Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Boards and Commissions Application Reviews
VACANCIES AND APPLICATIONS FOR CITY OF DUBUQUE BOARDS AND COMMISSIONS For Council Meeting of Monday, December 6, 2010 6:30 p.m., Historic Federal Building, 350 W. 6 Street APPLICANTS ARE INVITED TO ADDRESS THE COUNCIL ON THEIR POSSIBLE APPOINTMENT Human Rights Commission Three 3 -year terms through January 1, 2014 (Terms of Davis, Scott, and Rubenstein) One 3 -year term through January 1, 2013 (Term of Sharrad) One 3 -year term through January 1, 2012 (Term of Wilberding) Applicants: Frederick Davis, Jr., 2274V2 Washington Street Kurt Hansen, 511 Nocturnal Lane Marcos Rubinstein, 663 Fenelon Place This Commission is subject to the State of Iowa Gender Balance Law effective January 1, 2012. Mediacom Cultural Affairs Charitable Foundation Two 1 -year terms through December 31, 2011 (Terms of Chavenelle and Twining) Applicants: Gail Chavenelle, 1155 Kelly Lane Connie Twining, 421 N. Booth Street Safe Community Advisory Committee Nine 1 -year terms through December 31, 2011 Applicants: 1. Anthony Allen, 1725 Delhi Street 2. Mary Rae Bragg, 350 Kaufmann Avenue 3. Diane Callahan, 531 Sapphire Circle 4. Jonathan Cheatham, 2396 University Avenue 5. Rachel Daack, 800 Laurel Street 6. Amanda Elkins, 2257 Chaney Road 7. Ann Ernst, 899 Mt. Carmel Road 8. Phil French, 1035 Rockdale Road 9. Bob Lanka, 2280 Jackson Street 10. Doug Stillings, 1255 Locust Street 11. Susan Stork, 2115 Golden Eagle Drive 12. Lynn Sutton, 876 Yale Court Mr. Allen currently serves on the Human Rights Commission. Ms. Sutton currently serves on the Human Rights Commission and the Housing Commission CITY OF DUBUQUE, IOWA - BOARDS AND COMMISSIONS * - Denotes Chairperson; For Information: 589 -4120 AIRPORT COMMISSION - 4 Yr. Term Meets 4th Monday 4 p.m. - Airport 09 -14 -12 09 -14 -13 09 -14 -13 09 -14 -14 09 -14 -14 Amy Wagner Douglas Brotherton *Michael A. Santillo Charles Daoud Steven R. Accinelli AIRPORT ZONING COMMISSION 6 Yr. Term - Apptd. 1996, Meets on Call *Steve Horsfield Linda Lucy Marianne Krause Tom Henschel Jeff Stiles (By Board Vote) 01 - - (County) 12 -31 -02 (county) 12 -31 -08 (City ZAC) 01 - - (City zAC) 01 -03 -14 AIRPORT ZONING BOARD OF ADJUSTMENT 5 Year Term, Meets on Call *Vacant (By Board Vote) Randall J. Klauer (City ZBA) 02 -15 -11 Michael A. Ruden (City ZBA) 02 -15 -11 Darlene Burds (county) 02 -15 -11 Ron Koppes (county) 02 -15 -11 ARTS AND CULTURAL AFFAIRS ADVISORY COMM. 3 Yr Term Meets 4 Tues., 4:30, Library Brd Rm. Ellen H Henkels Julie Steffen *Geri Shafer Louise Kames Marina O'Rourke Rosenow Susan Riedel Paul Hemmer (Bus/Prof) 06 - - (Bus /Prof Dist) 06 - - (At Large) 06 - - (Arts) 06 -30 -13 (Arts) 06 -30 -13 (Arts) 06 -30 -13 (Arts) 06 -30 -13 BOARD OF APPEALS - BUILDING CODE Appt. 3 Yr. Term, Meets on Call Ryan Anglese (At Lrg) 08 -01 -11 Marla Cruise (ADA Rep) 08-01-12 Chuck Carr (Gen. Cont.) 08 -01 -12 Richard G. Luchsinger (At Lrg) 08 -01 -12 John Schwendinger (Jrny.carp) 08 -01 -13 *F. James Kolf (Arch/Engr.) 08 -01 -13 1 (ADA new position awaiting applicants) TBD CITY BOARD OF REVIEW (w /County) Appt. 6 Yr. Term, Meets May 1 -30 Robert Schaub Greg Hutchinson Ruth Ann Hanson John F. Ganshirt Donald Lochner Cynthia A. Fuller *Bryce Parks Rod Bakke Marilynne Field Barb Kurt Elizabeth Takes *Daniel White James Schilling James Dixon Dan Hammel Ronald Mueller Elaine L. Reiss *Kevin Pfohl Bob Schmidt Paul J. Uhlrich 01 -01 -11 01 -01 -11 (Realtor) 01 -01 -14 (Constr) 01 -01 -14 01 -01 -16 CIVIC CENTER ADV COMMISSION 3 Yr. Term - Meet 4:30 p.m. 4th Monday at Five Flags 06 -29 -12 06 -29 -12 06 -29 -13 06 -29 -13 06 -29 -13 CIVIL SERVICE COMMISSION 4 Yr. Term, Meets on Call 04 -06 -12 04 -06 -13 04 -06 -14 COMMUNITY DEVEL ADV. COMMISSION 3 Yr. Term, Meets 3 Wednesday, 5:30 p.m. at Federal BIdgJHousing Ann Michalski (At Large) 02 -15 -11 David Shaw (Low /M Inc Area) 02-15 -11 Janice Craddieth (Low /M Inc Area) 02 -15 -11 Thomas Wainwright (At Large) 02 -15 -12 *Hilary A. Stubben (Low /M Inc A) 02 -15 -12 Paula Maloy, SVM (At Large) 02 -15 -13 Theresa Caldwell (Low/M Inc A) 02 -15 -13 Peter Koshakji (At Large) 02 -15 -13 Vacant (Term of Eddy) (Housing Rep) 08 - - ELECTRICAL CODE BOARD 3 Yr. Term; Meets Bi- Monthly (Elec. Con.) 05 - - (Jour/Maint) 05 - - (At Large) 05 - - (Elec. Engr.) 05 - - ( Jour/Maint) 05 - - (EIec.Bkground) 05 - - (EIec.Bkground) 06 - - ENTERPRISE ZONE COMMISSION 3 Year Term, Meets on Call Peggy Murray Mike Van Milligen Daniel White *Rick Stein Dan LoBianco Doug Stillings Richard Van Iten Kelley Deutmeyer Dave Baker *Wayne Klostermann Edward Cawley Gayle Walter Aditi Sinha Vacant - Youth (Term of Miller) Michael J. Buelow Chad Oberdoerster (IA Workforce Dev) 2 - 15 - 11 (Council Rep) 2 - - (NICC) 2 - - (At Large) 2 - - (At Large) 2 - - (At Large) 2 - - (from LRP) 2 - - (IDED) 2 -15 -13 (Intl Labor) 2 -15 -13 ENVIRONMENTAL STEWARDSHIP ADVISORY COMMISSION - 3 Yr. Term Meets 1' Tues. 4 p.m. City Hall Annex 10 -01 -11 10 -01 -11 10 -01 -12 10 -01 -13 06 -01 -13 10 -01 -13 10 -01 -13 HISTORIC PRESERVATION COMM. Appt. 3 Yr. Term, Meets 3 Thursday, 5:30 p.m., Federal Bldg D. Joseph Rapp (Old Main Interim) 07 -01 -11 Christopher J. Wand (Arch /At Lg) 07 -01 -11 David Klavitter (Langworthy) 07 -01 -11 Mary Loney Bichell (At Large) 07 -01 -12 Michael Knight (At Large) 07 -01 -12 *Christine Olson (At Large) 07 -01 -12 Peggy Stover (Cathedral Interim) 07 -01.12 Robert McDonell (Jackson Pk) 07 -01 -13 John E. Whalen, MD (w. ltth) 07 -01.13 HOUSING COMMISSION 3 Yr. Term, 4 Tues. 4:30 p.m., Fed Bldg Vacant (Term of Melling) 08 - - Vacant (Term of Frommelt) 08 - - Lynn Sutton 08 -17 -11 *David J. Kepler 08 -17 -12 Dorothy CUlbertson(Trost Fund Rep)08 - 17 - 12 Jim Holz (Trust Fund Rep)08 - 17 - 12 Lisa McAllister (Sec. 8 Area) 08 -17 -12 Judie Root 08 -17 -13 Dorothy Schwendinger, OSF 08 -17 -13 Ricardo Woods 08 -17 -13 HOUSING TRUST FUND ADVISORY COMMITTEE 3 Yr. Term, Meets 6x/Year *Jim Holz Dorothy Culbertson Doris M. Hingtgen Vacant (Term of Eddy) John V. Walsh (From Hsg) 08 (From Hsg) 09 - - (At Large) 09 - - (From. Hsg.) 08 - - (At Large) 09 - - HOUSING CODE APPEALS BOARD 3 Yr. Term, 3 Tues. 4:30 p.m. Fed Bldg. Vacant (Term of Moore) David Young Fred Miller Paul Newman *Robert Schaub William J. Kinsella Vacant (Term of Matheos) HUMAN RIGHTS COMMISSION 3 Yr. Term, Meets 2 Mon. 4:15 Annex *Marcos Rubenstein Frederick Davis, Jr. Vacant (Term of Scott) Anthony Allen Vacant (Term of Wilberding) R.R.S. Stewart Lori Apel Lynn Sutton Vacant (Tenn of Shand) INVESTMENT OVERSIGHT ADVISORY COMMISSION - 3 Yr. Term, Meets Qtrly; 4 Wednesday 3 p.m. City Hall "A" Virgil Blocker Brad Chalmers Hiram Melendez Gary Ruden *Stephen V. Reisdorf LIBRARY BOARD OF TRUSTEES 4 Yr Term, Meets 4 Thurs. 