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Boards and Commissions Application ReviewVACANCIES AND APPLICATIONS FOR CITY OF DUBUQUE BOARDS AND COMMISSIONS For Council Meeting of Monday, August 1, 2011 6:30 p.m., Historic Federal Building, 350 W. 6th Street APPLICANTS ARE INVITED TO ADDRESS THE COUNCIL ON THEIR POSSIBLE APPOINTMENT Housing Commission Three 3 -year terms through August 17, 2014 (Expiring terms of Eudaley, Rogaskie, and Ronek) Applicants: Amy Eudaley, 950 Wood Street Patricia Rogaski, 1502 % Maple Street Regine Ronek, 2282 White Street Ms. Ronek also serves on the Human Rights 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 Amy Wagner Douglas Brotherton *Michael A. Santillo Charles Daoud Steven R. Accinelli 09 -14 -12 09 -14 -13 09 -14 -13 09 -14 -14 09 -14 -14 AIRPORT ZONING COMMISSION 6 Yr. Term - Apptd. 1996, Meets on Call 'Steve Horsfield (By Board Vote) 01 -03 -02 Linda Lucy (County) 12 -31 -02 Marianne Krause (county) 12.31 -08 Tom Henschel (City ZAC) 01 -03 -14 Jeff Stiles (City zac) 01 -03 -14 AIRPORT ZONING BOARD OF ADJUSTMENT 6 Year Tenn, 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 4ei Tues., 4:30, Library Brd Rm. Ellen H Henkels (eus/Prof) 06 -30 -12 Julie Steffen (Bus /Prof Dist) 06 -30 -12 *Geri Shafer (At Large) 06 -30 -12 Louise Karnes (Arts) 06 -30 -13 Marina O'Rourke Rosenow (Arts) 06 -30 -13 Susan Riedel (Arts) 06 -30 -13 Paul Hemmer (Arts) 06 -30 -13 BOARD OF APPEALS - BUILDING CODE Appt. 3 Yr. Term, Meets on Call Vacant (Term of Anglese) (At Lrg) 08 -01 -11 Maria 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 Ruth Ann Hanson John F. Ganshirt Donald Lochner Robert Schaub Greg Hutchinson (Realtor) 01 -01 -14 (Constr) 01 -01 -14 01 -01 -16 01 -01 -17 01 -01 -17 CIVIC CENTER ADV COMMISSION 3 Yr. Term - Meet 4:30 p.m. 4th Monday at Five Flags Cynthia A. Fuller 'Bryce Parks Rod Bakke Vacant (Term of Field) Barb Kurt 06 -29 -12 06 -29 -12 06 -29 -13 06 -29 -13 06 -29 -13 CIVIL SERVICE COMMISSION 4 Yr. Term, Meets on Call Elizabeth Takes *Daniel White James Schilling 04 -06 -12 04 -06 -13 04 -06 -14 COMMUNITY DEVEL ADV. COMMISSION 3 Yr. Term, Meets 3rd Wednesday, 5:30 p.m. at Federal BIdgJHousing 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/in Inc A) 02 -15 -13 Peter Koshakji (At Large) 02 -15 -13 Ricardo Woods (Housing Rep) 08 -15 -13 Ann Michalski (At- Large) 02 -15 -14 David Shaw (Low/M Inc Area) 02 -15 -14 Vacant (LO Craddieth) (Low /M Inc Area) 02 -15 -14 ELECTRICAL CODE BOARD 3 Yr. Term; Meets Bi- Monthly Bob Schmidt Paul J. Uhlrich James Dixon Dan Hammel Ronald Mueller Elaine L. Reiss *Kevin Pfohl (Elec. Bkground) 05 -21 -12 (Elec. Bkground) 05 -21 -12 (Elec. Con.) 05 -21 -14 (JourlMaim) 05 -21 -14 (At Large) 05 -21 -14 (Elec. Engr.) 06 -21 -14 (Jour /Mainz) 05 -21 -14 ENTERPRISE ZONE COMMISSION 3 Year Term, Meets on Call *Rick Stein (At Large) 2 -15 -12 Dan LoBianco (At Large) 2 -15 -12 Doug Stillings (At Large) 2 -15 -12 Richard Van hen (from LRP) 2 -15 -13 Kelley Deutmeyer (IDED) 2 -15 -13 Dave Baker (Intl Labor) 2 -15 -13 Peggy Murray (IA workforce Dev) 2 -15 -14 Mike Van Milligan (Council Rep) 2 -15 -14 Daniel White (NICC) 2-15-14 ENVIRONMENTAL STEWARDSHIP ADVISORY COMMISSION - 3 Yr. Term Meets 1 *t Tues. 5 p.m. City Hall Annex *Wayne Klostermann Edward Cawley Gayle Walter Aditi Sinha Vacant - Youth (Term of Miller) Michael J. Buelow Chad Oberdoerster 