HomeMy WebLinkAbout2021-04-06 AppointmentItem Number: 16.a.
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CITY OE IOWA CITY
www.iogov.org
April 6, 2021
Ad Hoc Truth and Reconciliation Commission - Four vacancies to fill
unexpired terms, upon appointment - June 30, 2022. (Johnson County
residency is required. Iowa City residency is preferred but not required if an
applicant offers expertise or representation not available from applicants who
reside in Iowa City. Members of other City boards and commissions are
eligible to serve on the TRC.) (Anthony Currin, Royceann Porter, T'Shailyn
Harrington and Raneem Hamad resigned) Correspondence included in
Council packet.
ATTACHMENTS:
Description
Raneem Hamad Resignation
Vacancy Notice/Coversheet
Board Demographics/Attendance
Alexakis, I oannis -Application
Ali, Nada -Application
Aron, Arianna - Application
Beining, Kaleb -Application
Biancheri, Theresa -Application
Borger Germann, David -Application
Buckley, Jennifer -Application
Burrell, Nicholas -Application
Carroll, James -Application
Culp, Priscilla -Application
Daly, Daniel -Application
Daniel, Daphney -Application
Dillard, Chasity -Application
Dirks, Sarah -Application
Erwin, Heather -Application
Garrison, William -Application
Gathua, Wangui -Application
Greer, Sarah -Application
Johnson, Clifton -Application
Jones, Nikesha -Application
Matharu, Wangui -Application
Melvin, Tineke -Application
Nelson, Erik -Application
Nichols, Amanda - Application
Nobiss, Sikowis (Christine)
Ramseyer, Amy - Application
Taylor, Angel - Application
Kellie Fruehling
From: Geoff Fruin
Sent: Thursday, March 25, 2021 10:05 AM
To: *Council Members
Cc: Eleanor M. Dilkes; Ashley Monroe; Rachel Kilburg; Kellie Fruehling
Subject: FW: TRC Resignation Letter
Attachments: Letter of Resignation.docx.pdf
Council,
Please see below and attached from TRC Commissioner Hamad.
Geoff
From: Stefanie Bowers
Sent: Thursday, March 25, 20219:52 AM
To: Geoff Fruin <Geoff - Fru in@iowa-city.org>; Eleanor M. Dilkes <Eleanor-Dilkes@iowa-city.org>
Subject: Fwd: TRC Resignation Letter
Begin forwarded message:
From: Raneem Hamad <raneemhamad @Rmail.com>
Date: March 25, 2021 at 9:38:30 AM CDT
To: Stefanie Bowers <Stefanie-Bowers@iowa-city.org>
Subject: TRC Resignation Letter
Your attachments have been security checked by Mimecast Attachment Protection. Files where no threat or malware
was detected are attached.
Hi Stefanie, attached below is my resignation letter. Thank you.
Raneem Hamad
Pronouns: She/Her/Hers
BA Candidate 2021, Human Rights & Public Health
Columbia University in the City of New York
Delta Sigma Theta Sorority, Inc., Rho Chapter
PLEASE NOTE: THIS EMAIL IS SENT TO PROVIDE THE COUNCIL WITH TIME -SENSITIVE INFORMATION. TO AVOID AN
UNINTENDED "MEETING' IN VIOLATION OF THE IOWA OPEN MEETINGS ACT, PLEASE DO NOT "REPLY TO ALL." IF YOU
HAVE A QUESTION, PLEASE CALL THE CITY MANAGERS OFFICE AT (319) 356-5010.
Resignation Statement of Raneem Hamad
As the Iowa Freedom Riders explained in an earlier stated (attached below), the City Council's decision
on March 16 to reprimand the Truth and Reconciliation Commission (TRC) with a month-long
suspension in response to the TRC's procedurally valid and substantively grounded decision to elect new
leadership demonstrated that the Council controls the TRC like a hand puppet and is prepared to
shamelessly use its power to get the results it wants from the TRC, even in the face of overwhelming
public pressure to the contrary.
The sad but unavoidable fact is that the TRC is limited to telling truths that the Council wants to hear.
These are not the truths that I and others from IFR wanted to focus on when we originally demanded a
TRC in June 2020. The Council, after all, has plenty of opportunities to hear its own voice and pat itself
on the back through commissions like the TRC and other forums, events, spokespersons, etc. We wanted
to focus on precisely those voices and truths that the Council desperately does NOT want to hear. Truths
that the Council continues to ignore, sideline, shut out, gaslight, and delegitimize in countless ways.
The TRC, for me, is not only a waste of time, it is draining and counterproductive. I am a Black, Muslim
woman and a young activist focused on a true struggle for Black liberation. I know that entrenched
systems of white supremacy will gladly sap the energies of Black women before ever giving up power. I
was willing to negotiate with Iowa City's neoliberal establishment to "assimilate" last summer's
revolutionary energy on strategic terms that could have enhanced and institutionalized that energy
without suppressing or distorting it. The Council has made a mockery of that agreement.
Effective immediately, I resign from the TRC. There is no longer any IFR representation or participation
with the TRC and the Council can breathe a sigh of relief.
This is a difficult decision for me. I have been fighting for racial justice, truth, and reconciliation in Iowa
City since childhood. I have spent hundreds of hours trying to bring the real vision of the TRC to life. I
literally worked on TRC matters from a hospital bed. I have faced a constant deluge of disrespect,
personal attacks, and emotional abuse — a fact acknowledged by a wide range of current TRC members
and members of the observing public.
But this decision isn't about me. While the abuse I faced was intolerable, I have borne it and would
continue to do so if there was still a chance of achieving anything like IFR's vision of an independent,
BIPOC community -led, transformative justice process through the current TRC. Council's actions on
March 16 made clear that there is not.
Raneem Hamad
March 25, 2021
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
AD HOC TRUTH AND RECONCILIATION COMMISSION
Four Vacancies: Unexpired Term
Upon appointment — June 30, 2022
• The City Council has established the Truth and Reconciliation Commission (TRC) to bear witness to the
truth of racial injustice in Iowa City and to carry out restorative justice, through the collection of testimony
and public hearings, with such work to include a recommendation to the Council of a plan for dedicating
and/or renaming public spaces and/or rights of way in honor of the Black Lives Matter movement;
The charges of the TRC are as follows:
A. Fact -Finding The TRC shall collect evidence, including first-hand testimony, of discrimination and racial
injustice in multiple settings and compile a complete record of racial injustices that will inform and support
the fundamental institutional and policy reforms necessary to address systemic racism.
B. Truth -Telling The TRC shall: 1) Provide multiple fora and creative opportunities for persons impacted
and traumatized by racial injustice to share their stories of racial injustice and experience to be heard by:
(a) fellow communities of color; (b) a broad cross section of the entire Iowa City community; and (c) key
decision -makers in city government, the business community and the University; 2) Explore ways to
provide such opportunities through art, music, theater, workshops, rallies and other forms of
congregation, multimedia and listening designed to reveal truths that cannot be fully expressed in
traditional fora; and, 3) Create a repository for community stories expressed in multiple media (written,
video, audio, art) that can be catalogued and used to educate and inform members of the community.