4 p.m.Library Paula Connors Elizabeth Leeper David Hammer Kristen L. Smith Mike Willis *Diann Guns Fred Miller 01 -01 -11 01 -01 -11 01 -01 -11 01 -01 -12 01 -01 -12 01 -01 -12 01 -01 -13 01 -01 -13 01 -01 -13 07 -01 -11 07 -01 -12 07 -01 -12 07 -01 -13 07 -01 -13 (12) 07 -01 -11 (12) 07 -01 -11 (15) 07 -01 -11 (15) 07 -01 -11 07 -01 -13 07 -01 -14 07 -01 -14 As prepared for 12/06/10 Council meeting LONG RANGE PLAN'G ADV COMM. 3 Yr Term Meets 3 Wed. 7p.m. Fed Bldg Dirk Voetberg Richard Van Iten Alan Vincent John Pregler Chad Darter *Charles Winterwood, MD James F. Prochaska MECHANICAL CODE BOARD 3 Yr. Term - Meets Qrtly, City Hall Gary Hillard *Tom W. Giese Corey Valaskey David Grothe Michael P. Kelly Paul J. Papin Ronald Billmeyer MEDIACOM CHARITABLE FOUNDATION 1 Yr. Term, On -Call, CC Appt'd Reps. Gail Chavenelle Connie Twining (Council Rep) 07 - - (Ent Zone Rep) 07 - - 07 -01 -11 07 -01 -12 07-01-12 07-01-13 07 -01 -13 03 -16 -11 03 -16 -11 03 -16 -12 03 -16 -12 03 -16 -13 03 -16 -13 03 -16 -13 12/31/10 12/31/10 MISSISSIPPI RIVER PARTNERSHIP Council Apptd. Rep - 3 Year Term Edward Cawley (Apptd Citizen Rep) 12 -31 -12 PARK AND RECREATION ADV. COMM. 3 Year Term Meets 2 Tues. 4:30 p.m. Bunker Hill *Tom Blocklinger Mark Noble Evelyn Nadeau Robert Blocker Karen C. Lyness David Schlueter Paul Hoffmann, D.D.S. 06 -30 -11 06 -30 -11 06 -30 -11 06 -30 -12 06 -30 -13 06 -30 -13 06 -30 -13 PLUMBING CODE BOARD 3 Yr. Term, Meets Quarterly, City Hall Stanley G. Gonner (Master) 11 - 02 - 11 *Harlan J. Willenborg (Master) 11 -02 -11 Vacant (Tenn of Swift) (At Large) 11 - 02 - 12 Dan Harris (At Large) 11 - 02 - 12 Paul Papin (at will) (Journeyman) 11 - - TRANSIT ADVISORY BOARD 3 yr. Term, Meet Bi- Monthly, 2 Thurs. Lib Vacant (Tenn of Schmidt/Croissant) George Enderson *Joel Lightcap Matthew Esser Rhonda Knight TV CABLE REGULATORY COMMISSION 3 Yr. Term, Meets 2 Wed OC. 5:30 Annex Andy Bellings Ronald Tigges Walter Webster *Charlie Ellis Kevin R. Stevens Pauline J. Maloney George P. Herrig Sr. Carol Hoverman Jennifer L. Tigges Alan Vincent Vacant (Term of McDonough) Vacant (Term of Everist) Martha E. Christ Thomas Henschel Ron Smith Charles Miller Stephen Hardie Patrick Norton *Jeff Stiles Randall J. Klauer William J. Gibbs Jeff Cremer Heath Hutchinson *Michael A. Ruden 07 -30 -11 07 -30 -11 07 -30 -11 07 -30 -12 07 -30 -13 06-30-10 06 -30 -11 06 -30 -11 06 -30 -12 06 -30 -13 TV CABLE COMMUNITY TELEPROGRAMMING COMMISSION 3 Yr. Term, Meets 1' Tues. 5:30 Annex 06 -30 -11 06 -30 -11 06 -30 -11 06 -30 -12 06 -30 -12 06 -30 -12 06 -30 -13 ZONING ADVISORY COMMISSION 3 Yr. Term, Meets 1' Wed. 6:30 Fed Bldg 07 -01 -11 (Airport ZC) 07 - - 07 -01 -11 07 -01 -12 07 -01 -12 07 -01 -13 (Airport ZC) 07 - - ZONING BOARD OF ADJUSTMENT 5 Yr Term; Meets 4 Thurs. 4 pm Fed Bldg (Airport ZBA) 03 - - 03 -25 -12 03 -25 -13 03 -25 -14 (Airport ZBA) 03 - - 69.16A Gender balance. 1. All appointive boards, commissions, committees, and councils of the state established by the Code, if not otherwise provided by law, shall be gender balanced. No person shall be appointed or reappointed to any board, commission, committee, or council established by the Code if that appointment or reappointment would cause the number of members of the board, commission, committee, or council of one gender to be greater than one —half the membership of the board, commission, committee, or council plus one if the board, commission, committee, or council is composed of an odd number of members. If the board, commission, committee, or council is composed of an even number of members, not more than one —half of the membership shall be of one gender. If there are multiple appointing authorities for a board, commission, committee, or council, they shall consult each other to avoid a violation of this section. 2. All appointive boards, commissions, committees, and councils of a political subdivision of the state that are established by the Code, if not otherwise provided by law, shall be gender balanced as provided by subsection 1 unless the political subdivision has made a good faith effort to appoint a qualified person to fill a vacancy on a board, commission, committee, or council in compliance with subsection 1 for a period of three months but has been unable to make a compliant appointment. In complying with the requirements of this subsection, political subdivisions shall utilize a fair and unbiased method of selecting the best qualified applicants. This subsection shall not prohibit an individual whose term expires prior to January 1, 2012, from being reappointed even though the reappointment continues an inequity in gender balance. 86 Acts, ch 1245, §2041; 87 Acts, ch 218, §8; 88 Acts, ch 1150, §1; 2009 Acts, ch 162, §1, 2 Chapter 2 HUMAN RIGHTS COMMISSION 8 -2 -1: CREATED: There is hereby created a human rights commission. (Ord. 18 -09, 4 -6 -2009) 8 -2 -2: COMPOSITION: The human rights commission created by this chapter shall consist of nine (9) members. (Ord. 18 -09, 4 -6 -2009) 8 -2 -3: APPOINTMENT; TERMS; FILLING OF VACANCIES: The human rights commission members shall be appointed by the city council for terms of three (3) years each and shall serve thereafter until a successor has been appointed. Vacancies shall be filled for the remainder of the unexpired term. Appointments shall take into consideration the various racial, religious, cultural and social groups of the city. (Ord. 18 -09, 4- 6 -2009) 8 -2-4: OFFICERS: The human rights commission created by this chapter shall elect from its own membership, at its regular March meeting, its chairperson and vice chairperson, each to serve a term of one year. The chairperson shall appoint a secretary, who need not be a member of the commission. The commission shall fill vacancies among its officers for the remainder of the unexpired term. (Ord. 18 -09, 4 -6 -2009) 8 -2 -5: COMPENSATION: The members of the human rights commission created by this chapter shall serve without compensation; provided, that they may receive reimbursement for necessary travel and other expenses while on official commission business and such shall be within the limits established in the city budget. (Ord. 18 -09, 4 -6 -2009) 8 -2 -6: REMOVAL OF MEMBERS FOR UNEXCUSED ABSENCES: In the event a member of the human rights commission created by this chapter has been absent for three (3) or more consecutive meetings without being excused by the chairperson, the commission by majority vote may certify such fact to the city council and petition the city council to declare a vacancy by reason of such unexcused absence and appoint a successor to fill such vacancy. (Ord. 18 -09, 4 -6 -2009) 8 -2 -7: RULES: The human rights commission created by this chapter may adopt, amend, or rescind such rules as may be necessary for the conduct of its business. (Ord. 18 -09, 4 -6 -2009) 8 -2 -8: MEETINGS: A. Regular Meetings: The human rights commission shall meet not less than monthly on a regular basis. B. Special Meetings; Notice: The chairperson, the vice chairperson, or any three (3) members of the human rights commission may call a special meeting by giving at least twenty four (24) hours' notice to every other member of the commission. The call for a special meeting shall include an agenda and only matters included in that agenda may be acted on at the meeting. C. Conformance With Open Meetings Law: All meetings of the human rights commission shall be held in conformance with the Iowa open meetings law'. D. Attendance: Members of the human rights commission shall attend at least two- thirds ( of all regularly scheduled meetings within any twelve (12) month period. If any member does not attend such prescribed number of meetings, it shall constitute grounds for the commission to recommend to the city council that said member be replaced. Attendance of all members shall be entered on the minutes. (Ord. 18 -09, 4 -6 -2009) 8 -2 -9: QUORUM: A quorum of the human rights commission shall be five (5) members. A majority of the members present and voting shall be necessary for the passage of any motion. The chairperson shall vote as a member of the commission. (Ord. 18 -09, 4 -6 -2009) 8 -2 -10: RECORDS TO BE PUBLIC; EXCEPTIONS: All