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 3id Thursday, 6:30 p.m., Federal Bldg D. Joseph Rapp (old Main interim) 07 -01 -12 Mary Loney Bichell (At Large) 07 -01 -12 Michael Knight (At large) 07 -01 -12 Christine Olson (At Large) 07 -01 -12 Robert McDonell (Jackson Pk) 07 -01 -13 John E. Whalen, MD (w. 11th) 07 -01 -13 Christopher J. Wand (Arch /At Lg) 07 -01 -14 'David Klavitter (Langworthy) 07 -01 -14 Mitzi Krey (Cathedral) 07 -01 -14 HOUSING COMMISSION 3 Yr. Term, 4d' Tues. 4:30 p.m., Fed Bldg Amy Eudaley 08 -17 -11 Patricia Rogaskie 08 -17 -11 Regine Ronek 08 -17 -11 'David J. Kepler 08 -17 -12 Dorothy Culbertson(Trust Fund Rep)08 -17 -12 Jim Holz (Trust Fund Rep)08 -17 -12 Lisa McAllister (Sec. s Area) 08 -17 -12 Judie Root 08 -17 -13 Dorothy Schwendinger, OSF 08 -17 -13 Ricardo Woods (CDAC Rep) 08 -17 -13 HOUSING TRUST FUND ADVISORY COMMITTEE 3 Yr. Term, Meets 6x/Year *Jim Holz Dorothy Culbertson Doris M. Hingtgen Vacant (Tenn of Eddy) John V. Walsh (From Hug) 08 -17 -12 (From Hsg) 09 -08 -12 (At Large) 09 -08 -12 (From. Hag.) 08 -17 -13 (At Large) 09 -08 -13 HOUSING CODE APPEALS BOARD 3 Yr. Term, 3rd Tues. 4:30 p.m. Fed Bldg. Fred Miller Paul Newman 'Robert Schaub William J. Kinsella Vacant (Term of Matheos) David Young Vacant (Term of Moore) 01 -11 -12 01 -11 -12 01 -11 -13 01 -11 -13 01 -11 -13 01 -11 -14 01 -11 -14 HUMAN RIGHTS COMMISSION 3 Yr. Term, Meets tad Mon. 4:30 Annex 'Anthony Allen Kurt Hansen R.R.S. Stewart Regine Ronek Mitzi Krey Judie Root Andrea Beacham Michael Elliot Megan Gloss 01 -01 -12 01 -01 -12 01 -01 -12 01 -01 -13 01 -01 -13 01 -01 -13 01 -01 -14 01 -01 -14 01 -01 -14 As prepared for the 8 /1 /11 Council meeting INVESTMENT OVERSIGHT ADVISORY COMMISSION - 3 Yr. Term, Meets Qtrly; 4ui Wednesday 3 p.m. City Hall "A" Brad Chalmers Hiram Melendez 'Gary Ruden Stephen V. Reisdorf Paul Lassance 07 -01 -12 07 -01 -12 07 -01 -13 07 -01 -13 07 -01 -14 LIBRARY BOARD OF TRUSTEES 4 Yr Term, Meets 46 Thurs. 4 p.m.Llbrary Paula Connors John Anderson- Bricker Mike Willis *Diann Guns Fred Miller David Hammer Jenny Leigh Hams (07 -01 -12 (07 -01 -12 07 -01 -13 07 -01 -14 07 -01 -14 (07 -01 -15 (07 -01 -15 LONG RANGE PLAN'G ADV COMM. 3 Yr Term Meets 3rd Wed. 7p.m. Fed Bldg John Pregler 07 -01 -12 Chad Darter 07 -01 -12 Charles Winterwood, MD 07 -01 -13 *James F. Prochaska 07 -01 -13 Vacant (Term of enlg) 07 -01 -14 Richard Van !ten (Ent Zone Rep) 07 -01 -14 Alan Vincent 07 -01 -14 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 03 -16 -14 03 -16 -14 03 -16 -12 03 -16 -12 03 -16 -13 03 -16 -13 03 -16 -13 MEDIACOM CHARITABLE FOUNDATION 1 Yr. Term, On -Call, CC Appt'd Reps. Gail Chavenelle Connie Twining 12/31 /11 12/31/11 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"d Tues. 4:30 p.m. Bunker Hill Robert Blocker Karen C. Lyness David Schlueter Paul Hoffmann Chuck Harris Kenneth Klinge Evelyn Nadeau 06 -30 -12 06 -30 -13 06 -30 -13 06 -30 -13 06 -30.14 06 -30 -14 06 -30 -14 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 (Term of Swift) (At- Large) 11 -02 -12 Dan Harris (At Large) 11 -02 -12 Paul Pepin (at will) (Journeyman) 11-02-12 SAFE COMMUNITY ADVISORY CMTE 1 Yr Terms, Terms, Meets Quarterly Anthony Allen Mary Rae Bragg Diane Callahan Jonathan Cheatham Rachel Daack Ann Emst Doug Stillings SusanStork Amanda Elkins 12/31/11 12/31/11 12/31/11 12/31/11 12/31 /11 12/31/11 12/31 /11 12/31/11 12/31/11 SISTER CITY