C. Reconciliation The TRC shall: 1) Provide opportunity for and facilitate direct conversation among and
between community members of color, white community members and representatives of various
sectors in which people of color experience discrimination and injustice (e.g. police and protesters,
landlords and tenants, students and teachers, patients and health care providers, business owners and
staff); 2) Create a replicable model that provides a structure for enabling these conversations throughout
the city; 3) Make available opportunities for a broad cross section of the community to learn about
discrimination and racial injustice in our community; and, 4) Identify and recommend to the City Council
institutional and policy reforms, new social practices, expectations, protocols, habits, rituals,
conversations and celebrations that will move Iowa City toward a shared experience of race and
difference, justice and equity and community and harmony.
The TRC shall have members who are representative of the City's BIPOC communities and
organizations, including those who have direct lived experience with systemic racism, as well as
experts who support those communities. To the extent possible, as determined by the City Council,
the TRC shall include representation from groups such as the Iowa Freedom Riders, the Black
Voices Project, the South District Neighborhood Association, the Iowa City Human Rights
Commission, and the Community Police Review Board. Johnson County residency is required.
Iowa City residency is preferred but not required if an applicant offers expertise or representation
not available from applicants who reside in Iowa City. Members of other City boards and
commissions are eligible to serve on the TRC;
• The TRC will have an organizational meeting within 30 days of appointment of all its members by the City
Council and will determine the frequency and conduct of its meetings.
Applications must be received by 5:00 p.m., Tuesday, March 30, 2020. An application can be completed and
submitted on the City of Iowa City website at www.icgov.org or by contacting the City Clerk's office. Questions
about the TRC appointment process should be directed to Stefanie Bowers at 356-5022.
Board/Commission Application Cover
Board/Commission: Ad Hoc Truth and Reconciliation Commission
Four vacancies to fill unexpired term
Upon appointment - 6/30/2022
It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to
a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be
limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve.
Council Announcement Date: 3/16/2021
Application Deadline: 3/30/2021
Council Appointment Date: 4/6/2021
Date of Non -Gender Appointment: 6/14/2021
After date above Council may appoint without regard to gender
Gender Balance Requirement: 2 -Female, 1 -Male, 1 -None
Current Gender Balance: Female: 2 Male: 3
Gender
Name and Address
Male
Alexakis, loannis
1017 E Burlington St
Female
Ali, Nada
2534 Bartelt Road
Female
Aron, Arianna
2203 1/2 Apt B Muscatine Ave
Male
Beining, Kaleb
540 Westside Drive
Female
Biancheri, Theresa
1162 E Jefferson St
Male
Borger Germann, David
108 Colchester Dr.
Female
Buckley, Jennifer
192 Columbia Dr
Male Burrell, Nicholas
1483 Westview Dr, Coralville
Male Carroll, James
1121 Gilbert Court c/o crisis center
Female
Culp, Priscilla
1815 Sara Court, North Liberty
Male
Daly, Daniel
2325 Mayfield Road
Female
Daniel, Daphney
1121 Carver St.
Female
Dillard, Chastity
203 5th St., Apt. 4, Coralville
Female
Dirks, Sarah
3300 Muscatine Avenue
Female
Erwin, Heather
43 Green Mountain Dr
Male
Garrison, William
527 E College St., Apt. 3
Female
Gathua, Wangui
1700 S 1st Ave
Female
Greer, Sarah
35 Juniper Ct, North Liberty
Male
Johnson, Clifton
1710 Flatiron Ave.
Female
Jones, Nikesha
917 20th Avenue Place, Coralville
Female
Matharu, Wangui
172 Hawkeye Court Apt 218
Female
Melvin, Tineke
711 Blue Jay Ct, Tiffin
Male
Nelson, Erik
North Liberty
Female
Nichols, Amanda
2713 East Court St
Female
Nobiss, Sikowis (Christine)
412 Kimball Road
Female
Ramseyer, Amy
308 N. Linn
Female
j Taylor, Angel
1 32 Jaro Way, North Liberty
Ad Hoc Truth and Reconciliation Commission Demographic Re ort
p
Name Term Term
Stop Resident Occupation
Gender" Age* Countryof
Sexual
Religion*
Disability*
Ethnicity"
Gender
Rat;L
Type Number
Term Years
Origin*
Orientation*
Identity*
Amel Ali
6/30/2022 20 years Student
Female 25 Sudan
Bisexual
N/A
No
African
Female
Black
American
VACANT Unexpired
6/30/2022
VACANT Unexpired
6/30/2022
Kevin John
6/30/2022 6 years Resident Physician
Male 30 United States
Queer
Christian/My
No
Filipino-
Agender
Asian
Rivera
$tic
American
Mohamed Traore
6/30/2022 Since 1999 Web Designer
Male 25 United States
Straight/Heterose Muslim
Yes
Non -Hispanic
Male
Black/African-
xual
American
VACANT Unexpired
6/30/2022
Eric Harris
6/30/2022 1.5 Years Cook/Community
Male 41 United States
Straight
Christian
No
African
Male
Black
Liason
American
Layana Navarre-
6/30/2022 more than College Instructor &
Female 46 United States
Heterosexual
Christian
No
African-
Female
Black
Jackson
10 years Other Laborer
of America
American
VACANT Unexpired
6/30/2022
Please note: The information provided is the information provided on the application at the time of submission.
* Information is voluntary
AD HOC TRUTH & RECONCILIATION COMMISSION
ATTENDANCE RECORD
YEAR 2021
(Meeting Date)
NAME
TERM
EXP.
12/21/20
1/7/21
1/21/21
2/4/21
2/18/
21
3/4/
21
3/18/21
4/1/21
4/15/
21
4/29/
21
5/13/
21
5/27/
21
6/10/
21
6/24/
21
ALI
6/22
X
X
X
X
X
CURRIN
6/22
X
X
X
X
X
HARRINGTON
6/22
X
X
X
X
X
NAVARRE-
JACKSON
6/22
X
X
X
X
X
PORTER
6/22
X
X
X
X
X
HAMAD
6/22
X
O/E
X
X
X
HARRIS
6/22
X
X
X
X
X
RIVERA
6/22
X
X
X
X
X
TRAORE
6/22
X
X
X
X
X
KEY: X = Present
0 = Absent
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated.
Date of Application
3/17/2021
First Name
loannis
Last Name
Alexakis
Home Address*
1017 E Burlington St
City*
Iowa City
State
IA
Zip Code*
52240-3207
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3195417419
Email Address*
Samalexion@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
20 Years
Occupation:
Production/Technical Supervisor for the Englert Theatre
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
V Male
r Female
Experience and/or activities which you feel qualifyyou for this position:*
Long time resident in Iowa City, well-known in the are, consciously aware of many issues facing the various
communities. Live by progressive and anti -fascist ideologies, committed to the redirection of police funding to
better serve community services, such as mental health and rehabilitation prospects
What is your present knowledge of each advisory board you are interested in?*
My knowledge is the the work of the Truth & Reconciliation Commission is necessary to restructuring the
underside of society
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
29
Country of Origin
Greece
Sexual Orientation
Straight
Religion
Jewish Descent
Do you have a disability?