records of the human rights commission shall be public except charges, complaints, reports of investigations, statements, and other documents or records obtained in investigation of any charges shall be closed records. (Ord. 18 -09, 4 -6 -2009) 8 -2 -11: CONFIDENTIALITY OF COMPLAINTS: No member of the human rights commission or its staff shall disclose the filing of a charge, the information gathered during the investigation, or the endeavors to eliminate such discriminatory or unfair practice by conference, conciliation, or persuasion unless such disclosure is made in connection with the conduct of such investigation or after the commission has held a public hearing upon a complaint filed in connection with such charge. This section does not prevent any complainant, witness, or other person from publicizing the filing of a charge or complaint or the matter therein complained of. (Ord. 18 -09, 4 -6 -2009) 8 -2 -12: POWERS AND DUTIES: The human rights commission created by this chapter shall have the following powers and duties: A. To receive, investigate, and finally determine the merits of complaints alleging unfair or discriminatory practices. B. To investigate and study the existence, character, causes, and extent of discrimination in public accommodations, employment, apprenticeship programs, on the job training programs, vocational schools, other educational institutions, and housing in the city and to attempt the elimination of such discrimination by education and conciliation. C. To hold hearings upon any complaint made against a person, an employer, an employment agency, a labor organization, or the employees or members thereof, to subpoena witnesses and compel their attendance at such hearings, to administer oaths and take the testimony of any person under oath and to compel such person, employer, employment agency, labor organization, or employees or members thereof, to produce for examination any books and papers relating to any matter involved in such complaint. The commission shall issue subpoenas for witnesses in the same manner and for the same purpose on behalf of the respondent upon the respondent's request. Such hearings may be held by the commission, by any commissioner, or by any hearing examiner appointed by the commission. If a witness either fails or refuses to obey a subpoena issued by the commission, the commission may petition the district court having jurisdiction for issuance of a subpoena and the court shall, in a proper case, issue the subpoena. Refusal to obey such subpoena shall be subject to punishment for contempt. D. To issue such publication and reports of investigations and research as in the judgment of the commission shall promote civil and respectful behavior which shall tend to eliminate discrimination. E. To prepare and transmit to the mayor and city council from time to time, but not Tess often than once each year, reports describing its proceedings, investigations, hearings conducted, and the outcome thereof, decisions rendered, and the other work performed by the commission. F. To make recommendations to the city council concerning discrimination. G. To cooperate, within the limits of any appropriations made for its operation, with other agencies or organizations, both public and private, whose purposes are consistent with those of this chapter, in the planning and conducting of programs designed to eliminate discrimination or cultural and intergroup tensions. H. To adopt, publish, amend and rescind regulations consistent with and necessary for the enforcement of this chapter. I. To delegate any of its functions, duties and powers to its staff including functions, duties and powers with respect to investigating, conciliating, determining, certifying, reporting, or otherwise acting as to any work, business, or matter under this title. J. To receive, administer, dispense, and account for any restricted funds that may be voluntarily contributed to the commission and any grants that may be awarded the commission for furthering the purposes of this title. No disbursements will be made of any restricted funds without authority from the city council. (Ord. 18 -09, 4 -6 -2009) 8 -2 -13: CITY POLICIES APPLICABLE TO COMMISSION OPERATIONS: All administrative, personnel, accounting, budgetary and procurement policies of the city shall govern the human rights commission in all its operations. (Ord. 18 -09, 4 -6 -2009) 8 -2 -14: SUBPOENAS: The human rights commission may issue subpoenas and order discovery in aid of investigations under this title. Such subpoenas and discovery may be ordered to the same extent and subject to the same limitations as would apply for county attorney subpoenas. (Ord. 18 -09, 4 -6 -2009) (11/30/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support@civicplus.com> To: <kfirnsta @cityofdubuque.org >, <klarson @cityofdubuque.org> Date: 11/30/2010 11:12 AM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for:: Human Rights Commission Name:: Frederick Davis Jr Home Address:: 2274 1/2 Washington St. Home Phone Number:: 563- 663 -0978 Business Name and Address:: Dubuque Community Schools Business Phone Number:: 563- 552 -4050 Occupation:: Para Educator Email Address:: oldbluphi @hotmail.com Experience or education which qualifies you for this board or commission:: I have been a volunteer in the community for over 10yrs as a youth football coach as well as many hours of service in my churches bus ministry. I have been on Human Rights Commission for limos. What contributions can you make or state reason for applying ?: I feel the need to be more active in city /community areas and I feel this would be a great opportunity for me to dedicate more of myself to the community's voice. List two reference with names and addresses:: Anthony Allen - 1725 1/2 Delhi St. Lynn Allen Spicer - 2205 Aspen Are you currently serving on other Boards, Commissions, or Committees ?: Yes If yes, which ?: Human Rights Commission Have you served on a Board, Commission, or Committee before ?: Yes If yes, which ?: Human Rights Commission Signature:: Frederick Davis Jr Date:: 11/30/10 Additional Information: Form submitted on: 11/30/2010 11:11:25 AM Submitted from IP Address: 209.56.9.40 0 in m (11/10/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support@civicplus.com> To: <kfirnsta @cityofdubuque.org >, <klarson @cityofdubuque.org> Date: 11/10/2010 10:43 AM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for:: Human Rights Commission Name:: Rev. Kurt Hansen Home Address:: 511 Nocturnal Lane, Dubuque, IA 52003 Home Phone Number:: 563 - 556 -3444 Business Name and Address:: New Hope Lutheran Church 502 Second Ave. SW Farley, IA 52046 Business Phone Number:: 563- 744 =9160 Occupation:: Pastor Email Address:: revkurthansen @gmail.com Experience or education which qualifies you for this board or commission:: Masters in Social Work, Univ. of Kansas, 1986 Masters in Divinity, Wartburg Seminary, 1991 Eleven years in mental health work and fifteen years ministry experience. What contributions can you make or state reason for applying ?: Want to serve the community in which I live. List two reference with names and addresses:: Rev. Ken Gibson 1011 Golden Woodstock, IL 60098 Roger Klosterman 540 Candlewick Ct. Dubuque, IA 52003 Are you currently serving on other Boards, Commissions, or Committees ?: No If yes, which ?: Select One Have you served on a Board, Commission, or Committee before ?: No If yes, which ?: Select One Signature:: Kurt