RELATIONSHIPS ADV CMS 3 Yr Terms, Meets Quarterly (Council Rep) (Council Rep) 2/1/12 2/1/12 2/1/12 2/1/13 2/1/13 2/1/13 2/1/14 2/1/14 2/1/14 2/1/14 2/1/14 Kevin Lynch Joyce Connors Jeffrey Jochum William Mclntee Pat McNamara Michael Coty Betty Phillips Louise Thurn Larissa Filimonenko Sheila Castenada Dick Landis Jill Connors Annalee Ward TRANSIT ADVISORY BOARD 3 yr. Term, Meet Monthly, rd Thurs. Lib Matthew Esser Rhonda Knight R.R.S. Stewart George Enderson *Joel Lightcap 07 -30 -12 07 -30 -13 07 -30 -14 07 -30 -14 07 -30 -14 TV CABLE REGULATORY COMMISSION 3 Yr. Term, Meets 2nd Wed OC. 5:30 Annex *Charlie Ellis Kevin R. Stevens Vacant (Term of Bellings) Ronald Tigges Walter Webster 06 -30 -12 06 -30 -13 06 -30 -13 06 -30 -14 06 -30 -14 TV CABLE COMMUNITY TELEPROGRAMMING COMMISSION 3 Yr. Term, Meets 1 °` Tues. 5:30 Annex Jennifer L. Tigges Alan Vincent Vacant (Term of McDonough) Vacant (Term of Everist) Pauline J. Maloney George P. Herrig Sr. Carol Hoverman 06 -30 -12 06 -30 -12 06 -30 -12 06 -30 -13 06 -30 -14 06 -30 -14 06 -30 -14 ZONING ADVISORY COMMISSION 3 Yr. Term, Meets 1" Wed. 6:30 Fed Bldg Charles Miller 07 -01 -12 Stephen Hardie 07 -01 -12 Patrick Norton 07 -01 -13 *Jeff Stiles (Airport ZC) 07 -01 -13 Martha E. Christ 07 -01 -14 Thomas Henschel (Airport ZC) 07 -01 -14 Ron Smith 07 -01 -14 ZONING BOARD OF ADJUSTMENT 6 Yr,Tefm; Meets 4th Thurs. 4 pm Fad Bldg William J. Gibbs 03 -25 -12 Jeff Cremer 03 -25 -13 Heath Hutchinson 03 -25 -14 *Michael A. Ruden (Airport ZBA) 03 -25 -15 Randall J. Klauer (Airport ZBA) 03 -25 -16 = Indicates State- mandated board /commission subject to 2012 Gender Balance Law. Title 2 Chapter 5 Housing Commission 2 -5B -1: COMMISSION CREATED: There is hereby created a housing commission. (2007 Code § 15 -21) 2 -5B -2: PURPOSE; APPROVAL OF PROPOSALS: A. Duties And Responsibilities: The housing commission shall monitor and evaluate city housing needs and shall make recommendations to the city council as to how those needs can be met. In furtherance of this mission, the housing commission's duties and responsibilities shall include, but not be limited to, the following: 1. To contribute as appropriate in the planning, coordinating and review of housing development; 2. To conduct public hearings to ensure meaningful citizen input in the planning, implementation and assessment of the city's housing programs; 3. To provide for and encourage the participation of low and moderate income persons in the planning, implementation and assessment of housing programs; 4. To provide input into the community planning process and to assist in accomplishing a coordinated and consistent housing development program of the city in accordance with present and future housing needs; 5. To request and review ongoing surveys assessing housing needs and identifying future community housing needs, particularly the needs of persons of low and moderate income; 6. To support the efforts of the city council and other city commissions in the assessment of the general housing needs of the community; 7. To undertake from time to time other specific ongoing housing planning which may be referred to it by the city council; 8. To research and recommend to the city council policies and programs facilitating the development of affordable housing; 9. To undertake public information efforts to educate citizens of the availability of federal, state and