No
Ethnicity
Greek
Race
Other
Gender identity
Male
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
10/20/2020
First Name
Nada
Last Name
Ali
Home Address*
2534 Bartelt Road
City
IOWA CITY
State
IA
Zip Code
52246
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3195128783
Email Address*
aliaaanada@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
Ad Hoc and Reconciliation Commission
How long have you been a resident of Iowa City?*
6 years
Occupation:*
Unemployed
Gender*
"This question is mandatory in order for the City to corrply with the state's gender balance requirerrant, which treats gender as binary. "Gender Identity" may
be provided in the Derrographics sectionof the application below.
F Male
I7 Female
Experience and/or activities which you feel qualifyyou for this position:*
As a person who experienced racial injustice and saw others experience it as well. There was always a hope
that one day I will be able to play apart in resolving the issue, this newly formed commission to address racial
injustice just became the hope that I was looking for. As a board member, I know I will do my best to bring
justice and peace to families and persons who have experienced discrimination solely based on their
appearance and skin color.
Some of the activates and experiences that worth to mention; I'm a member of the Sudanese Community
Center here in Iowa City, I also did few internships, one of them was in Congress, another one was for the
United Nations and the other was for the presidential elections 2020. 1 have also obtained my B.S in Political
Science - major: International Relations from the University of Iowa.
I hope these information provides you with a brief introduction about myself, gives you an idea about my
capabilities and skills and I hope it would lead you to consider me for the position. Looking to hear back from
you.
What is your present knowledge of each advisory board you are interested in?*
I know the Ad Hoc and Reconciliation Commission is established to promote and honor the Black Lives Matter
Movement. Where the Commission members are appointed to conduct meetings, collect witnesses and
testimonies, and draft plans for the City Council to carry out the restorative justice in Iowa City.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
29
Country of Origin
Sudan
Sexual Orientation
Heterosexual
Religion
Islam
Do you have a disability?
No
Ethnicity
Arabs
Race
Black or African American
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
A49010
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/1/2020
First Name
arianna
Last Name
Aron
Home Address*
2203 1/2 Apt B Muscatine Ave
City
IOWA CITY
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3193609091
Email Address*
arianna.aronl4@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
28 years
Occupation: *
Youth & Family Advocate
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
Working as a crisis advocate at UAY with youth and families. Being an Iowa City native, a parent to two black
boys who are growing up here. Experience with topics close to this, spent time on Human Rights Commission.
What is your present knowledge of each advisory board you are interested in?*
Was in touch with lisa Burgess about applying on this board. Its to assist wit BLM related topics, gather
community members stories and share with the larger community.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate familyties, during their tenure orfor one yearthereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
28
Country of Origin
United States
Sexual Orientation
Heterosexual
Religion
Christian
Do you have a disability?
No
Ethnicity
African American
Race
Black
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/24/2020
First Name
Kaleb
Last Name
Beining
Home Address*
540 Westside Drive
City
IOWA CITY
State
IA
Zip Code
52246
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3195309249
Email Address*
kalebbeining@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Select a Board or Commission you are interested in:*
Housing and Community Development
Commission(HCDC)
Do you receive rental assistance? (?)
r Yes r No
Do you have expertise in construction?*(?)
r Yes r No
Do you have expertise in finance?*(?)
r Yes r No
Select a Board or Commission you are interested in:*
Planning and Zoning Commission (P&Z)
Select a Board or Commission you are interested in:
Human Rights Commission
Preference on first choice
If rrultiple boards are being applied for.
Housing and Community Development Commission
How long have you been a resident of Iowa City?*
23 years
Occupation:*
Property Manager, Construction, Property Investor
Gender*
`This question is rrandatory in order for the oty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the tkrrographics sectionof the application below.
V Male
F Female
Experience and/or activities which you feel qualifyyou for this position:*
Through my professional life, I have extensive experience in both housing and construction. I specialize in
affordable housing; everyday I strive to operate property in a way that curates a positive community impact-- it
is a deep rooted passion of mine.
What is your present knowledge of each advisory board you are interested in?*
I have a moderate -high understanding.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
23
Country of Origin
USA
Sexual Orientation
Straight
Religion
None
Do you have a disability?
No
Ethnicity
Zimbabwean/German
Race
African American
Gender identity
Male
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
*fxe 3 � xww
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
10/13/2020
First Name
Theresa
Last Name
Biancheri
Home Address*
1162 E Jefferson St
City
IOWA CITY
State
IA
Zip Code*
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
319-541-7239
Email Address*
theresa.biancheri@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Select a Board or Commission you are interested in:
Community Police Review Board (CPRB)
I
Select a Board or Commission you are interested in:*
Housing and Community Development
Commission(HCDC)
Do you receive rental assistance? (?)
r Yes r No
Do you have expertise in construction?*(?)
r Yes r No
Do you have expertise in finance?*(?)
r Yes r No
Select a Board or Commission you are interested in:
Human Rights Commission
Preference on first choice
If rrultiple boards are being applied for.
Ad Hoc Truth and Reconciliation
How long have you been a resident of Iowa City?*
14 years
Occupation:*
Director ELA, Literacy at the College Board
Gender*
`This question is rrandatory in order for the oty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
r Male
V Female
Experience and/or activities which you feel qualifyyou for this position:*
Iowa Youth Writing Project advisory council member and treasurer
NARAL Chicago board members
ACT diversity committee
American Association of University Presses Diversity committee
Field Museum exhibit developer
What is your present knowledge of each advisory board you are interested in?*
I am only generally familiar with most of them, but I know more about the Truth and Reconciliation Commission
because I sat in on one of the city council meetings that discussed it and have read a description of what this
commission intends to do. I think it's vital that we start this process on a local level so that we can eventually do
this at a national level. As a white woman, I know that I'm not ideal as a member, but many of my jobs have
been about making sure that things comply with fairness and sensitivity guidelines. I want to be of service in
this endeavor because I work hard and have an eye for detail. If I'm chosen for any commission, I would check
any white savior inclinations at the door and do my best to serve this community.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
53
Country of Origin
USA
Sexual Orientation
Straight
Religion
Atheist
Do you have a disability?
No
Ethnicity
None
Race
White
Gender identity
Cis female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
CITY OF IOWA CTI'
uNEscoarroF urca,uuR
Advisory Baer-d/Commission/Cornmittee .application
This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
considered for any vacancy during that time.
NOTE: Must be 18 years of Age and live within city limits of Iowa City to apply
Date of Application October 22, 2020
Which Board or Commission(s) are you interested in: Truth and Reconciliation Commission
Which one do you prefer? Truth and Reconciliation Commission
A licanl In -
First Name David Last Name Borger Germann
Home Address 108 Colchester Dr.
City Iowa City State IA Zip Code 52245
Contact phone number 319-333-2380 Email Address david(&sanctuaryic.org
f k
1. Is your home address (listed above) within the corporate limits of Iowa City? YES= ..NO'-:
2. How longhaveyoubeen aresident ofIowaCity? 24 years
3. Occupation: Clergy t ,
4. Gender* CA
'This question is mandatory in order for the City to comply with the State's gender balance requirement which
treats gender as binary "Gender Identity" may be provided in the demographics section of the application below.
❑✓ Male
❑ Female
5. Experiences and/or activities which you feel qualify you for this position:
I have been a pastor for 10 years at a church that emphasizes justice, service, and social action
through collaboration. I helped many within our church join the BLM protests in Iowa City this
past summer, and I highlighted the demands of IFR during Sunday worship. I also serve as the VP
of the Consultation of Religious Communities, and I will be President in 2021. CRC voted to apply
for a role on the TRC with me as representative. As pastor and CRC President, I can serve as a
bridge to predominantly white faith communities committed to advancing racial justice and equity.