Hansen Date:: 11/10/2010 (11/10/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 2 Additional Information: Form submitted on: 11/10/2010 10:43:16 AM Submitted from IP Address: 173.21.106.126 Referrer Page: http: / /www.cityofdubuque.org /Search.aspx Form Address: http:// www. cityofdubuque .org /forms.aspx ?FID =75 11 E Cfi`X OF Masterpiece n the Mississippi 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 Street, Dubuque, IA accepts applications for any Board and /or Commission at any time, and the application stays active for one year from the date of receipt in the Clerk's Office. At the appropriate regularly scheduled meeting, applications will be submitted to the City Council for their review and applicants are encouraged to address the Council stating their reasons for wanting to serve on this particular Board or Commission. Applicants will be advised when the application is being presented. Appointment to the Board or Commission will be made at a later meeting. Applicants will then be notified as to the outcome of the Council's action. If not appointed at that time, this application will be resubmitted, as needed, as long as the application is active (unless the applicant advises they are no longer interested). DATE: November 16, 2010 ADVISORY BOARD /COMMISSION APPLYING FOR: Heiman Rights Commission (Some boards /commissions require State of Iowa Gender Balance compliance) NAME: Marcos Rubinstein ADDRESS: 663 Fenelon PI, Dubuque IA 52001 (City of Dubuque residency required) BUSINESS: IT and Political Consultant ADDRESS: OCCUPATION: IT and Political Consultant POSITION WITH COMPANY: Self / Owner HOME PHONE: 563.588.0418 BUSINESS PHONE: 563.580.5036 E-MAIL ADDRESS(ES): Marcos.Rubinstein @gmall.com EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: I am a Human Rights Board Commissioner, and former Chair of it and of DCAP WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: I can bring the Latino /Hispanic perspective to the Commission LIST TWO REFERENCES: NAME: Anthony Allen, Chair, H.R. Commission ADDRESS: (563) 517 -7181 NAME:Graciela Caneiro, Dean, Clarke UniversityADDRESs: 1550 Clarke Drive, Dubuque. IA Specific attention should be directed to possible conflict of interest. For further clarification, if a situation arises, contact the appropriate staff person or the City's legal staff. Are you currently sewing SIGNATURE: CITY OF DUBUQUE, IOWA BOARD /COMMISSION APPLICATION Iry Board - Com sion: Yes Name: Humman Rights Commission 2907 If questions, cont ie City Clerk's Office, City , aII, 60 W. 13 St., Dubuque, IA 52001. Phone 563/589 -4120. Fax 563 /589 -0890, www.cityofdubuque.org. All names 'II be dropped from the list after a one -year period. RECEIVED 10 NOV 17 PM 12: 58 City Clerk's Office Dubuque, IA Masterpiece on the Mississippi CITY OF DUBUQUE, IOWA BOARD /COMMISSION 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` Street, Dubuque, IA accepts applications for any Board and /or Commission at any time, and the application stays active for one year from the date of receipt in the Clerk's Office. At the appropriate regularly scheduled meeting, applications will be submitted to the City Council for their review and applicants are encouraged to address the Council stating their reasons for wanting to serve on this particular Board or Commission. Applicants will be advised when the application is being presented. Appointment to the Board or Commission will be made at a later meeting. Applicants will then be notified as to the outcome of the Council's action. If not appointed at that time, this application will be resubmitted, as needed, as long as the application is active (unless the applicant advises they are no longer interested). DATE: ADVISORY BOARD/COMMISSION APPLYING FOR: iNt �' (._k_ C 6' ) -{ (-)C ) '�Z i 15 (2 / 1 � � NAME: ( k ' �V G `C�. 'JJ I _' L f ADDRESS: l (�' 4 k',_ ,. Lc k. - .e.�c- 4 BUSINESS: 1 V1l' iaL i kL -1 r(.) rr' al wib', . /- 1-1) s k OCCUPATION: c - , 1 V ' -tC (- -U ptelgSITION WITH COMPANY: -,f _'" -j 3 L(_ HOME PHONE: ' b i 3 ' -1);) (A BUSINESS (- -,1;(41 SS PHONE: (i. 4t./ E -MAIL ADDRESS(ES): (la—LC O--' C Vo__ U V (LC..4f))r ii(() ; (t (;) r EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: Ct 1 ( vx, / as 1 be4-_ 1 -11)2 tin UV - 1 LILT 1 f_ 1(1 )/ - ( j } rte, c � c : ` ' L 1 .+ j. (V t. s C O M WHAT CONTRIBUTION CAN YOU MAKE OR STATE REASON FOR APPLYING: IA) (-1 [16 tock(1.-_6tb00/ , (lia. S( ;�cc v�� (.� C (� c.,o cat -z LIST TWO REFERENCES: Me OS C-YI Dubuque kaltd 11 1 d4 /i li //CJ NAME: ADDRESS: NAME: ADDRESS: Specific attention should be directed to possible conflict of interest. For further clarification, if a situation arises, contact the appropriate staff person or the City's legal staff. n, Are you currently serving on a City Board or ,,Commission: + ommission: Name: I VC (Qk(k 6 SIGNATURE: LI If questions, contacl the City Clerk's Office, City Hall, 50 W. 13 St., Dubuque, IA 52001. Phone 563/589 -4120. Fax 563/589 -0890. All names will be dropped from the list after a one -vear period. RECEIVED 10 OCT I 4 AM 8: 54 City Clerk's Office Dubuque IA (11/15/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support@civicplus.com> To: <kfirnsta @cityofdubuque.org> Date: 11/15/2010 4:26 PM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for:: Mediacom Charitable Foundation Name:: Constance Twining Home Address:: 421 N. Booth St Home Phone Number:: 563- 583 -6870 Business Name and Address:: Outside the Lines Art Gallery, LLC 409 Bluff St Dubuque, IA 52001 Business Phone Number:: 563 - 583 -9343 Occupation:: Gallery owner Email Address:: conkybirdl @aol.com Experience or education which qualifies you for this board or commission:: Three years experience as manager (chair) of the Rocco Buda Art Gallery (an entity of the Dubuque County Fine Arts Society) and seven years as co -owner of a fine art & craft gallery. What contributions can you make or state reason for applying ?: I am co -owner of a retail commission art gallery that directly represents or works with many of our local artists and artisans. This gives me the unique opportunity to communicate often and directly with a large number of our area cultural contributors; artists, musicians, theatre folk, etc. This vantage point allows insight that I in turn bring to the MediaCom Foundation committee members. In addition, after serving for three years on this committee, there is a high level of respect and cooperation between the MediaCom employees, and the other commissioner and myself. We have fine tuned the process during our time together, and have worked diligently to make thoughtful, educated choices in our granting. List two reference with names and addresses:: Geri Shafer 1207 Adeline Dubuque, IA 52001 Stormy Mocha! 1756 Wood St Dubuque, IA 52001 Are you currently serving on other Boards, Commissions, or Committees ?: No If yes, which ?: Select One Have you served on a Board, Commission, or Committee before ?: Yes If yes, which ?: Mediacom Charitable Foundation (11/15/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 2 Signature:: Constance L. Twining Date:: 11/15/10 Additional Information: Form submitted on: 11/15/2010 4:26:27 PM Submitted from IP Address: 208.126.216.42 Referrer Page: http: / /www. cityofdubuque .org /index.aspx ?nid =78 Form Address: http: / /www. cityofdubuque .org /forms.aspx ?FID =75 Safe Community Advisory Committee 2 -9 -1: Commission Created: There is hereby created the Safe Community Advisory Committee to have such powers and responsibilities as hereinafter provided. 