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HomeMy WebLinkAboutAgenda Bill 3.BPart2 09/20/2010~ ~ ,~ .~ ~. ~~ ~ .~~~, ~~~, ~ '~ : J ~t , ~ ~~~~7 y ~~~. ~:~ I • ~ ~ Applicca$ions fo~ Anor~°cal Services Adviso~y Comrvei~ee ~ Three vacancies for 3-year terrns .expiring 2013 ~ ,,. ~ ~.. ~. ,:a142Q'~'2l~ ~ AL~~ir~ <y ,~i .~~ ,~~~'A.d*y"`.°"Yi`ia~~$° ~'"~I`'~ ~a`"~.~'~~ ~q-+~'Z~~~~` 4~kb~ "f k d ~ i °~ Y\V ``~. 4 ~ a'~sX"z' ~#w ry. `a'k ~ h"~~ 4„w rZ II~'# i~ ,~ £ '2 ~, ~' fy , S f ',~~ ~~~" *~~; ~ ,~ ~ ~ ~ k fi~r~ +~ t ~ s,~ ~ ~ ~ ~ ~"~ F r~ ~. ~~- , ~~ ~,~yr.-- ~` ~+~~~ ~`~ ~ ~ ~ ~ ~ ~ i 9 ,~"~~ , '~"Ti1 '.. tt,§#'!I`'~"~ ~h i~~~~ ~ ~Ya ~~ ~~~^'"~ L~3~Y "~ ~'r `w~ ~~~31'fk t .~f '~+S F4 ~'~ ~~' ~,: ~ ~ ~ ~ ~ a ,~ ~t ~~~ a , ~ ~. t a ~~~ ~~~. .~~ ~~~x~~~r~ ~~ j ~ : ~~ ~~ ~ ~~~-~~~~~~ ~r~ :~ ,~ ~ ~-: ~~~etal~u~~;~ ~~ala ~° ~ ` ~~~~~~,~Q, ~~~}~~~~~~~~~"~k~'~~~~~ ~ ~ ~ , '~d~~~Y'~~ s~ A Y~ ~~~4~`~'~"~,r~ ~,,~i~~.~~~ ~~~ ~- s~~r ~ . ~~r ,.~, aa ~. .`~~~ ~ ~ ~'~J ~ ~ z~~~~'~' ~ ~~~,~ ~C~#y~~oc~rtl~Comrnissron~andrCoez~rnitt ~ v '~" ~ °p' ~C~" k ~ ~~ ~~ ~~'~~~~' ~ ~ ~~ ~ ~~ ~ ~ ' j 8 6 $ ~ ~ .~ ~ ~ ~' Cp : , y ~ s ~at ~ `~ ~~~14*'~' `~~`~~`'~~`~~~ar _~r~ ~~ '~ ~ ~ ~ ~ ~" ~~ „~~ ~,~~~. ~~~ ~ ~ „~~`~ ,~~ ~ ~_,~~ ,~, ~ ~ ~ , ~~ .,_; , ~., ~ ~.,~~~~ ,~ ~ .~~~~ . v~,: ~Y ~ ~ ~~ ,. ~.~,, ~;' - ~~~~ [ ' Instructions: Use this form fio apply to serve on any of the City of Petalum ~ f rnia' ~~ ds , Commrssions, or Committees. Pleose fill out the form com pletel y. If a ques tion doe pe or write N/A in the space provided. When completed, please forwprd to ti~e City Clerk's Office City of Retcriuma, 11 English Street, Pefialuma, CA 94952. All appfications,are reviewed by the Cify Council. k ''`~` Y eiL r 'u+ e 1 ~ Y }~ 3'~ ~ ; 1 `~'~ y~+' 6~' f~~S~Rb ~ ~~4~"kz Ix°~-.~t ~Y/t'} k~~ _i ~ S +p~vT :TF F ~ J ~~ 'k . ~p f ~.