Finally, racial justice is personal to me as I am a parent to two Black and Latino children.
6. What is your present knowledge of each advisory board you are interested in?
I participated in the nonviolent BLM protests this summer, attended community listening posts, and
paid close attention to the Iowa Freedom Riders demands, so I'm well aware of the origin and goals
of the TRC. Mayor Bruce Teague was the guest at a CRC meeting in Sept., and he shared about the
formation and goals of the TRC. A couple years ago I served as a co-chair for the Iowa Poor
People's Campaign. We held events and trainings that matched the goals of the TRC. We provided
a platform where those most impacted by racial and societal injustice could have their voices heard,
and we made policy recommendations as a result of those hearings.
Please contact the city attorney at 319-356-5030 to discuss questions or concerns regarding a potentia;
conflict of interest. The following describe some but not all potential conflicts.
Dote: `'ai L-onfliC.1% af tgrest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise
or have exercised any functions or responsibilities with respect to federally funded activities, or who are in
a position to participate in the decision-making process or gain inside information with regard to such
activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial
interest in any contract, subcontract, agreement with respect to the proceeds of the federally -assisted
activity, either for themselves or those with whom they have business or immediate family ties, during their
tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a
city Board or Commission from having an interest in a city contract. Section 362.5
City Council Resolution #15-300 established a policy that the following persons shall not be eligible for
appointments to Boards and Commissions.
r ..,
A council member's spouse, domestic partner or partner in cohabitation, children, step childj,! ra, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, Vdughterrin-
law, sister-in-law, grandparents, and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent,
poster child, persons who are parents of the same child, and persons whom the employee is iR n intimate
relationship.
.-., e
Res. #15-300 states that each application for reappointment to a City Board or Commisk e1n will be
considered without regard to incumbency. If reappointed, an individual would be limifed to one
reappointment to a full term in order to increase the opportunities for new applicants to serve.
7. Do you currently have a conflict of interest? YES_ NO X
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial iriterests and your Jutes to an employer/ List all businesses in which you or
your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more
of corporation's stockholdings).
List potential conflicts of interest (See above for information regarding conflict of interest)
Please indicate if there are none.
BUSINESS NAME I BUSINESS ADDRESS
Council poiicy is not to permit an inuividua, to serve on two Boards or Commissions at t re same
time. You will be asked to resign from one if appointed to another.
8. Do you currently serve on another Iowa City board or commission? YES_ NO X
The City Council values all types of diversity on its boards and commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the board and commission is representative of the community and the groups(s)
which it serves, please provide your information for the following:
De POP r.a-ahictnforraaa±io :
9. Age 43
10. CountryofOrigin United Uniteates___.
11. Sexual Orientation Heterosexual
12. Religion -Christian ------------------------------------------------------
13. Do you have a disability? YES_ NO X
14. Ethnicity
15. Race -white
----------------------------------------------------
16. Gender Identity.._male-------- _____,
Note:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social
and economic groups in the city. (Ordinance) _
The Housing and Community Development Commission strives to satisfy its purpose and.,-Ttent, when
possible to have at least one person with expertise in construction, at least one person with expertise finance
and one person who receives rental assistance. (Resolution)
Signature of Applicant* A__C� _ _
C�0�
Misrepresentations on this application will constitute just cause for removal of an appointee. If you
fail to answer all the questions, except demographics, Council will not consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving. Contact information is attached.
(rev. 11/27/18)
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/10/2020
First Name
Jennifer
Last Name
Buckley
Home Address*
192 Columbi Dr
City
IOWA CITY
State
IA
Zip Code*
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
6467043565
Email Address*
jen.ann.buckley@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
11 years
Occupation: *
educator
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
Education Committee co-chair, NAACP Iowa City Adult Branch
What is your present knowledge of each advisory board you are interested in?*
A Truth and Reconciliation committee's charge is to create the essential conditions for justice and healing by
bringing to public consciousness the histories of oppression in a given community. I am aware that Iowa City
has a great deal of work to do in this regard, and it would be an honor to serve as a member of this committee,
which will gather testimonies and information about racist policies, events, and behaviors of the past and
present for the purposes of creating a new and more equitable community.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
44
Country of Origin
USA
Sexual Orientation
Religion
Do you have a disability?
No
Ethnicity
Race
White
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
PAN If- W11
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated.
Date of Application
3/9/2021
First Name
Nicholas
Last Name
Burrell
Home Address*
1483 Westview Dr
City*
North Liberty
State
IA
Zip Code*
52241
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
5155544719
Email Address*
nburrell.versafitness@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
Occupation: *
self employed
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
V Male
r Female
Experience and/or activities which you feel qualifyyou for this position:*
On other boards, minority business owner
What is your present knowledge of each advisory board you are interested in?*
Reading the press, and all meeting notes etc
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
28
Country of Origin
USA
Sexual Orientation
male
Religion
Do you have a disability?
No
Ethnicity
Mixed
Race
Mixed
Gender identity
male
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
IWMI AV -?4W1
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated.
Date of Application
3/30/2021
First Name
James
Last Name
Carroll
Home Address*
1121 Gilbert Court c/o crisis center
City*
Iowa City
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3195123126
Email Address*
jccdalejrno1 @gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
IF multiple boards are being applied for.
How long have you been a resident of Iowa City?
5 years
Occupation: *
SSI
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
V Male
r Female
Experience and/or activities which you feel qualifyyou for this position:*
It's a simple as this. This is a country built on checks and balances. With this city so far left it should be in
California. I am a fiscal and non-progressive conservative by nature. I am clearly out numbered being this and I
will make it clear, that I am a straight homeless conservative white Caucasian over the ago of 40. Whose peer
group is now the target of systematic destruction, with extremely biased hatred toward my gender, race, and
my god based political views. The tools to achieve this objective are based on slimy lawyer based gray area
legal garbage language, media control and flat out lies. I'm coming to drain the swamp.
What is your present knowledge of each advisory board you are interested in?*
Job description
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
56
Country of Origin
USA
Sexual Orientation
Heterosexual
Religion
Non denominational
Do you have a disability?
Yes
Please explain:
Hippa
Ethnicity
Irish
Race
White
Gender identity
Male
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/10/2020
First Name
Priscilla
Last Name
Culp
Home Address*
1815 Sara Court
City
IOWA CITY
State
IA
Zip Code*
52317
Is your home address (listed above) within the corporate limits of Iowa City?*
Not Sure
Contact Phone Number*
3195042123
Email Address*
pculpskillz1 @gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
4 years
Occupation: *
Educator
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
Problem solving with employees, mediator, and public speaking. Utilizing Restorative Justice strategies in
solving peer conflict.
What is your present knowledge of each advisory board you are interested in?*
The Truth & Reconciliation Advisory Board is responsible for addressing the perceived wrongdoing by a city
employee of an alleged victim.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate familyties, during their tenure orfor one yearthereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
49
Country of Origin
United States
Sexual Orientation
Female
Religion
Christian
Do you have a disability?