2 -9 -2: Mission: The mission of the Committee shall be to monitor the implementation and progress of the Safe Community Task Force recommendations. 2 -9 -3: Internal Organization and Rules: The Committee may adopt rules and regulations to govern its organizational procedures as may be necessary and which are not in conflict with City or State Code. 2 -9 -4: Procedures for Operation: All administrative, personnel, accounting, budgetary, and procurement policies of the City shall govern the Committee in all its operations. 2 -9 -5: Membership: The Safe Community Advisory Committee shall consist of nine (9) residents of the City of Dubuque, appointed by the City Council. 2 -9 -6: Terms: The term of office for members of the Safe Community Advisory Committee shall begin January 1, 2011 and end on December 31, 2011. 2 -9 -7: Vacancies: Vacancies caused by death, resignation, or otherwise shall be promptly filled by the City Council for the unexpired term of office. 2 -9 -8: Officers /Organization: The Committee shall choose annually, from its own membership, a chairperson and vice chairperson. The chairperson shall appoint a secretary, who need not be a member of the Committee. The Committee shall fill vacancies among its officers for the remainder of the unexpired term. 2 -9 -9: Meetings: 1. Regular Meetings. The Safe Community Advisory Committee shall meet quarterly. 2. Special Meetings. Special meetings may be called by the chairperson or at the written request of three (3) members. 3. Open Meetings. All meetings shall be called and held in conformance with the Iowa Open Meetings Law. 4. Attendance. a. In the event a member of the Safe Community Advisory Committee, created by this Chapter, has been absent for two (2) or more consecutive meetings of the Committee, without being excused by the chairperson, it shall be grounds for the Committee to recommend to the City Council that the position be declared vacant and a replacement appointed. b. Attendance shall be entered upon the minutes of all meetings. 5. Minutes. A copy of the minutes of all regular and special meetings of the Committee shall be filed with the City Council within ten (10) working days after each meeting. 6. Quorum. Five (5) members of the Committee shall constitute a quorum for the transaction of business. The affirmative vote of at least five (5) members shall be necessary for the adoption of any resolution. 2 -9 -10: Compensation: The members of the Safe Community Advisory Committee created by this Chapter shall serve without compensation, provided that they may receive reimbursement for necessary travel and other expenses while on official Committee business and such shall be within the limits established in the City budget. 2 -9 -11: Removal: The City Council may remove any member of any board or committee which it has established. 2 -9 -12: Powers: The Safe Community Advisory Committee shall have the following powers, duties, and responsibilities: 1. Monitor the implementation and progress of the Safe Community Task Force recommendations. 2. Serve as conduit for information to the City Manager. 3. Provide reports to the City Council as needed. 4. Research and tasks as assigned by the City Council. 2 -9 -13: Sunset of Safe Community Advisory Committee: The Safe Community Advisory Committee shall cease to exist on December 31, 2011. Thom Determan 2087 Kaufmann Avenue Dubuque, IA 52001 (10/18/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support@civicplus.com> To: <kfirnsta @cityofdubuque.org> Date: 10/15/2010 10:07 PM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for: -1 Safe Community Advisory Committee Name: -I Anthony R. Allen Home Address: -I 1725 Delhi Street Home Phone Number: -I (563) 513 -2122 Business Name and Address: -I Business Phone Number: -1 (563) 517 -7181 Occupation: -I Self- Employed Email Address:-1sqr1@hotmail.com Experience or education which qualifies you for this board or commission: -I Educational background in Sociology and Pshychology. Certified Mediator/Trainer for the City of Dubuque. Member of the Intercultural Competency Team for the City of Dubuque. Worked for the Dubuque Community School District as a Behavioral Modification Associate in the past. Training in conflict resolution. What contributions can you make or state reason for applying?-1 Calling Dubuque my home for the last 20 plus years, I have devoted my time and energy to help our community to continue to grow and develop into a safe environment for all. List two reference with names and addresses: -I Kelly Larson City Hall Annex 1300 Main Street Dubuque, IA 52001 Are you currently serving on other Boards, Commissions, or Committees ? -I Yes If yes, which ? -I Human Rights Commission Have you served on a Board, Commission, or Committee before?-1 Yes If yes, which ? -I TV Cable Community Teleprogramming Commission Signature: -I Anthony R. Allen Date: -1 10/15/2010 CZ t 0 -1 CO a CO CD JJ rn 0 m m 0 (10/18/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 2 Additional Information: Form submitted on: 10/15/2010 10:06:38 PM Submitted from IP Address: 173.19.241.208 Referrer Page: http: / /www. cityofdubuque .org /index.aspx ?NID =78 Form Address: http: / /www. cityofdubuque .org /forms.aspx ?FID =75 Masterpiece on the Mississippi 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 Street, Dubuque, IA accepts applications for any Board and /or Commission at any time, and the application stays active for one year from the date of receipt in the Clerk's Office. At the appropriate regularly scheduled meeting, applications will be submitted to the City Council for their review and applicants are encouraged to address the Council stating their reasons for wanting to serve on this particular Board or Commission. Applicants will be advised when the application is being presented. Appointment to the Board or Commission will be made at a later meeting. Applicants will then be notified as to the outcome of the Council's action. If not appointed at that time, this application will be resubmitted, as needed, as long as the application is active (unless the applicant advises they are no longer interested). DATE: /O - �L - 2.6 / Q ADVISORY BOARD/COMMISSION APPLYING FOR: S4 -w, tom, + l /IAA' So-v A-rn ( fr2e NAME: 1cur y fist 1 rac q ADDRESS: 3S d ,� -�jn a h n 4U e. t BUSINESS: / J ADDRESS: r OCCUPATION: Teter 1kY'aId rel e HOME PHONE: (..6 3) 5 ^cy 3- 6 5 a 5 sk FON e - cCC; I' + � ar e rf ) ca,', cern s o,v4 �-c c Be ss GC`W1N1tlt1 LIST TWO REFERENCES: CITY OF DUBUQUE, IOWA BOARD /COMMISSION APPLICATION Dubu 11 2007 POSITION WITH COMPANY: fDo t+;cci 1 re(�;r�v BUSINESS PHONE: I f E ADDRESS(ES): b`cT rna - )tract 3 �{vi.cii / , L6w� EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD/COMMISSION: 5� r v e c t oi Scc4 t y 1-a s k Fo - cnwo -h 4e e ( cutka e4 Pkis emu,( Envj\cc5 me -k"„i I`f9�''- - °? �Yesc - 1cyoI Pi-evth-ark i Y'os;c4p1A+ 04 e K , &4\h ue— Lesd`( RVe, hej■ WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: a� +IAe Ta-S k goYce n e+i r.q 5 khck. rw-e.A.V v A 7'4f 3- orso-n Secorck Ccryn ni fre e y -L hove_ K ape Ye o-y.. 4-0Y - e- CG.Ye 4t kt0 e re caw,mett,c ;ov1S aK 4 file n •Q eck 5 a -[= e t C vt c erns Can cCL y e Y ce Io+ s a s c*. S Q c 5 NAME: 3 ce- r.v.o‘r rnew..6e\- ADDRESS: 6,66 UiH\ J` c;lOV/ NAME: II 1&? -S+i lI 1 hqS , Se+t�GY tricereSikt, ADDRESS: I3 9 LQ+ Y 4 (u 6 ,2oo � F .J kJ � Specific