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HomeMy WebLinkAboutAgenda Bill 5APart3 06/21/2010nip as Service-s vis rnrnite ~licat~:s Five vacancies for 3-year'terms expiring 2013 22 ~,ALU ' a ~ (~'~~ ® ~~~~1~1~~~ ~Clll~®~~AZd . _ E,, , . 'City Board; Commission and Committee App 'r~;a I85$ ~..> _ C Instructions: Use this form to apply to serve on any of the City of Petaluma, Califo Commissions, or Committees. Please fill out the form completely. If a question does not al_,_ _,,,`~~_. write N/A in the space provided. When completed, please forward to the City Clerk's Office i y of Petaluma, 1 1 English Street, Petaluma, CA 94952. All applications are reviewed by the City Council. Name: .. Norris Robert Dyer ("Bob Dyer") Home Atldress;;Gity State artid Zi Code: P 1708 Granada Court, Petaluma, 94954 ,._ _ aHome Phone: (If appointed, do you'wdnt this ~ _ number to be available to the' public?( ,Work Phone: ^ YES.. ~'NO ~ ; ~ 707 ~ 763 _ 2934 ( ~ _ E-AAail: ((f dppointed, do you,want this dddress°to.' FAX:. _ - "be available to the public?J ~ 'YES. ^ NO f ~ _ nrdyer @ comcast.net Are you a registered voter in Retaluma? If so, for how long?: YES ® NO 1975 Bo4rd(s),-,Commission(s), or Committee(s) of Lnterest* *,: Animal Advisory Committee *Note: To serve on the Senior Advisory Committee, you must be age 55 or above. y , , 9 Have ou attended a meetin of'this y nterviewed; or applied;for Have ou served on, i -body? this body`previously?' °^ YES ^ NO ~ YES ® NO Dyer, Bob Animal Services Advisory Committee 23 Present Employer::.. ; . , _ , . , ,, _- ~ _ ,. _, . ,; _ Job Title: .. Previous Governmental Bodies/Elective Offices you have`served, Position/Office Held°and . ,:Dates: Career Executive, State Compensation Insurance Fund. Retired in 1997 after 32+ years of California state service (1965-97) Civic .or Cha~itdble Orgonization_to.which-you have belonged, Position/Office Held, and Dates: _ Petaluma Wetlands Alliance (Member of the Board) Madrone Audubon Society Point Reyes Bird Observatory Friends of the Petaluma River ~Whdt-Special lnteres#s/Skills/Talents would you bring to this_Board, Commission, or°Commttee? Docent for the Petaluma Wetlands since 1998 Nature writer and photographer Amateur naturalist Certified Risk Manager (A. R.M.) 24 College, Professional, Vocafipnal Sch'ools'Attended (Major'Subject, Dates; Degree/Date):. San Diego State College (1954-58) B.S. Radio and Television Broadcasting University of San Francisco (1979) M.A. in Rehabilitation Administration .Special Awards or Recognition Received::' Appointed "Senior Docent" for the Shollenberger Alman Marsh Portions of the Petaluma River by Jim Carr in 2002 Martha Bentley & Ernestine Smith Award for "Outstanding Contributions to the Community" from Madrone Audubon Society in 2004 Please