No
Ethnicity
African American
Race
Black
Gender identity
Woman
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
10/1/2020
First Name
Daniel
Last Name
Daly
Home Address*
2325 Mayfield Road
City
IOWA CITY
State
IA
Zip Code
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
319 338 4399
Email Address*
dan-daly@uiowa.edu
Boards & Commissions
Select a Board or Commission you are interested in:
Human Rights Commission
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If rrultiple boards are being applied for.
Human Rights Commission
How long have you been a resident of Iowa City?*
67 years
Occupation:*
Retired
Gender*
*This question is rrandatory in order for the City to comply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Demographics sectionof the application below.
V Male
F Female
Experience and/or activities which you feel qualifyyou for this position:*
Active with the Center for Worker Justice of Eastern Iowa, the Iowa City Federation of Labor, and St.Patrick
Parish. Over some decades, occasional writer, speaker, and protester on behalf worker, minority, civil, and
human rights.
What is your present knowledge of each advisory board you are interested in?*
The HRC meets monthly to consider if circumstances, practices, actions, or events that may sink to the level of
discrimination against individuals or groups based on specific legally defined criteria. The HRC makes
determinations and recommendations to council.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
67
Country of Origin
USA
Sexual Orientation
Heterosexual
Religion
Roman Catholic
Do you have a disability?
No
Ethnicity
Irish/Czech
Race
Caucasian
Gender identity
Male
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
PAVIi,L - PALY
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
10/23/2020
First Name
Daphney
Last Name
Daniel
Home Address*
1121 Carver St.
City
IOWA CITY
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
4012615987
Email Address*
daniel.daphney@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
Seven years
Occupation: *
Attorney
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
I may be uniquely qualified to assist the committee in its it first charge: fact-finding. In college, I had to complete
two theses in order to complete my dual major. One thesis required more conventional modes of fact-finding
(reading books, reviewing newspaper articles, etc). My other thesis forced me to get out of the library (and my
comfort zone). My work lead me into deciphering centuries old military rolls, exploring the gravestones of long
overgrown cemeteries, and to exploring a long forgotten green space between two busy sections of interstate.
As a college student I learned that to get the facts, a person had to be creative enough to think beyond the
traditional fact -find methods, then brave enough to follow-through and get the job done. Law school and my
work experience as an attorney have only helped expand my fact-finding abilities. I believe my contributions to
the commission can make it stronger and more effective.
What is your present knowledge of each advisory board you are interested in?*
My knowledge of Iowa City's Truth and Reconciliation Commission is limited to what is published on the city's
website. I am familiar with the Truth and Reconciliation Commission of South Africa, established after the fall of
the apartheid regime and with TRC commissions in general. I believe I understand the role of the Iowa City
commission and the goals set forth for it. I hope to learn more whether or not I join the commission.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
30
Country of Origin
USA
Sexual Orientation
Heterosexual
Religion
Catholic
Do you have a disability?
Yes
Please explain:
My disability does not require any special accommodation.
Ethnicity
Haitian -American
Race
Black
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/10/2020
First Name
Chastity
Last Name
Dillard
Home Address*
203 5th St., Apt. 4
City
IOWA CITY
State
IA
Zip Code
52241
Is your home address (listed above) within the corporate limits of Iowa City?*
Not Sure
Contact Phone Number*
5635059248
Email Address*
chastity.dillard@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
10
Occupation:*
Nonprofit Admin
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
Black woman born and raised in Iowa
6 years of experience working with marginalized minority populations throughout Johnson County
Huge passion to help more stories be shared about racial trauma and negative experiences in our community
What is your present knowledge of each advisory board you are interested in?*
The TRC was created out of the Iowa Freedom Riders' 2020 summer demands. The commission aims to give
people of color a voice and space to talk about and express feelings/issues involving racism in Johnson
County. This commission will focus on Fact -Finding, Truth -Telling and Reconciliation within our communities.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
31
Country of Origin
USA
Sexual Orientation
Straight
Religion
Christian
Do you have a disability?
No
Ethnicity
Black
Race
Black
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
C' xzaw
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated.
Date of Application
3/17/2021
First Name
Sarah
Last Name
Dirks
Home Address*
3300 Muscatine Avenue
City*
Iowa City
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3193339942
Email Address*
sarahpdirks@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
28 years, lifelong resident.
Occupation: *
Adolescent & Women's Health Services Coordinator at
Johnson County Public Health
Gender*
*This question is mandatory in order for the City to corrply with the State's gender balance requirerrant, which treats gender as binary. "Gender Identity" may
be provided in the Derrographics sectionof the application below.
F Male
rJ Female
Experience and/or activities which you feel qualifyyou for this position:*
I was born and raised in Iowa City and have been involved in advocacy in Iowa City since 2013, working with
local organizations such as the Emma Goldman Clinic, Shelter House, and the Rape Victim Advocacy Program.
I am involved in local organizations such as IC Mutual Aid Collective and most recently the Iowa City Tenants
Union. I have a strong understanding of the functionality of social services in Iowa City and the unbalanced
allocation of resources which are meant to support the needs of all people. I have both experienced and
witnessed the harmful, violent practices of groups such as the Iowa City Police Department, housing leaders,
and the University of Iowa, actions which always most harshly effect historically marginalized populations
including Black and Indigenous people, trans and non -binary people, and poor folks. In my role with JCPH I am
dedicated to creating a safe and equitable environment for all people in the community, and improving the
relationship between the local government and community members who have experienced violence at the
hands of that very same local government, by creating transparent and trauma informed practices and
centering the needs of those harmed in order to foster a safer, more accountable environment.
What is your present knowledge of each advisory board you are interested in?*
The purpose of the Truth and Reconciliation Committee is to bear witness to and address the racial disparities
in our community by acknowledging the violence experienced by people of color in Iowa City. This discussion is
long over due, and I hope to use my power within the community to uplift the voices of those most directly
impacted by these practices in order to address them truthfully and directly.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
28
Country of Origin
USA
Sexual Orientation
Bisexual
Religion
Do you have a disability?
Ethnicity
Race
White
Gender identity
Cis -Woman
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute iust cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
10/27/2020
First Name
Heather
Last Name
Erwin
Home Address*
43 Green Mountain Dr
City
IOWA CITY
State
IA
Zip Code
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3196215738
Email Address*
heather-erwin@uiowa.edu
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
43 years
Occupation:*
Director, Liberal Arts Beyond Bars College in Prison
Program
Gender*
*This question is mandatory in order for the City to corrply with the state's gender balance requirerrant, which treats gender as binary. "Gender Identity" may
be provided in the Derrographics sectionof the application below.
F Male
rJ Female
Experience and/or activities which you feel qualifyyou for this position:*
I currently serve as the Director of the University of Iowa's Liberal Arts Beyond Bars college in prison program.
Prison serves as a microcosmic representation of the broader issues of social justice across society. Within
this context I have been tasked with navigating those challenging systems and issues and have developed
strengths as both an advocate and a diplomat.
I am a law graduate from the University of Iowa's School of Law. During the summer after my first year of law
school, in 1997, 1 traveled as part of a study abroad program in partnership with Howard University to Cape
Town, South Africa, where I spent six weeks in school at the University of the Southern Cape and as an
international intern for the South African Truth and Reconciliation Commission. While my duties were tangental
to the process, the experience was transformative and I wholly believe in the power of speaking truth in order
to reconcile harm within a community.