~ ~s u~ ~-~ NG119'1~ ~~ ~~~, ~ w h " ~ ~" ` '~ k+` a i~ '€ ~ ~ ~ ~ ~ ? ~~ ~ ~ ~ r , , ~ r , s w .. t ~- v ~` ~ ~- ~ - - - ~ , ~ 7:~~-y ~Wk & ~ ~ ~ ~ ~a~ m~' ~ ~ ~ ~ ~ ~~ ~ ~ _ - , ~ , .a ~ zx . z x ' ~s~4 r .rt ,« ~,.+~ ~- r s i.'_ a - a Kitty Doyle . Y ~'i'M +a ~s - '~- .~~~ ,~ ^C' ~"r9,pn'F~ ~5~~~'~}~ ,~ ~~~~~i4.~ e4~ ~ ~~"'y~ 'F~Sw#Cy~ : p ~'• S •, . ~Moen~}I~c~dress ~C~y,~State andfZip Code ~~~ ~~ y~ ~~~ ~~ ~ =~ ~ ~ ~~ ~ } ~j ~ ' , ~ ,~ ~ ~ ~ ~ - Mi.~ u*:.A i=~v` r~._~ ~Sb~; ~~t:~y,~-1 f'r.~4.h, iri?P.Ft sRd `"i" s'~'. ~k,~'~~ •d ~ 6 ~~ ~ ~ ~ ~" ' ~ ~ ~= . .. . a w.k~,+.1n,..,~~ -.z ?~A ~ a _x 44, 4w~ ,k'~ d 2040 Easton Drive Petaluma, CA 94952 ~~ ~- ~ ~Hom ~Phone ~(If~ap'poinfe`'d'~rJo ~ou~`wanf~this~ *~~~ ~~```' ~~'~ ~~~-~"~~ ~ ~~~Y ~ ~ ~ ~ ~ - 5 #numbeF ta~be a~aifable to~fhe p bl c2 '~:~~~ ~ ~ ~~~~` ""~~~~u ~ `~ ' ~~~" ~~;" ~ ~ ~' ~ ~~" '~~r ' ~ ' ` ~ y ~`. u i J ~ ~ ~ ~~ -~-~~ s ~ ~ ~ ~ n ~, a P ~ " ` r ~ ~; ~t~~ ,~ ~ ~$ ~ ~ ~ ~ .~ INork hone ~ ~ ~ ~ x ~ ~ ~ .~.~u ~ ~ } ~ ~~ > r6^~ ! i" ; F r~' '..'u'~"~~ / C~ 5`i+` 3~ ~+ ~~ b01 1~'M ~~~M`~f h~~. rIs i~ t g~ ~~~ ,'n 9 + . R . l _.`} h l Y' ' £~ ' ~t ~ # '~ F~ ~'"~ L ~ ~ k ~ ~ i ~ ~ A 9 ^ ~~ ~-~ ~O(~~ ~! ., k ~r ~r. ~ - ~7 . .1 Y{ _t l ~ f i~ ~~. ~ q h S'~a ~- -: ~ {~ /~'XT ~ ~?w r ~b'~F7' f~ Y' 1.. ~ T ) A .k ~ , f4 i~'~' '~ 4 - ~, x F: ~ " r . a . ~, q ; ,n li . 4? ., . '~..v ~ r F r . ~'S - ~r. °- , ~~e m~~Aa~w as :1 ~ ~.'~,~5 ~ 707 ~ 765 _ 1623 ~ ~ _ , r, 7 ~ ~ ~} ~ : , ~ ,i~+"c~'~.yx . {~ 7~~; 5~' ~ , ~'~ : ~ ~~y} ~~~ ~„~~fi'G~ ~ ~ : ~ ~ ,~t ~ ~ ~~ ~~~~~~ ~~ ~ € ~~ ~ ~ ~ ~ {`FAX ~ ~~ ~ t ~ , s q .. , ~ . y ~E flNail (lf~appointed do~you wantfthis address to ~ ~ ~ s ~~-~ ~~, ~ r ~ ~ t~, ~ ,~ ~ ~ -~e _~! s S ttk '. 7 ~ ~. S` . r ~ .~~v~' ,! Y't#, ~~- ~~ €~, ~ ~ _ ~ ` ~ ~f ~'"~r~~~~~ ~~ ~ ;~;~~ „ ~ ~~ ~ r~, ,~~t ~ , ~ ~ '~k,~~, ~~ ~ rQ~~ rw 5r~. ~r" ~ w 1 .~k~i~: r ~ ~• s. ,~ ' $ be`ava+lable to the publi ?) ~~ ~YES ~ ~ iV0 ~ -' , ~ , c ~ ~ ( ) - kittydoyfe @ sbcglobal.net ~ `~~ a,' ~ ro ,,~_y ~ ~,e~* h.xi x~ri k ' `~a~-~i~s ~'*~`-°a 5 k' -`~'t ~'rh y ~ ~~l`` h54- P ~r ,.