state reasons why you~want to become a member of'this Board,_ Commission`or Committee, including what pecifc objectives you would be working toward-as a,member of .. this advisory body: I have worked closely with and have been along-term supporter of Animal Services. I have worked with Animal Service administration and Animal Control Officers on issues relating to the Petaluma Wetlands. I am able to provide information to the committee on wetland animals. I am a nature writer and photographer and can help in that regard, also. I was appointed to the committee in August of last year. Since then I have contributed an article to PET TALK. I also worked a shift selling raffle tickets for Animal Services in May and am scheduled to work another shift, at the Fair on June 25th. Is there any. other information thaf you.feel would be usefu~'to the City Council in reviewing,: ~` your application? :. 2~ Are you associated with any.©rganization/Employmerit that mightbe deemed a conflict of interest irrperfo~ming,yourduties if-'appointed~to'this position? ^ YES ^~ NO if{yes; please state name.of Organization/Employment: (Currently on this committee Ap,plicant's. Signature Date „/ ~~ _ June 8, 2010 Revised August 12, 2008 26 `S,ent By:: HP La`serJ~et 3100; . ~ 1707526914;7; Post-it` Fax Note ~67t Dice 5~7~~a pages® ~` ~.,, .~~tarlua, ~1 . -~ 3'.~ ~ ~~ nmigsion and Corvimi#f ~:~ ~ Instructions:. Use ffiis form `to gpp(y to sere on ony of 'the City of Pctol~ ivommissions, or Comrni ees, ,Please `fill out tfie firm completely. If o question write. N/A. in 'fhe--spo"ce provided- when compreteq, .please forwvrd to the Peaolurna, '11 English, Street, Petalur»a, CA, 94952. A11'applicatioris are reviewec ivam ~~~~H ~ ~~ Homy Address; ,Cif, S#pfe-:and Zip`~ode; Hamer Phone: (Jf Up~?oinYed; do you'want;this number to be ava`iraf5le to titnhe puelle?j` ' IlUorkPhone: DES :lam IWO E MdiL• (Jf, apPoinfed; do FAX: `''be. available to the; pobric F~ P'a g e Y . ..~ ~ \r~~es__ ~C }~,.,q California's B - G~syt jes not apply, type:,or 'Clerk's Office City of ~Ihe.City Council:, r' ~.~ - wpn.t this address to YES ^ Pi0 Are. you p re isfere~l :v:oler to Pe4aluma7: - !af so, for tiow long? ~ ' 9 L:'J YES U NO ~ ~'P R QX (~ °1,i a Board(s),. Commissfon(s),.or C.omtrilfPee('s) of lnterest• ~~~M~(-~ ~~czv ~~Es A~VISos~y' C~1~a'~i1~'TE ,; RNoPe: To serve o.nfhe Senior Advisory Commlf4ee, you must'be pge.55 r: pbove• Haile"you attended a meeting af.this 'Have you served on, interv a eti,"or dpplled for ~ . body? this body prewlavsly:?. ® YES LJ NO ~ .YES i N:O Brillhart, Dee Animal Services Advisory Committee _-- 27 I Sent B,y, HP` L-aserJet 31;'00,.; 170,75269147^; May-7-10 8:11AM;; i ,. Page `2'/~, Present Employer, ~3 1 ~~5 U L_ f. S i Jobt'Tifle: ~C~~FI l~ ~ L._ C.