Furthermore, as a Senior Program Associate for the Vera Institute for Justice I worked with college in prison
programs across the country to develop and support programs, which required an understanding of systems
reform and the importance of amplifying the voices and experiences of people directly impacted by systems of
oppression. I also worked on the Re -imagining Prisons project, in which we strove to envision restorative
alternatives to current punitive systems of punishment.
As a white woman I am working to critically examine my privilege and continue to work toward anti -racism in
thought and practice, both personally and professionally. I believe my background and experience position me
well to meaningfully contribute to the process of finding truth and reconciliation for the Iowa City community.
What is your present knowledge of each advisory board you are interested in?*
I have read and digested Resolution 20-228, establishing the Ad Hoc Truth and Reconciliation Commission in
response to the Black Lives Matter Movement and systemic racism after the unjust deaths of George Floyd
and other Black men and women across the country. Further, I have examined the charges and duties of the
TRC as set forth on the ic.gov website.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
51
Country of Origin
USA
Sexual Orientation
Heterosexual
Religion
Do you have a disability?
No
Ethnicity
Race
White
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
f Utxa j- rbvr L
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/5/2020
First Name
william
Last Name
garrison
Home Address*
527 E College St., Apt. 3
City
IOWA CITY
State
IA
Zip Code*
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
5155569413
Email Address*
wgarrison@unitedactionforyouth.org
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
4 years
Occupation: *
Youth Development Outreach Specialist
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" may
be provided in the Derrographics sectionof the application below.
V Male
r Female
Experience and/or activities which you feel qualifyyou for this position:*
I have a social justice degree from the University of Iowa and also studied a semester in South Africa studying
the original TRC and the pros and cons that came with the commission. Since I moved here 4 years ago I have
been as involved in the community as I can be and even more now with my job at a nonprofit here in IC work
with youth development.
What is your present knowledge of each advisory board you are interested in?*
I know about the TRC and the purpose of what it is supposed to be and how it is supposed to be used for good
and as a healing process for those that have been affected by the intersectional inequalities that the system
has imposed on certain people.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
21
Country of Origin
United States
Sexual Orientation
queer
Religion
NA
Do you have a disability?
No
Ethnicity
European
Race
Mite
Gender identity
gender fluid
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
�U'r.1.lr.�r,�r �rrr.•�•ir.t
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/25/2020
First Name
Wangui
Last Name
Gathua
Home Address*
1700 S 1st Ave
City
IOWA CITY
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3193332453
Email Address*
wanguigathua@nisaa-afs.org
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
18 years
Occupation:
University Faculty
Gender*
*This question is rrandatory in order for the 0ty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
I am a teacher, counselor, and a researcher in the areas of social justice. I have also served as Human Rights
Commissioner in Iowa City. Currently, I coordinate Nisaa African Family Services. This position allows me to
work with African Immigrants/Refugees, who would benefit from this commissions work.
What is your present knowledge of each advisory board you are interested in?*
I have been following closely, the Council's work and given my input as the Council has been listening to the
Iowa City communities as they work on improving the communities using the communities feedback. I also
followed closely as the idea and fruition of this Commission were discussed. This is how I knew I am able
tocontribute positively to this Commission.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
55
Country of Origin
Kenya
Sexual Orientation
Female
Religion
Roman Catholic
Do you have a disability?
No
Ethnicity
African
Race
African
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/8/2020
First Name
Sarah
Last Name
Greer
Home Address*
35 Juniper Ct
City
IOWA CITY
State
IA
Zip Code
52317
Is your home address (listed above) within the corporate limits of Iowa City?*
Not Sure
Contact Phone Number*
319-621-5785
Email Address*
Sarahgreer02@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
20 years
Occupation:*
Medical Technician
Gender*
*This question is rrandatory in order for the 0ty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
rJ Female
Experience and/or activities which you feel qualifyyou for this position:*
I have worked with the under -served community and mentored a diverse group of teens for the past 10 years.
What is your present knowledge of each advisory board you are interested in?*
To help find real solutions for issues of inequality facing our community.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
42
Country of Origin
United States
Sexual Orientation
Female
Religion
Christian
Do you have a disability?
No
Ethnicity
American
Race
Black
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
)� 1z P
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated.
Date of Application
3/29/2021
First Name
Clifton
Last Name
Johnson
Home Address*
1710 Flatiron Ave.
City*
Iowa City
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
2159703743
Email Address*
icorboxing@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
IF multiple boards are being applied for.
How long have you been a resident of Iowa City?
7 years
Occupation: *
Gym owner and boxing coach
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
V Male
r Female
Experience and/or activities which you feel qualifyyou for this position:*
I am an African-American 8 -year veteran of the US Marine Corps. I am also a boxing coach and own and
operate a gym in Iowa City since 2013.
What is your present knowledge of each advisory board you are interested in?*
My understanding is that there has been conflict within the truth and reconciliation committee and 4 board
members have recently resigned. I know the TRC is intended to shed light on racial injustice that POC have
experienced and currently experience in Iowa City and to make recommendations to the city council to make
our city more inclusive and just for our minority citizens. My goal is to help bring people together for a positive
outcome.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
39
Country of Origin
United States
Sexual Orientation
Straight
Religion
Not religious
Do you have a disability?
No
Ethnicity
Black
Race
Black/African American
Gender identity
Male
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
a —
....... ..............................
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/10/2020
First Name
Nikesha
Last Name
Jones
Home Address*
917 20th Avenue Place
City
IOWA CITY
State
IA
Zip Code
52241
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3193252195
Email Address*
jonesacademyic@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
21 years
Occupation:*
ESC Case Manager and Van driver
Gender*
*This question is rrandatory in order for the oty to corrply with the State's gender balance requirement, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
rJ Female
Experience and/or activities which you feel qualifyyou for this position:*
The Director of the Jones Academy of Performing Arts and Program Director at the Dream Center
What is your present knowledge of each advisory board you are interested in?*
A committee tasked to hear the community on racial Justice.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
46
Country of Origin
Us
Sexual Orientation
Female
Religion
Non
Do you have a disability?
No
Ethnicity
African American
Race
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/10/2020
First Name
Wangui
Last Name
Matharu
Home Address*
172 Hawkeye Court Apt 218
City
IOWA CITY
State
IA
Zip Code
52246
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
571-502-5403
Email Address*
matharuw@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
Truth and Reconciliation Commission
How long have you been a resident of Iowa City?*
1 year
Occupation:*
Scrum Master
Gender*
"This question is mandatory in order for the City to corrply with the state's gender balance requirerrant, which treats gender as binary. "Gender Identity" may
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualify you for this position:*
I have over 8 years experience coaching and facilitating teams. I am a certified Life coach that has facilitated
groups and coached individuals with emotional and heart issues.
• Identified process changes required to remove impediments and accelerate development. In eight weeks,
reduced time to ship by 30%.
• Leading two scrum teams consisting of 17+ on-site and remote team members and one off -shore team.
• Applying Agile best practices such as time -boxing, transparency, accountability, empowerment, self-
management, and role training resulting in realized velocity improvement of more than 25%.
• Collaborated with the Product Owner, and the Scrum teams on backlog refinement and product planning to
maximize value for the business stakeholders.