`~ '~ ~" '~~r.rJa~, #~~'~ ~a'i~ir ~y =~~re you a~r ister c~~ t i P t Y ~ ~ v~~i~.~tk A5 ~~a p~ ~, '.; ~•~v~ ~~k~~~~~~d"7'YS?iTU`ya ~j, ~ ~~'~°~~K ~•F .~-~` ,ty.~~ -.~ ~} ~ ~'k. ; , eg e do er n~ e a urna M~ ~ x~, , ~ ~ ~ ~r ~.~, ~ ~ ~ ~~~ ~ ~ , ~,~~, r rx l , "' i~n ^ ~Fy " ~ ~ '~ ; " . . ~ff so~for~how fong~~~~ Y~ ~~~ E ~ . ~~ '~ ~ ~ ~ ~ ~ ~ F . , ~s , i3~ .-i ~,: i ;~C, }~ ~ a„F+-~3 ~g ', ~' ~ ~¢,.. ? .~~nz `~~ 4 ~~ i r -e '~ ~. : ! -"} e ~5 h~,~. zh,:`a„ -r ia#~~,, ~i~~F,~ ro-~.A., .~".. ~;~'~ e. 4lu.. •,te ~/ YES ^ NO 10 years ~a~ ~ r x ~.'1 z ,/ ~:. ~ ] ~&i ~ ~"~'-fa~~'r~+r ~ t"#rK F ~ ~,. a~y ~~.~R Y;; 2 x ~~Yk ~~$~ l ~ ~-~~ 15 ~ t d , . i3yF . ~ '~'t~~ ~ h`:d~f ~ `~ ~~' ~h.'q .d'7'~~ I~ :°N ~~~hi'~ ~+ ~ hW.^ P ., j ~ ~'I"'i. Y~ ~ f4 ~' i .~. -Boa d(s) Commis ion Co n ~o * ~~ ~" , r ,~, s (s);~yo~r mr i~ttee(s) f la~terest ~ ~;~ ~~ ~ ~~~ ~~ ~ ~ ~~ ~ 7 ~~ ~ y I ~, 4.%i . *~ k7..e~ , AS~iY -0r ~1~"J ~ S~ 1k~ n~Y.~W~;~IF '.~ '.k: ~k~'..'~~~.~&$ Av4~f_L. "~ s~}~~ ,~~ k~""'k~ ?i " ~ ~ ~ ~ i~`?~to-5~ ~ h~ : ! ~ K 3 - i~ ~' [ - ' ~i h ~ ' . '~ µ , .P ~ . , . : ~ ~, { 3 t., ~ . i . F t rs f eri;; h , x; r w ~ ~~ . ,- . _ ' Y. ai, .~,sT,~ ,`Wz.~'~~'t^~ .F. ~Jr~'72' ~'4 ^Ne c?S`s#.i~.,cF~~~-~;~.; ~i'. Animal Ad~isory Committee ` "`Plote:'To serve on the Senfor Advisory Commii4ee, yov must be age 55 or above. ~' ~' ~ xt4'~GtiF bv gw''~`~,'~-s.:~~~h'~"a'~ ~ ~~'.~.* H'°~:•~4~~.k!'~°}~~'~i-v^~"`y'~ n4. '~- ,~`, ',~"#F+.,~ ~S. '~~ 4 Itt `~ pp' fr ;. ~ _k .5 ' { ~;Hcrve y ou a#tended~a~meet~rog~of ~his'~°~ ~~~ ~Have ou~se e~ ' n in eni ~w ~ °r ~E''~l ' xaT, ~ , { ~ y rv d o ; t i ec9 ~o ~ca i e f `~` d~ o~ , ~ ^ ~;~-~'~ ~ ~ ~ ' PP 'Y~ ` ~ ~ ~° ~" ~~ ~ ff~ ~ = ~ ~ ~ ' '~` ~~ y k ~ ~ ad x ti ~ ~~,, §r Y ~ , ~ rE` i ~ ~; ~, ~ V? , 7 ~ ~ ~ .,~ t n r " L ~ ~~ ~~~~~e~~~ k ~ ~ ~~ y~,~ ~ ~ ~ , ~~, '-#.rtz~'~1 v.y ~ f~. { l,il'~x ~~d s' i $^ '~'~ x~ Y~~~ p« V ~' 1 ~ 3 ~"'~ ~IM~S ~~ ~ ~ ~ ~ '~~ ~~ ~/,~ i . ~ ~ t,~ ~^ , h~ ~ -; ~ y4 .5„~ „~,4 k. . .7 s~ ~ s~'•~k ~ge~ 7 . - - . `-3.':?' x~ .. ~_.."