locally funded housing assistance programs; 10. To assist in the preparation of the housing element of the city comprehensive plan and the annual consolidated plan; 11. To offer comment, as appropriate, on the consistency of proposed housing development with the comprehensive plan, consolidated plan and existing city-housing strategies. B. Project Approval: Any proposed low rent housing project shall be subject to specific approval by the city council and any project requiring a referendum as provided in the code of Iowa shall be submitted to the voters of the city in accordance with the code of Iowa. C. Monitor Housing Program; Conduct Hearings On Grievances: The housing commission shall monitor the city's housing program and conduct hearings on grievances which arise out of the operation of such program except in the area of housing code enforcement. D. Additional Duties: The housing commission shall undertake such additional duties, with regard to the housing trust fund, as are specified in this code. (2007 Code § 15- 22) 2 -5B -3: MEMBERSHIP; VACANCIES; QUALIFICATIONS: A. Membership: The housing commission shall be comprised of ten (10) members. B. Term Of Office: Appointments shall be for a term of three (3) years. C. Vacancies: Vacancy caused by death, resignation or otherwise on the commission shall be promptly filled by the city council for the unexpired term of office. D. Manner Of Selection: At least three (3) members of the commission shall be selected specifically on the basis of experience in real estate development, banking, finance, accounting, funds management or other related areas of expertise. E. Member Receiving Rental Assistance: One member of the commission shall be a person who is a recipient of tenant based rental assistance under section 8 of the United States housing act of 1937 (42 USC 1437f) whose name appears on a lease of section 8 property and who is eighteen (18) years of age or older. If such member ceases to be a recipient of rental assistance under section 8, the term of such member shall be deemed terminated and a new member who meets the requirements of this subsection shall be appointed for the remainder of the term. (2007 Code § 15 -23) 2 -5B-4: MEETINGS: A. Frequency Of Meetings: The housing commission shall meet not less than monthly. B. Attendance Of Members: Members of the commission shall attend at least two- thirds (2/3) of all regularly scheduled and held meetings within a 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 the member be replaced. The attendance of all members shall be entered upon the minutes of all meetings. C. Minutes Filed With Clerk: The housing commission shall file with the city clerk a copy of the minutes of each regular and special meeting of the commission within ten (10) working days after each such meeting. (2007 Code § 15 -24) 2 -5B -5: COMPENSATION: All members of the commission shall serve without compensation except for reimbursement of necessary expenses. (2007 Code § 15 -25) 2 -5B -6: INTERNAL ORGANIZATION AND RULES: The commission may adopt rules and regulations to govern its organizational procedures as it may deem necessary and which are not in conflict with this article. (2007 Code § 15 -26) 2 -5B -7: PROCEDURES FOR OPERATIONS: All administrative personnel, accounting, budgetary and procurement policies of the city shall govern the commission in all of its