippi
Completing the following information is optional. It is considered confidential and will not be
associated with individual applicant information nor used in the selection process. When your
application is received, this sheet will be removed. Do Not include your name anywhere on this
page. This information is used to assist staff in fulfilling City Council goals related to equity and
diversity.
Gender(choose all that apply):
❑ Man
❑Woman
❑ Trans or transgender (please specify):
❑ Another identity (please specify):
Age category.� 0 18-21 ❑ 22-30 ❑ 31-40 ❑ 41-50 ❑ 51-60 ❑ 61 & over
Please specify your race and/or ethnicity(please check all that apply):
❑ American Indian/Alaskan native
❑ Asian
❑ Black/African American
❑ Hispanic/Latino
❑ Native Hawaiian/Other Pacific Islander
❑ White
❑ Multi-racial (fill in the blank)
❑ (fill in the blank)
Person with a disability.� ❑ yes ❑ no
Formal education completed:
❑ Did not complete high school
❑ High school graduate
❑ College graduate
❑ M.A. degree or equivalent level graduate degree
❑ M.D., Ph.D. degree or equivalent level graduate degree
❑ (fill in the blank)
How long have you lived in Dubuque? (fill in the blank)
How long has your family lived in the United States?
❑ First generation American
❑ Second generation American
❑ Third generation American
❑ (fill in the blank)
Household/ncome:
❑ Less than $10,000
❑ $10,000 to $49,999
❑ $50,000 to $149,999
❑ $150,000 or more
Federal law prohibits discrimination on the basis of race, co/or, religion, disability, sex, or national origin,
as well as discrimination on the basis of age against persons over the age of 40. Some state and city
legislation prohibits discrimination on the basis of age, marital status, sexual preference, race, co/or,
religion, sex, national origin, or any other basis prohibited by law.