~Ytn a..~F'd~J,4.W .aaE aul. F... T~x'T5-.s1.+'~, ~~~~,..fs'kd~ v~+N"5.~..4- ~'~~.s! ~xk~=t~~~ C~ ~~f~ ~ l`Y / A ~- . ~ r : .. ~ , s . . tti.. .: 9: d ~ ; ~ ~ ^ YES ~ NO . . . . ._ , . .. . :y .... L~ YES ~/ P!O Doyle, Kitty Animal Services Advisory Committee ~',~ U~'~ a~ ~ ~ ~,~~ ~'~!;~ s~~ ~~. ~ -~ ~ w,~' ~~~"`"~P~" ~r~ 5.~ ~i '~y~~~~r~~ ~ '~ u ~.~'~1~`' .~.`s.~ ~~~~~y, e ~ ~ `~ t '~€'~-^": i ~` ~ ~F d~ ~ C -~ ~ ~Pres~r~t~Employer t ~ ''al rj~ ~1 ~i qaTN.~€ii~ '~- ~F~r ~ ~~~ ~~~u~4r~i S.'~,Y ~~~ ~„~ ~ *`y ~~ ~" G, ~ ~ 3~n A , .~ ~:~'~ , x a ~, ~~~ ~?, ~~, t 1 ~T.~ v r.~, :1~ ~ ~~'. ~~r ~ ~S~ ~'r~ ~" r -5~~g~,~ fk-, .~ ~ fi w I c^~ .~ ~ ~. .~ ~ t„ _ x ~}, .3ls ' -~ r _.-~.~°r~~~'' ~ a-~~„ ~s"~~ ~~` ~` ~~~4~ .~r' "''~ ,r ~."n a,~i ~ a '~ - ~ ?a .r.~ e ~ _a~ .~~",~`"~:~ .:''~~ ti ~~r_ ~e,.~'~~~ =s.:k ~'~"1,~~.. ~` ~s'_ ~ Unemployed '~ ~-~ k k ~'I"~ "~ v ~ s~ ~r r t~A ~ ~ `~ k~ "~ '~ a ~1 .wa ~,'.~ a T ~ z k ,r ; ~ k t~,~ . . w s fr~Ob~Title ~ '~ SH~. . ~.~'~'~'x _. 'K"~i ~~ 'a'`~c ~ s ~'r,~! ~r~ _ F~"7 ~,d.~ ~ ~ .:~-~ :~~y ~ ... ti- ~-~ 3 r ; '~ ,~' ~i fti ~' u ~-~'r~ ~ ~'~~ F ~si ~ ~v`~~~4 ~5~,'~.~ ~ ~~~ '` ~ C ~';R . ,~ i t~y: r' ~~i ~ y.r . 1 ~ :~ ~} ~4; ~ . r~~j ~..> _ ' - ~ . .D £ ..f~ I f ~ k ~ ~ ,.~ ~ ~t ~Y~ .~l ~ ~' ~' ~ 4 ~mf.. ~ ~ y ~ ~ ~r +Y ' '4'~ ~",~'A - '~y #'~„s-,-.-~r ~rc `~k~!#~e G. ~1„~'' ~4~'a t~z~'n~-~'X ~i~ r ~"L 5 `~~,,'~~.d µ, {'F" °m, H,~n~.sa ~ t~. `.s~'u ~- .. r ~£ ti~ ;~s ,Pre~tous Gor~ernmental~Botlies%~Elect~v~e~Officesfyou hav~e~ s~rvecl,~Pasition Office Helcl~anci 6 asDMIP.~ 4 ~ C ~ ~ 7~ ~~Y"~'~~~~~ ~.~~7~~ ~j '~ ~.,~~~s,~~.w`'~~p~r~„5Y,#r"4% ~~4~~ tf~l~~~ -, i ~S:/O5y ,~+ .~~- S , w x ~,r~ >~4 s -r t i ir € ~ h .c . t ~ ~ ;. ~ ~ _ . ,,Yl,.~s,W '~ fr_ v~"s*rn ~ ,~d~~. n `ha~ ,-,n ~' ~~ y ~' ~ _ - a5 none .~ ~ 5.~ ~'~ ¢~'~ r- ~~- ' `~i :~5.