operations. (2007 Code § 15 -27) Masterpiece on the Mississippi CITY OF DUBUQUE, IOWA BOARD /COMMISSION APPLICATION Dubuque �I �j► II 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 13th 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: 4hU / (�( tet BUSINESS: DATE() 7 ' % L(- ac/ I tD L51 Ut L y1A F1& V S \ ou (Some boards /comrrs ions require State of Iowa Gender Balance compliance) ADDRESS: Q, b tip D 0(9. ti ((City of Dubuque residency required) ADDRESS: OCCUPATION: lnVr WV.I - ( d j ►1,QJc— POSITION WITH COMPANY: Po +- - �1 HOME PHONE: 6-6 3 - 55 -- BUSINESS PHONE: 54Z— 2, (3 5-3 E -MAIL ADDRESS(ES): EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: rr CAAji nQm ∎1 fAvioity,t1 r ex -t a ids I� L-. [. Ii' La.. /_�.1 I /1 .'AL! _ mo_ iii/ 'AA • it WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: dal) Calte-- 1g-eV.' 0 c (0.1/1 1 J� , `'`� 44- JC.Cit/"l. J/YV LIST TWO REFERENCES: NAME: J i/tl .vl R00± NAME: i'\V\ Sckr"D1 ADDRESS: 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. 140 Are you currently i g n a ity - -rd •�,,;;�ssion: V�� Name: tr .,St C�l►�- SIGNATURE: If questions, cont he City Clerk's Offic4/6ity Hall, 50 W. 13th 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 11 JUL 25 AM 7: 59 City Clerk's Office Dubuque, IA (4/12/2_g11) Kevin Firnstahl - Online Form Submittal: Board /Commission _ Page 11 From: <support @civicplus.com> To: <kfirnsta @cityofdubuque org >, <dharrjs @cityofdubuque.org >, <jawalker @cit... Date: 4/11/2011 6:06 PM %1', )/ = 6//( 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:: Housing Commission Name:: Patricia J Rogaskie Home Address:: 1502 1/2 Maple St Home Phone Number:: 563 -495 -2188 Business Name and Address:: N/A Business Phone Number:: N/A Occupation:: School Bus Driver Email Address:: patriciadubuque @yahoo.in Experience or education which qualifies you for this board or commission:: BA Management/Leadership emphasis on Human Services. Worked in Group home as an Assistant learning state requirements and policies. PROFESSIONAL EXPERIENCE Area Residential Care Dubuque, IA QMRP Assistant 12/2006 —11 /2008 • Managed client's personal accounts • Organized and scheduled monthly outside activities • Balanced group home grocery account and activity accounts • Delegated and scheduled staff to individuals (maintaining individual to staff ratios) • Reviewed prepared and collected monthly data • Planned and coordinated in home activities Administered medications Work History School Bus Driver 10/2008- Current Dubuque Community Schools Dubuque, IA Bakers Helper Sara Lee Bakery Dubuque, IA 8/2006 - 8/2010 Sales Associate Health and Beauty/Customer Service Desk Dubuque, IA 12/2008 -4/2008 Wal -Mart QMRP Assistant 12/ 2006- 10/2008 Area Residential Care Services Pharmacy Technician 2001 -2004 OSF Saint Anthony Medical Center UNITED STATES AIR FORCE Dubuque, IA Rockford (4/12/2011) Kevin Firnstahl - Online Form Submittal: Board /Commission Page 2 Chanute Air Force Base /Sembach Air Base Civil Engineering Squadron — Interior Electrician EDUCATION AND TRAINING • BA — Management and Leadership, Judson College, IL • Interior Electrician course — Sheppard Air Force Base, TX AWARDS AND COMMENDATIONS • Small Arms Marksmanship Ribbon • NCO Professional Military Education Ribbon • Air Force Longevity Service Award Ribbon • Air Force Good Conduct Medal What contributions can you make or