attention should b directed to possible conflict of interest. For further clarification, if a situation arises, contact the appropriate staff person or the City's legal staff. Are you currently serving on a City Board or Commission: 1VD Name: SIGNATURE: If questions, contact the City Clerk's Office, City Hall, 50 W. 13 St., Dubuque, IA 52001. Phone 563/589 -4120. Fax 563/589 -0890. All names will be dropped from the list after a one -Year period. RECEIVED 10 0CT 21 AM I 1 : 3 3 City Clerks Office Dubuque, IA (11/30/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support@civicplus.com> To: <kfirnsta @cityofdubuque.org> Date: 11/30/2010 3:51 PM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for:: Safe Community Advisory Committee Name:: Diane Callahan Home Address:: 531 Sapphire Circle Home Phone Number:: 563- 513 -8880 Business Name and Address:: U.S.Bank 435 JFK Rd Dubuque, Iowa 52001 Business Phone Number:: 563 - 513 -8880 Occupation:: Vice President/Branch Manager Email Address:: diane.callahan @usbank.com Experience or education which qualifies you for this board or commission:: I am involved in the community working with various charities and organizations such as the American Cancer Society, Make -A -Wish and currently serve on the Project Concern Board. I am a professional who has owned and operated businesses in Dubuque. What contributions can you make or state reason for applying ?: I am a native of Dubuque and have watched her growth and cultural changes over the last several decades. I have always said "there isn't a better place to live and raise a family ". This encouraged my professional children moving back to Dubuque to raise their families. I feel a responsibility to better understand the changes taking place and would appreciate the opportunity to be a positive influence. List two reference with names and addresses:: Amy Breitfelder Sr Vice President U.S. Bank 270 West 7th St Dubuque, Iowa 52001 Doris Gorius, Owner, Cookin Something Up, 1640 JFK Rd Dubuque, Iowa 52002 Are you currently serving on other Boards, Commissions, or Committees ?: No If yes, which ?: Select One Have you served on a Board, Commission, or Committee before ?: No If yes, which ?: Select One Signature:: Diane Callahan Date:: 11/30/2010 (11/30/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 2 Additional Information: Form submitted on: 11/30/2010 3:50:31 PM Submitted from IP Address: 170.135.241.45 Referrer Page: No referrer - Direct link Form Address: http:// www. cityofdubuque .org /forms.aspx ?FID =75 (12/1/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support@civicplus.com> To: <kfirnsta @cityofdubuque.org> Date: 12/1/2010 12:44 AM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for:: Safe Community Advisory Committee Name:: Jonathan Cheatham Home Address:: 2396 University Ave. Home Phone Number:: 5158229238 Business Name and Address:: Business Phone Number:: 5158229238 Occupation:: Full -time student, NICC - Peosta Email Address:: jche75 @yahoo.com Experience or education which qualifies you for this board or commission:: Resident, citizen of Dubuque 9+ years What contributions can you make or state reason for applying ?: I am applying for this committee because, I believe that would be able to help my community with a diverse set of, research, facts, and opinions. List two reference with names and addresses:: Mike Van Milligan,City of Dubuque,IA. Tim Trenkle, Dubuque,IA. Are you currently serving on other Boards, Commissions, or Committees ?: No If yes, which ?: Select One Have you served on a Board, Commission, or Committee before ?: No If yes, which ?: Select One Signature:: Jonathan Cheatham Date:: 12/01/10 Additional Information: Form submitted on: 12/1/2010 12:43:23 AM Submitted from IP Address: 97.127.251.195 Referrer Page: No referrer - Direct link Form Address: http:// www. cityofdubuque .org /forms.aspx ?FID =75 0 0'‹ m M c L' 7 si CD a) y' Tl D0 m 0 co (11/12/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support@civicplus.com> To: <kfirnsta @cityofdubuque.org> Date: 11/12/2010 1:50 PM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for:: Safe Community Advisory Committee Name:: Rachel Daack Home Address:: 800 Laurel Street Home Phone Number:: 563- 557 -3005 Business Name and Address :: Clarke University 1550 Clarke Drive Dubuque, IA 52001 Business Phone Number:: 563- 588 -6411 Occupation:: professor Email Address:: rachel.daack @clarke.edu Experience or education which qualifies you for this board or commission:: Safe Coummunity Task Force member, 2009 -2010 Member of the research advisory group working with the city on the crime research that resulted from the SCTH, 2009 -2010 Geography, MA, 1999 Interdisicplinary PhD (social sciences), University of Iowa, 2009 Lincoln Elementary PTO member (2002 -2010) What contributions can you make or state reason for applying ?: I bring my deep interest in the health of the Dubuque community. My specific contributions include insight from my experiences as a parent in the Dubuque schools (Lincoln, Washington, Senior), my experience as a teacher of sociology (urban sociology, crime, poverty, race and research are content areas that I have taught), and my experience with social research. I am applying so my energy and my skills can be better guided to do some good for the whole community. List two reference with names and addresses:: Dr. Regina Boarman Clarke University 1550 Clarke Drive Dubuque, IA 52001 Dr. Donna Loewen Lincoln Elementary School 5th and Nevada Dubuque, IA 52001 Are you currently serving on other Boards, Commissions, or Committees ?: No If yes, which ?: Select One Have you served on a Board, Commission, or Committee before ?: No -v cn O 0 m m 0 (11/12/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 2 If yes, which ?: Select One Signature:: Rachel K. Daack Date:: 11/12/10 Additional Information: Form submitted on: 11/12/2010 1:49:34 PM Submitted from IP Address: 192.231.201.2 Referrer Page: http: / /www. cityofdubuque .org /index.aspx ?nid =78 Form Address: http: / /www. cityofdubuque .org /forms.aspx ?FID =75 TIME CITY OF Dus Masterpiece on the Mississippi 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 Street, Dubuque, IA accepts applications for any Board and /or Commission at any time, and the application stays active for one year from the date of receipt in the Clerk's Office. At the appropriate regularly scheduled meeting, applications will be submitted to the City Council for their review and applicants are encouraged to address the Council stating their reasons for wanting to serve on this particular Board or Commission. Applicants will be advised when the application is being presented. Appointment to the Board or Commission will be made at a later meeting. Applicants will then be notified as to the outcome of the Council's action. If not appointed at that time, this application will be resubmitted, as needed, as long as the application is active (unless the applicant advises they are no longer interested). ADVISORY BOARD /COMMISSION APPLYING FOR: NAME: _ A3n6,47 \ 1Da �S ADDRESS: 51 lam u V1� cL Ao (City of Dubuque residency ce BUSINESS: OCCUPATION: Ak HOME PHONE: ¶ Q - lc t o 0- E -MAIL ADDRESS(ES): a Clk,t (7 )RA QXSI \ , IOm EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: e c� 1ohr� aacatrytij A car - \ l ca lr 'Th PI r. \i o - � �,�, -ot ) _.g:.. V_.tbt% WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: al/ \L _:ate ` •. LIST TWO REFERENCES: NAME: u(j �+�} J NAME: SIGNATURE: Osc 0.0P k- ly r\eas Specific tti ri - aid "' d t CITY OF DUBUQUE, IOWA BOARD/COMMISSION APPLICATION t. ias AS ( ome boards /commissions requ - State of Iowa Gen DATE: Q\9r X-)�O . at, V \ a �t Balance compliance) ADDRESS: POSITION WITH COMPANY: cue BUSINESS PHONE: `J193 - 3 *Q-' c` l C.. lianas && - .1P poi '0 1 ADDRESS: (i)a7 St'.0_r. L,r� �c r �� t \J ADDRESS: b oo n + ai-vo O B0 interest. For fu her clarification,Jif a situation arise , contact IC « erect o p. s •1conflict of the appropriate staff person or the City's legal staff. Are you currently serving on a City Board or Commission: Name: If questions, contact the City Clerk's Office, City Hall, 50 W. 13 St., Dubuque, IA 52001. Phone 563/589 -4120. Fax 563 / 589 -0890, www.cityofdubuque.org. All names will be dropped from the list after a one -year period. RECEIVED 100CT28 P1114 :26 City Clerk's Office Dubuque, IA (11/29/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support©civicplus.com> To: <kfirnsta©cityofdubuque.org> Date: 11/28/2010 2:26 PM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for:: Safe Community Advisory Committee Name:: Ann R. Ernst Home Address:: 899 Mt. Carmel Rd. Home Phone Number:: 563 582 -3721 Business Name and Address:: Am not an employee but am under contract on a part time basis with Operation New View 1473 Central 563 556 -5130 Business Phone Number:: N/A cell is 563 581 -8097 Occupation:: psychologist Email Address:: ernstannr @mchsi.com Experience or education which qualifies you for this board or commission:: I hold a PhD from the University of lowa,am licensed by the IA Dept.of Health and have worked for many years in hospitals, schools and clinics in Dubuque. This experience could be helpful in recommendations for overcomiong roadblocks to implimenting the Advisory Committee's proposal. What contributions can you make or state reason for applying ?: Fascilitating communication, information gathering and cooparative endeavors are skills developed while a Board member of organizations such as the Friends of the Mines of Spain, the YMCA and Camp Courageous.) recognize the anxiety about safety expressed by those whom I have counseled as well as friends in Dubuque.I would like to help address and alleviate these concerns. List two reference with names and addresses:: Mary E. Richards 1695 Mt. Pleasant Dubuque, IA 52001 Douglas G. Olk, MD 750 Tangelwood Ct. Dubuque, IA 52003 Are you currently serving on other Boards, Commissions, or Committees ?: No If yes, which ?: Select One Have you served on a Board, Commission, or Committee before ?: No If yes, which ?: Select One Signature:: Ann R .Ernst PhD Date:: 11/29/10 (11/29/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 2 Additional Information: Form submitted on: 11/28/2010 2:25:59 PM Submitted from IP Address: 173.20.129.214 Referrer Page: http: / /www.cityofdubuque .org /index.aspx ?NID =78 Form Address: http: / /www.cityofdubuque .org /forms.aspx ?FID =75 f THE CITY OF Dui Masterpiece on the Mississippi 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 Street, Dubuque, IA accepts applications for any Board and /or Commission at any time, and the application stays active for one year from the date of receipt in the Clerk's Office. At the appropriate regularly scheduled meeting, applications will be submitted to the City Council for their review and applicants are encouraged to address the Council stating their reasons for wanting to serve on this particular Board or Commission. Applicants will be advised when the application is being presented. Appointment to the Board or Commission will be made at a later meeting. Applicants will then be notified as to the outcome of the Council's action. If not appointed at that time, this application will be resubmitted, as needed, as long as the application is active (unless the applicant advises they are no longer interested). ` DATE: JOB /,/ / e /C) ADVISORY BOARD /COMMISSION APPLYING FOR: NAME: p\ \ •x rev..c BUSINESS: fn U OCCUPATION: f e. (A.- Co ;ry \ t --- , l'ekc:k- c c HOME PHONE: 5 (o .Y SS 1 ■ WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: LIST TWO REFERENCES: NAME: nee` NAME: SIGNATURE: -\v �� C. vti E CITY OF DUBUQUE, IOWA BOARD /COMMISSION APPLICATION Dubuque 11111, ca 2007 (Some bo s /commissions require St e of Iowa Gender B nce compliance) ADDRESS: /C.SS tKor tsc\c & 9 (City of Dubuque residency required) ADDRESS: /0 3S Pock ( ''.c .g0 POSITION WITH COMPANY: O i.A) fl C C / /040/- BUSINESS PHONE: jC�, 3 j 2 '� / �o ?< E -MAIL ADDRESS(ES): EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: cc, , r , 0.. \cp O WC 3ACkk- n 'CN. kvA t \ e \ v. n L.,) ?5 09 -c- U IL 4/36:3 SS 62 ADDRESS: ADDRESS: 6) h mil' n 5 (n 3 /q 5 ‘-rO q(J Specific attention should be directed to possible conflict of interest. For further clarification, if a situation arises, contact the appropriate staff person or the City's legal staff. Are you currently servi g on City Board or Commission: Name: If questions, contact the City Clerk's Office, City Hall, 50 W. 13 St., Dubuque, IA 52001. Phone 563/589 -4120. 563 / 589 -0890, www.cityofdubuque.org. All names will be dropped from the list after a one -vear period. Fax RECEIVED 10 OCT 26 PM 1:12 City Clerk's Office Dubuque, IA Masterpiece on the Mississippi CITY OF DUBUQUE, IOWA BOARD /COMMISSION APPLICATION Dubuque kraal II 1' I� 2007 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 Street, Dubuque, IA accepts applications for any Board and /or Commission at any time, and the application stays active for one year from the date of receipt in the Clerk's Office. At the appropriate regularly scheduled meeting, applications will be submitted to the City Council for their review and applicants are encouraged to address the Council stating their reasons for wanting to serve on this particular Board or Commission. Applicants will be advised when the application is being presented. Appointment to the Board or Commission will be made at a later meeting. Applicants will then be notified as to the outcome of the Council's action. If not appointed at that time, this application will be resubmitted, as needed, as long as the application is active (unless the applicant advises they are no longer interested). DATE: I/ /Z) ADVISORY BOARD /COMMISSION APPLYING FOR: . /// /> �/ _ ,Ii boards/commissions re • ire State of Iowa Ge• Balance compliance) / ADDRESS: 2..7._ // u `f// e� Ce` „ v` �� ty of Dubuque residency required L� r BUSINESS: h l,.. y d PV //' ---- i ' ' ADDRESS: z 00 08i,4 �•t `rizir6�'r yj OCCUPATION: / c4 v kj / L A -1 1 vt. G(, 1"e— '.POSITION WITH COMPANY: f Ct. ot HOME PHONE: 5 r,3 -- 44 `7 BUSINESS PHONE: L c/ � 9 Z 6 3 E -MAIL ADDRESS(ES): �I' 2 �'� / s,� a • EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: .ck s c' 5L.L, C- r� o t e d 6 e rri ems, [ 3o NAME: 4 L ct. rn { � WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: _1 t y 1A--e , !/` e s " LIST TWO REFERENCES: �U NAME: a v t [�ltk ( cvh �l NAME: .7'ev✓'7 /4€/ b e, v -A// — S ADDRESS: /T 6 V' . v' irvo i r /fir 3,5" 4faob„ Mfve -/. 