~, ~-~'~'°l+~'S '~i~ ~,~`"}r„-k sc E~ ~ ''.r ~~v'~Y ~,~v ~a. '~ - 4 ~"~~t~~ 3ak:e. yta .a`-tiu !~ a~~ ', ,~ `-, } i4 • ; -Civ~c~-or Chc~ritabie Organiaaticrra to~which~you~haVe b~longed;~Pos~ttionJOffBce Hettl t~nd ! ~`~ a~ e~`~~~~ f~ ~ ~ ~ ~ ~ c~ ~~~ ~ ~ ~j,~n~r"r^"' a~ r~ r~ ~ ~ '- w K i i~ p~ f~ , ~ ~d1e.q f,i +~ S ~4 : t~5 ~ x~ ~ A ~ ,s"` ,~ ~ ~2 ~ '~ ~ T^~''~``'~'7r 9 #` ~3 :. v t~ ~~~~ ~ s ,~~ ~ '~ 3 ..:1 'k ,h ~. ; s ~~;~ „ ~1 i .;: }-c '#~; { s .~ ~,# ~ ~ 7~~ ~ ~' ~~, `7~ .~ ~~7'~ vv°~ ~, s'~"~rmr`~.~ ~r-^~ . k ~, ~~ +~ ~.~ ~~_.~ ~d,r~r~.ut~.~ ,~i~~ n 5~;, ~~ ,'; x ~~` ~:v '~ t~,. - ~ a _'"~#~~i'fii .Kfi~~ # f ~~w`,~ra .!G~.h ~~f~~,y`~°~+~~~~f`.` st~, eY'""`,~~ fi.~~~tkl~ t~y~~~ r~ ~j 3fr~ ~' ~ ~_' ~f~ , o- _ '. k ~~v d ~i'~r,~5~ ~ ~~ e~, ~ s ~~€ '~ . ~~ ~~€gy Ya~ .~ 4 x r,~ ' '~~'~~' r ~ ~ ~F ~'~ , s M : {Whcat Speciaf Interests/Skilis/i'~plents~~would~y~ou4brong~to~th~s~Boarcl; Comrmisslon, oi Corr~rr~iftee~_ =: ~ ~ ~~~ 7 4 r x: 1 ~-i ~ ~' . - , r, ~ +~«F " , s+,r~ ~t >~:'rE ~ ;~ ~i~ ~ y~, r~~ r~ ~ ~~ ~r~~'S ~;: ~~~~ yr~, a r ,r-~ t ,j. ~ ~~„ . .. , .; . ~,. ..:~ . ~~ e .. ~. .. .::~ .-~. ~.,"rs.~~5 .,K . ~kt~'..*n ..] r. ...:.. ., ~a~ w.~.r,~ f .-, _. '~" -~ 1 ~r } rr°~ i;~"' ' - , t,ho- , ~i_... , r . :..!:.. .~:,. I respect and love animals. ! respect and love people and am a very effective communicator. I also love Petaluma and care about the heaith and weli being of my community. I am a responsible, hard working individual. t a;i ~' ur ' k ,~ ~ eF~~ r 't.Ta" wG ~, . -. . , k ~ :~K '~k '~~ ~ ~ fits£x ~ ~c,~ z~`"„P9°µ,~ 8~ ~tL ~:;`~,-~'~~.~ s ~ '~~i~~r~'" ,5 ` ~ ~, ~,~~'~Ig'~~ 4~nE"~ ~,~,~,~J ~ ,.~.~J` ~ „~ r ~ ~~ F ~'k I~ . ~' ~ " t ~ ~ i v.`;~k ~~3 a-~ r u $ 4 ~M~a R e~''~~~*':~'~~' ~~'~~`$~w.~. ~,c~~'~~~ C ,~,~,,-~l ~.~ ,~:?^r-~C 'r ~< , r ' 7'~;~; Colflege,~P~ofessio~pn-al,~~Vocat~onal~Schools Affentlect (A"Aajor,Subject, Date$,~Degree/Date~ ,4"'~' ?~ m"~. ~7"~'`~'9~'~'.~d'i ~~u,,~~~}- ~"LF ,~~,`"~" ~^y,~,~.~u,'§r Rj~wx~v ~ ~'s,"~~~"l~"f-~u" ~.r ~~` '.