• Encouraged improvement in team commitment and capacity planning for sprints by identifying tasks that
increased delivery time.
• Facilitated team and cross -team retrospectives to build good working relationships among the 12 agile teams
across three release trains.
• Utilized Kanban principles that resulted in a reduction of cycle time by 20%, consequently increasing the
team's throughput in less than four sprints.
• Coached new Scrum Master, which reduced process waste caused by a lack of common understanding.
• Provided team members with weekly/biweekly Ion 1's fostering in coaching opportunities and building
relationships.
• Supporting the teams in preparing for the Agile Release Train (ART) activities, such as Program Increment
(PI) Planning, Inspect and Adapt and system demos.
What is your present knowledge of each advisory board you are interested in?*
The Truth and Reconciliation group is responsible for bringing healing and reconciliation to the community.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
Country of Origin
Sexual Orientation
Religion
Do you have a disability?
Ethnicity
Race
Gender identity
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/8/2020
First Name
Tineke
Last Name
Melvin
Home Address*
711 blue Jay Ct
City
IOWA CITY
State
IA
Zip Code*
52340
Is your home address (listed above) within the corporate limits of Iowa City?*
Not Sure
Contact Phone Number*
3198558559
Email Address*
tnkrenee@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
8 years
Occupation: *
Management
Gender*
*This question is rrandatory in order for the City to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
rJ Female
Experience and/or activities which you feel qualifyyou for this position:*
I have worked with underprivileged and underserved for over 10 years.
What is your present knowledge of each advisory board you are interested in?*
To compose and help resolve issues of bias and inequality
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
53
Country of Origin
USA
Sexual Orientation
Female
Religion
Christian
Do you have a disability?
No
Ethnicity
American
Race
Black
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
0
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/10/2020
First Name
Erik
Last Name
Nelson
Home Address*
North Libert
City
IOWA CITY
State
IA
Zip Code*
52317
Is your home address (listed above) within the corporate limits of Iowa City?*
Not Sure
Contact Phone Number*
402 601 3915
Email Address*
erik-nelson@ncjc.org
Boards & Commissions
Select a Board or Commission you are interested in:*
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
5
Occupation: *
Director of After School Program NCJC at Alexander
Elemetnary
Gender*
*This question is mandatory in order for the City to corrply with the State's gender balance requirerrant, which treats gender as binary. "Gender Identity" may
be provided in the Derrographics sectionof the application below.
V Male
r Female
Experience and/or activities which you feel qualifyyou for this position:*
Neighborhood Centers of Johnson County and Four Oaks
What is your present knowledge of each advisory board you are interested in?*
High interest, would like to learn more
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
36
Country of Origin
United States
Sexual Orientation
Religion
Do you have a disability?
Ethnicity
Race
Black
Gender identity
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
10/16/2020
First Name
Amanda
Last Name
Nichols
Home Address*
2713 East Court St
City
IOWA CITY
State
IA
Zip Code
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3196771153
Email Address*
director@corridorcan.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
How long have you been a resident of Iowa City?*
20 years
Occupation:*
Clerk III, UIHC
Gender*
*This question is rrandatory in order for the 0ty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
At yesterday's Community Police Review Board meeting we were told that there was a specific request for a
CPRB member to join. I am a member of the CPRB and as the director of Corridor Community Action Network, I
have established communication channels with many organizations that could assist the Truth and
Reconciliation Commission with ensuring that we hear and amplify the voices of community members affected
by the recommendations we will be making.
What is your present knowledge of each advisory board you are interested in?*
I have read news articles, the resolution, and the description on the city website.
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
Yes
Board current serving on*
Community Police Review Board (CPRB)
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
37
Country of Origin
United States
Sexual Orientation
bisexual
Religion
Agnostic
Do you have a disability?
No
Ethnicity
White
Race
Not Hispanic/Latino
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
�JCltsl�l'r2.����is"FBt<!
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated.
Date of Application
3/22/2021
First Name
Sikowis (Christine)
Last Name
Nobiss
Home Address*
412 Kimball Road
City*
Iowa City
State
IA
Zip Code*
52245
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3193318034
Email Address*
sikoWs@greatplainsaction.org
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
IF multiple boards are being applied for.
How long have you been a resident of Iowa City?
16 years
Occupation: *
Executive Director of non-profit
Gender*
*This question is rrandatory in order for the Oty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
Sikowis (Christine Nobiss) is Plains Cree/Saulteaux of the George Gordon First Nation in Saskatchewan,
Canada and grew up in Winnipeg, Manitoba, Canada. At 19 she began her life's work of uplifting Indigenous
voices when she got her first job at the New Brunswick Aboriginal Peoples Council in Fredericton, Canada. In
2015, she founded Great Plains Action Society as a way to increase Indigenous solidarity in Iowa City. It turned
into a full-fledged organization during the fight against the Dakota Access Pipeline, which led her to start Little
Creek Camp in February 2017. From August 2017 to September 2020, she worked for Seeding Sovereignty
where she organized at a national level.
As her heart is with her people and the land Sikowis is back with Great Plains Action Society where she can
work at a grassroots level and a fully Indigenous -led organization.
Sikowis is also a speaker, writer, and artist. She believes that environmental and social justice work are
inextricably linked and change will only happen when we dismantle corrupt colonial -capitalist systems and
rebuild them with a decolonized worldview. She graduated from the University of Iowa in 2008 with a Masters
Degree in Religious Studies (with a focus on Native American Religion and Culture) and a Graduate Minor in
American Indian Native Studies. She fights for a better future for her two young children.
What is your present knowledge of each advisory board you are interested in?*
I've been following the development and fall out of this board and have noticed there has never been
Indigenous leadership on it, which makes me want to apply
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate familyties, during their tenure orfor one yearthereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
44
Country of Origin
Canada
Sexual Orientation
I'm Plains Cree/Saulteaux and I relate accordingly. And
within that I have some sexual practices that settlers might
think are queer but aren't queer to me!
Religion
Native American
Do you have a disability?
No
Ethnicity
Plains Cree/Saulteaux
Race
Plains Cree/Saulteaux and Roma Hungarian
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
50�vIz; chf )sn7 r h t56)
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
r Advisory Board/Commission Application Form
PAZsI; I+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Applicants must reside in Iowa City and be 18 years of age unless specific qualifications are stated.
Date of Application
3/30/2021
First Name
Amy
Last Name
Ramseyer
Home Address*
308 N. Linn
City*
Iowa City
State
IA
Zip Code*
52240
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
3193216207
Email Address*
ajramseyer@gmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If multiple boards are being applied for.
How long have you been a resident of Iowa City?
1984
Occupation: *
Housekeeping, raki/energy consultant
Gender*
*This question is rrandatory in order for the 0ty to corrply with the State's gender balance requirerrent, which treats gender as binary. "Gender Identity" rray
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
Lived in Iowa City for most of my adult life, being indigent most of the time. I have been systematically
discriminated for my income level and a bonafide easy target for would be revenue makers in this municipality.