64A.h tug, l� ADDRESS: 6 K q 6 5lbn ® Specific attention should be directed to possible conflict of interest. For further clarification, if a situation arises, contact the appropriate staff person or the City's legal staff. Are you currently serving on a City Board or ommission: N 0 Name: SIGNATURE: If questions, contact the City Clerk's Office, City Hall, 50 W. 13 St., Dubuque, IA 52001. Phone 563/589 -4120. Fax 563 / 589 -0890, www.cityofdubuque.org. All names will be dropped from the list after a one -year period. RECEIVED 10N0V23 PM 3: I I City Clerk's Office Dubuque, IA Masterpiece on Mc Missis ip1'i 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` Street, Dubuque, IA accepts applications for any Board and /or Commission at any time, and the application stays active for one year from the date of receipt in the Clerk's Office. At the appropriate regularly scheduled meeting, applications will be submitted to the City Council for their review and applicants are encouraged to address the Council stating their reasons for wanting to serve on this particular Board or Commission. Applicants will be advised when the application is being presented. Appointment to the Board or Commission will be made at a later meeting. Applicants will then be notified as to the outcome of the Council's action. If not appointed at that time, this application will be resubmitted, as needed, as long as the application is active (unless the applicant advises they are no longer interested). ADVISORY BOARD /COMMISSION APPLYING FOR: _ . � �c� K .'1 /0p -ad_ ;14," (Som boards /commissions regiire State of Iowa Oender Balance compliance) ADDRESS: /a ,S S hdc- , .. •it L54 ` )b f , .5) c: (City of Dubuque residency required) BUSINESS ,� .,,,` k /....c.st ADDRESS: t34 S Ca./L:6 iz 2 r ,s . / POSITION WITH COMPANY: t `5 . 61 :, v as ..„`( BUSINESS PHONE: CS �'o .3 - ,S- Y - /q7 0 E -MAIL ADDRESS(ES): , L�' : � ee ,,,. . r v,4vt oe � . s i•/ A »t.c .res,� EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: NAM OCCUPATION: HOME PHONE: \S ?. 3 -, ; f -7 WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: r•S 5 •♦ t dL CITY OF DUBUQUE, IOWA BOARD /COMMISSION APPLICATION DATE: (6 ' Z / -- / r iaC I -•• t r • r 41.42 I.:a :. I — yt /1 u. r .•._ .a e ,1�0 4 -S .S !• -Gs d ■ e r O,n_ cAM . c_ at. rCIL c: ca. , L) •' ..i �1 LIST TWO REFERENCES: NAME: Mc. �� / // Q..•� 11 � . rs/f..�w� , ,4 (> » ADDRESS: )10 fso NAM30. crq K� r,SC�rrt� rah ADDRESS: / y s (' ,Q l i<— ( , < tbitr , ski Specific attention should be directed to possible conflict of interest. For further clarification, if a situation arises, contact the appropriate staff person or the City's legal staff. Are you currently serving on a City Board or Commission: y. , Name: SIGNATU E / , / ; If questions, contact he City Clerk's Office, City Hall, 50 W. 13 St., Dubuque, IA 52001. Phone 563/589 -4120. Fax 563/589 -0890, www.cityofdubuque.org. All names will be dropped from the list after a one -vear period. RECEIVED 100CT25 APIII :21 City Clerk's Office Dubuque, IA (11/4/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 1 From: <support@civicplus.com> To: <kfirnsta @cityofdubuque.org> Date: 11/4/2010 12:56 PM Subject: Online Form Submittal: Board /Commission Application Form The following form was submitted via your website: Board /Commission Application Form Select the Board, Commission, or Committee applying for:: Safe Community Advisory Committee Name:: Susan Stork Home Address:: 2115 Golden Eagle Drive Home Phone Number:: 563- 564 -6843 Business Name and Address:: Northeast Iowa Community College Dubuque Center for Education 700 Main Street Dubuque 52001 Business Phone Number:: 563 - 557 -8271, x104 Occupation:: Center Coordinator Email Address:: storks @nicc.edu Experience or education which qualifies you for this board or commission:: I have served as a member of the Management of Physical Environment Sub Committee of the Safe Community Task Force. I was present at the first community meeting in September 2009, and have consistently attended Task Force and Sub Committee meetings ever since. What contributions can you make or state reason for applying ?: I believe I can offer continuity and perspective to the Advisory Committee since I have participated in this project since it's inception. My work at the NICC Dubuque Center makes me uniquely prepared to address the issue of education and job training in relation to a safe and healthy community. List two reference with names and addresses:: Wendy (Wheelock) Knight Executive Director of NICC Dubuque and Town Clock Center for Professional Development 680 Main Street Dubuque 52001 557-8271, x130 Joyce Connors City Council Member 660 Edith Street Dubuque 52001 582 -3843 Are you currently serving on other Boards, Commissions, or Committees ?: No If yes, which ?: Select One Have you served on a Board, Commission, or Committee before ?: No (11/4/2010) Kevin Firnstahl - Online Form Submittal: Board /Commission Application Form Page 2 If yes, which ?: Select One Signature:: Susan L. Stork Date:: 11-4 -2010 Additional Information: Form submitted on: 11/4/2010 12:56:29 PM Submitted from IP Address: 205.221.67.193 Referrer Page: No referrer - Direct link Form Address: http:// www. cityofdubuque .org /forms.aspx ?FID =75 Masterpiece on the Mississippi 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 Street, Dubuque, IA accepts applications for any Board and /or Commission at any time, and the application stays active for one year from the date of receipt in the Clerk's Office. At the appropriate regularly scheduled meeting, applications will be submitted to the City Council for their review and applicants are encouraged to address the Council stating their reasons for wanting to serve on this particular Board or Commission. Applicants will be advised when the application is being presented. Appointment to the Board or Commission will be made at a later meeting. Applicants will then be notified as to the outcome of the Council's action. If not appointed at that time, this application will be resubmitted, as needed, as long as the application is active (unless the applicant advises they are no longer interested). SIGNATURE CITY OF DUBUQUE, IOWA BOARD /COMMISSION APPLICATION ADDRESS: Cs-3—Z- r y Dubuque ahnericaCiry ' 11 1' 2007 DATE: J1 — 1 D ADVISORY BOARD /COMMISSION APPLYING FOR: (-4, fe d a) rn :,r 0 , ( y L- ✓YL m , '1-- 1- - Cr: y (Some boards /commissions require State of Iowa Gender Balance compliance) NAME: / y y� t) C iL t- 11 0 - - � ADDRESS: ? 7,' i I Gl - c 7 (City of Dubuque residency required) BUSINESS: 4//4— ADDRESS: A/ OCCUPATION: L P A/ POSITION WITH COMPANY: I t, /1 HOME PHONE: 5? - S --- 5 ` 4 BUSINESS PHONE: Al 1 E -MAIL ADDRESS(ES): 5 £e / k? N (f-' /-y/ S ,- , e c , EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: F O r ill_ < 5 u c m pl.- , �7 J s A C4 -j c - C ; vt <�L •I .-e S ' ! eirt / c, it -C AL / /( f,,Q v y !-.t' 4 - �; t, , / ; ; � T f'L /, r lie," A . So C • v, -� p, -9 s l e - t - e I y- 4 / -z � /c/ cJ Vc /� k I S C C ,i2 /� , ,. WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: T "i 4 et ` t >C` ( -h ( - S // m /i- i c-e rr , y 7--- 1 (p AOic L„,. 44 --- 7'7 CI l 11- C I k‘._ / F S C7 c Li , /, / 1 LIST TWO REFERENCES: !/ NAME: 1��/4 5 c� ( / -1 e y ADDRESS: S — r Y / NAME: .1 tc 0.. -e SC en c' / Specific attention should be directed to possible conflict of interest. For further clarification, if a situation arises, contact the appropriate staff person or the City's legal staff. Are you currently serving on a City Board or Commission: y / / < r L- - rf''1 'L If questions, contact the City Clerk's Office, City Hall, 50 W. 13 St., Dubuque, IA 52001. Phone 563/589 -4120. Fax 563/589 -0890, www.cityofdubuque.org. All names will be dropped from the list after a one -year period. RECEIVED 100CT29 PM 3 :35 City Clerk's Office Dubuque, IA