state reason for applying ?: I want to get involved in this community and believe that I would be an asset to the Housing Commission because I want to understand what it involves as wells as getting to know people in the community and work with builders, city officials, landlords, home owners to help build a strong community. List two reference with names and addresses:: Tom Budde 7258 Olde Davenport Road LaMotte, IA 52054 1- 563 - 543 -5361 Mary Jane Mitchell 5721 Fairway Drive South Beloit, Illinois 61080 815- 389 -6582 815 - 519 -1001 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:: Patricia J Rogaskie Date:: 4/20/2011 Additional Information: Form submitted on: 4/11/2011 6:06:17 PM Submitted from IP Address: 173.27.45.200 Referrer Page: No referrer - Direct link Form Address: http:// ■ww. cityofdubuque .org /forms.aspx ?FID =75 (4/12/2011) Kevin Firnstahl - Online Form Submittal: Board /Commission Page 2 Chanute Air Force Base /Sembach Air Base Civil Engineering Squadron — Interior Electrician EDUCATION AND TRAINING BA — Management and Leadership, Judson College, IL Interior Electrician course — Sheppard Air Force Base, TX AWARDS AND COMMENDATIONS Small Arms Marksmanship Ribbon NCO Professional Military Education Ribbon Air Force Longevity Service Award Ribbon Air Force Good Conduct Medal What contributions can you make or state reason for applying ?: I want to get involved in this community and believe that I would be an asset to the Housing Commission because I want to understand what it involves as wells as getting to know people in the community and work with builders, city officials, landlords, home owners to help build a strong community. List two reference with names and addresses:: Tom Budde 7258 Olde Davenport Road LaMotte, IA 52054 1- 563 - 543 -5361 Mary Jane Mitchell 5721 Fairway Drive South Beloit, Illinois 61080 815- 389 -6582 815- 519 -1001 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:: Patricia J Rogaskie Date:: 4/20/2011 Additional Information: Form submitted on: 4/11/2011 6:06:17 PM Submitted from IP Address: 173.27.45.200 Referrer Page: No referrer - Direct link Form Address: http:// www. cityofdubuque .org /forms.aspx ?FID =75 Masterpiece on the Mississippi CITY OF DUBUQUE, IOWA BOARD /COMMISSION APPLICATION Dubuque IICity II 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 13th 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 ADVISORY BOARD /COMMISSION APPLYING FOR: 1- 1,1', ;ry4 Gc y-Y"irr (Some boards /commissions require State of Iowa Gender Balance, compliance) NAME: Pi i r'1 r . ADDRESS: ( LL-41.1.41.5+- ity of Dubuque residency require L BUSINESS: ADDRESS: OCCUPATION: ?{t a/ C �cr�,r) �' POSITION WITH COMPANY: HOME PHONE: G.v:!j S / ?/ S BUSINESS PHONE: E -MAIL ADDRESS(ES): (IL v's -4-n 1..0? CL 9 \ Y7\ 5 (C f, 1 EXPERIENCE, EDUCATION WHICH QUALIFIES YOU FOR THIS BOARD /COMMISSION: 1 J , cr =r- ; � (Ltitid- r (LA WHAT CONTRIBUTIONS CAN YOU MAKE OR STATE REASON FOR APPLYING: LIST TWO REFERENCES: NAME: T", e_ rZoo+ ADDRESS: & -, R NAME: �� � �(! - -` l ADDRESS: !J C cc,t)t ) 1 • b �� 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: z5 Name: ADO in/ CAYrN �S-S t <Ty� v--‹* I SIGNATURE: ri,Q,(1)(k.,,v,tc •3'1l&_ If questions, contact they City Clerk's Office, City Hall, 50 W. 13th 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 11 JUL 12 API 10: 26 City Clerk's Office Dubuque, IA