~t~J S~..L." ~ ~~Z' s Prevlp~rs Governmefttdl:Bodies/El~~tiva Offit~s you.. leave served, Positio' ./ ce Held and Da4~sr C.oJ - c•~ A Lr ~~~v ~cE.' C- ~fl Jts~~',Y ~c.>4-t ~-~ ,-.~-.~:., - ~ `~~AC~ ~j'~.N~ o t~S O (~ 1 ~ ~ ~ ~ 1-/-E' ~ ~~~(' C%cr>l ~ ~ ~ T ~ ~ ~ ~ ~ O~~p ~.~ lz V i N G ' ~~ ~ ~'~ 1a~ C~ ~F?~ x.51.1; ~ , ~ ;;~. S y~A ~•.s ~ ~9;q ' IR~"["o~.. of M ~ - ~~ ~ v S i.. P• i~ ~.~ (:o~~ ~;~ C. ~ - IM ~ _ X10 ~ Cv1.~ ~t +T Civic. or Charitable arganizaton to i~rhich you have b~ionged, Posfflon/ 'e Held, and ~O° Dates: . ~~~N~~~ ~' -cum- ~~-~~~.~~ ~~;~~~~y ~ -~~ ~rA.~.~~~s YVhat Special Interests/Skiits/Talents::would you. bring to~this Board; eom 'is ipn, ar Committee? ~ 51~ ~ V ~.D c~ N '~1'-1E (t•1 ~-r~ Vii.... A-~ ~ M P~ L.. ~E~'~l t 6~ ~~ ~- L v' S 1o t~ Y ~~ Co~~ ~-t;: i i Ti~C ~ Gor.~ e -~ ;D. 3-'/~:p.~: 1 ~~1-f~ ~ ~fJ~M4~l~ 5k1~1~``~.: ~:i^~ovP.''C~i ot--~ w~~ ~~~V~~a'~~e ~:'~ . ' r- a-.~e•~~s 6~ A~ A :~v~n`~'y p~:~:;F~~~a-~'~~~~sS ~N.c.;~~'~e~•~~ ~~~~pt--cif a.N~r~A~- s~~~LT~,~ K°t~f~l'~R~~ .~~1~~ o.~ SJ~-aeM(a.. GroUn-Cy~(~`l~~ ~~~C`~ ~ 1 ~o~Gc~~iC~~ ~~UN~S ~ ~c~r,ot~,~ ~~'C~T~~ I~ ~Et`i~fV~ S ~`~. ~ ~ E:~,, EsT _~c i~~ ~--- _ 28 _ 'Sent B;y!: HP L'a's,erJet 31 QO' 1'70;75.2691.4`7, May=7=10 8'~ 1 ]AM ,, ~~ ~. y. Page 3/4;. College,. Prof®ssional, Vocations! Schaols:Attertded (Major Su4jec#; Dat „ IDegre~f.Date),: 7 i • t 1 1 1 .1 1 f 2 Special Ai%ards or ~ecognfflon Received: A J F, ~. ~ ~ ~/ ~ ~ L.i~ 5 Ark ~~-1 ~ ~ .v ~ ~.r\ ~o.~ `T ~ v~ Fes- ~ A s :~hv~i~cT ~~ ~~~~'~~~ ~~n~~nj°-~~NT A~ ~b P~'E ~`C ~-1.~ ~~, . i IBS i ~. ~ ~~ ~ p ~j ~ ~ Piease State reason; wrhy you wan4 to become o memberof'this'B~oard, o :mission or Committee, includitg`what specific obji}ctives you would be aroridng i;o qs a. neember of this.advisory body: '( O - wt ~E Tv ~ ; t`;u.~ ~~~ E3~ ~'~~ p~ ~v ~C.~t~ ~ ~: ~~ AN ~ M P t> is there any other irtf`ormatlon that you feel would be useful~to tttie City C` u eil in-reviewing your application? ~~~115..(~ ~° ~ r... ~~vt~1.C1fr '~N\~.~ Nt`~R~~ ~~n~ o, ~'~ `~~'1FZVE ~'C'~/~• uP~.p,NC. , ~ "Sent By'i- HP LaserJet 310q':; 170,752691?4`7~; May-7-10 Bc'11AM;; ~; ~~' Page 4./4 Are you associated:with any Or®aniYation/Employment;~that might be.d a ;ed. a contllct of interest:'in perftsnn1elg your duties it'cppdinted to 4his pcsiFivn? . , ,® YES ~ NO ' ~ : If'yes,. please state nwme af~Orgcmiafien/Employment: I. i - ~ i i City;policy directs oli.a olnted, adviso :',body:memb"ors no4~to vote~o PP N ~m fters.~here there exists o;potential conflict of int®r®st W~iuld you be. wlfllreg to abs4a{n tro" v Ins il`'such a coraPliCt arises? YfS ^ NO s ' How did you' heor dboVt'fhls opening? C.u C2 R~ c•1~'~~/ 3E~ v l `~1 <_- L`>1 N C E_ 4--C ~1 R- C~.-~1 2 0 ~ 'e~ ~ ~ ~'--~ ~ l4ppliGtant's Slgnatu~e fyafe ;. Revised August 12, 2008 j i t 3 t E i i s i