From the boys in blue, to utility entities, to the court system. Where the truth and facts fall way down in the
fiscal feeding frenzy conglomerate pecking order. I know my self truth, the truth of the land and it is beyond
reproach. It is not for sale, nor compromisable for no one. The income gouging that has been commenced
upon me in the form of fines to wages being garnished, to having my credit destroyed due to paper pushing
ordinances that has left a lifetime long scar. I keep my perspective rational however, due to personal traumad
highlighted by the well known death of my only brother. It has seated in a permanent empathy with only the
truth moral code that will fight any form of discrimination or any form of racism.
What is your present knowledge of each advisory board you are interested in?*
Minimal besides committee description
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
49
Country of Origin
USA
Sexual Orientation
Iffy
Religion
Non denominational
Do you have a disability?
Yes
Please explain:
Ethnicity
Caucasian
Race
White
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
VN-17
...........................................................................................................................................................................................................................................................................................................................................................................................
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
I Advisory Board/Commission Application Form
PAZ�`_.--..®�,�, rY
s��' �+z This application is a public document and as such can be reproduced and distributed for
the public. This application will be considered for twelve months only and automatically
CITY OF IOWA CITY considered for any vacancy during that time.
UNESCO CITY OF LITERATURE
If appointed to a Board/Commission, all other applications will be removed from
consideration.
NOTE: Must be 18 years of age and live within city limits of Iowa City to apply
Date of Application
11/9/2020
First Name
Angel
Last Name
Taylor
Home Address*
32 Jaro Way
City
IOWA CITY
State
IA
Zip Code
52317
Is your home address (listed above) within the corporate limits of Iowa City?*
Yes
Contact Phone Number*
319-594-1403
Email Address*
angeltaylor99@hotmail.com
Boards & Commissions
Select a Board or Commission you are interested in:
Ad Hoc Truth and Reconciliation
Commission
Preference on first choice
If Tultiple boards are being applied for.
Truth and Reconciliation
How long have you been a resident of Iowa City?*
All my life
Occupation:*
Realtor
Gender*
"This question is mandatory in order for the City to corrply with the State's gender balance requirerrant, which treats gender as binary. "Gender Identity" may
be provided in the Derrographics sectionof the application below.
F Male
fJ Female
Experience and/or activities which you feel qualifyyou for this position:*
Very active in the community
What is your present knowledge of each advisory board you are interested in?*
Community racial/social justice
Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict
of interest. The following describe some but not all potential conflicts.
Potential Conflicts of Interest
The Housing and Community Development Commission makes recommendations to the City Council
regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or
have exercised any functions or responsibilities with respect to federally funded activities, or who are in a
position to participate in the decision-making process or gain inside information with regard to such activities,
may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any
contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the
proceeds of the federally -assisted activity, either for themselves or those with whom they have business or
immediate family ties, during their tenure or for one year thereafter.
Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City
Board or Commission from having an interest in a City contract.
City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for
appointment to Boards and Commissions:
A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children
for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law,
mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law,
sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster
child, persons who are parents of the same child, and persons with whom the employee is in an intimate
relationship
Res. #15-300 states that each application for reappointment to a City Board or Commission will be
considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment
to a full term in order to increase the opportunities for new applicants to serve.
Council policy is not to permit an individual to serve on two Boards or Commissions at the same
time. You will be asked to resign from one if appointed to another.
Do you currently have a conflict of Interest?*
No
Do you currently serve on another Iowa City board or commission?*
No
Demographic Information
The City Council values all types of diversity on its Boards and Commissions. Your responses on this page
provide valuable information to the Council in achieving that goal.
In order to ensure that the Board and Commission is representative of the community and the groups(s) which
it serves, please provide your information for the following:
Age
47
Country of Origin
Usa
Sexual Orientation
Straight
Religion
Do you have a disability?
No
Ethnicity
Race
Black
Gender identity
Female
*NOTE:
The Human Rights Commission strives to ensure the Commission is representative of the community.
Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and
economic groups in the city. (Ordinance)
The Housing and Community Development Commission strives to satisfy its purpose and intent, when
possible to have at least one person with expertise in construction, at least one person with expertise in
finance, and one person who receives rental assistance. (Resolution)
Signature of Applicant*
CL*� f1'r
Misrepresentations on this application will constitute just cause for removal of an
appointee. If you fail to answer all the questions, except demographics, Council will not
consider your application.
You are encouraged to contact individual Council Members to express your interest in
serving.
Item Number:
r � �
+ at1Mw��al
+•ate_
CITY OF IOWA CITY
www.icgov.org
April 6, 2021
Airport Commission - One vacancy to fill a four-year term, July 1, 2021 - June 30, 2025. (Term expires for
Christopher Lawerence)
Community Police Review Board (At -Large) - One vacancy to fill a four-year term, July 1, 2021 - June 30,
2025. (Term expires for Latisha McDaniel)
Community Police Review Board (Current or former "peace officer)- One vacancy to fill a four-year term, July
1, 2021 - June 30, 2025. (Term expires for David Selmer)
Historic Preservation Commission (At -Large) - One vacancy to fill a three-year term, July 1, 2021 - June 30,
2024. (Term expires for Quentin Pitzen)
Historic Preservation Commission (College Green) - One vacancy to fill a three-year term, July 1, 2021 -
June 30, 2024. (Term expires for Helen Burford)
Historic Preservation Commission (East College St) - One vacancy to fill an unexpired plus a three-year term,
Effective upon appointment - June 30, 2024. (Formerly advertised)
Historic Preservation Commission (WoodlawnOne vacancy to fill an unexpired plus a three-year term,
Effective upon appointment - June 30, 2024. (Formerly advertised)
Housing & Community Development Commission -Three vacancies to fill a three-year term, July 1, 2021 -
June 30, 2024. (Term expires for Megan Alter, Peggy Aguilar and Maria Padron)
Library Board of Trustees -Three vacancies to fill a six-year term, July 1, 2021 - June 30, 2027. (Term expires
for John Beasley, Monique Washington and Wesley Beary)
Parks and Recreation Commission - One vacancy to fill an unexpired term Upon appointment - December 31,
2022. (Timothy Shea resigned) Correspondence included in Council packet.
Planning & Zoning Commission -Two vacancies to fill a five-year term, July 1, 2021 - June 30, 2026. (Term
expires for Mark Signs, Maggie Elliott)
Telecommunications Commission - Two vacancies to fill a three-year term, July 1, 2021 - June 30, 2024. (Term
expires for Gina Reyes, Adam Stockman)
Applications must be received by 5:00 P.M., Tuesday, May 11, 2021.
ATTACHMENTS:
Description
Timothy Shea Resignation
Kellie Fruehling
From: Tammy Neumann
Sent: Monday, March 22, 2021 8:10 AM
To: Juli Seydell Johnson; Kellie Fruehling
Subject: FW: Packet for tonight's Commission Meeting
Please see below
IIS IOWA CITY
A UNESCO CIF r OF 11fEtArURE
Tammy Neumann
Administrative Secretary/
Farmers Market Coordinator
office: 319-356-5210
220 S. Gilbert St. Iowa City, IA 52240
WWW.I000V.ORG/PR
From: Timmy Shea [mailto:timmynshea@gmail.com]
Sent: Friday, March 19, 20217:48 PM
To: Tammy Neumann <Tammy-Neumann@iowa-city.org>
Subject: Re: Packet for tonight's Commission Meeting
I
ftIK
Due to conflicting schedules I have to withdraw from commission. Good luck with everything going forward!!!
Sent from my Whone