~~"': r' ~ :,~~ s• ~ 1 ~ .,~ . .~ d~ e... ~ i~ w~,.;''S.~ ~,~~ p t,.~ u~" r,~ ~'~~~'n4''^` ~~~ u'~."'S ~r~'^.`~~'rz~-'.~."~~~~3~a,~'Wrs ~~~~~~~~~~ ~'r~~.~: °m. N~ a'~"~~~~ ~~ g su a City College of San Francisco - 2 years (1970 - 1972??) $ 4.~ ~s~' ~ a~ ~ ~ ~ y'`~ x ~ :~ ~ -~`~~'f~-~~~ ~~. ~t.~~~ J '~~ ~~"~ ~hfi ~~ tF'`n ~~' ~ ~ l~ ']~ .#,~ ~`~~"1~' ~*t,~~+~ : f .~ . ~ 1 ~ , g ~ ~r s~~~ '~`~ ~a 4 _`~'~ A ~ ~'h'#i ~ ~:~'~ -rw ~'tt ~* ,c v hSpecial Avv4rds or Recoge~rtion Rereived ~ ~, ~ ~M ° ~ ~, ~` ~ t z' t % , ~i ~ F '~ y,. : ^L,E..F~. ~ -K Y ~ i _ ~ 6 4 4 ~-F~n {~§h~ ~C 3 . ~'- _ > F~` ~., ,. , ,.~~._ "~ ~ ;Yea. r__ i, ~y~~ i` ~a- Gf~ ~ ~r ' r 4 4~ ~ n „'i J ~i. t ~ ~, a f .+~ s r r . .,., R . Ar'~a n ~ . , a ~ .. . r t ~. J s n`+~ ~ ra '3 .~,« ~ra^ ., 5ut 4,a..1 <a:~ ~ „y ~. ~ ~i ~,~ ~ ~ ~' _ - ~ . , - . ~. _ P ....-. _ , ~,.. .M a. .::. _ . ,. _ . . ,. F.~ . . ~ ~ ' Have received lots of awards in my career as an accomplished sales person. ~ ur -' ~ '~ `4Pr~ r{ ""~x ~~. ~ ~~~*("-~'4,~.~"~--'`~.'~i ~:~E~,~~„i~~l~Y~ ,1~~R~,~g'~~ a'~ 5~ ~aw~ ~'' 4sr -' s- -~ ~r r- „F'i s 'i t,~ ~_- Piease stafe rec~sons~why~~you~uvant~to~be~come~a rr~ember~of this~6oard,~Crae~missson or~~~= r~"~~~,; ~Coi9imstt~`e; m"clutlmg`iwhat~sp~eci~c ~object~es~>you~would~be wor~k~ing towcrc! as~a merveber of~ , ~ri ,.,~ ~-~ ~ti~ 4h~s aelviso .ry body ~ r~ ~ ~ ~'~` ~^~~ ~~a~~',~~~ad*d k ~ 4~ ~ ~~ ~e rv, ~3 { '~ysi~ ~k ~~~^d~~~~ ~ x,~ `~zi ~ ~~ ^s~ K: S4 g '~C F { +~ ."`s ,rA: ~ar a ,~e~ ~ 4 _t` s 3: 7 r~..- € ~ ! ~, ' ~d r ,:~i-,i ';;rz},.,~ ~" ~ m ai.{*~~~'~s ~,~ , x¢,„~:- s~-~E.~~4z~:,~nr~.~ ? 1 ~ ."~;;~+ra~;r~~~.~` +~r4'i;:~s'J',~;nf ~ '~' 4 ~, ~` s I feel that I would be a good candidate for a position on the Animal Advisory Board because of my love of all animals. Additionally, my sales experience would definitely be helpful in fundraising ac#ivities for the Animal Shelter. ~ ~r t',° 1 2,~,~i~m,~ukifis~§J~.t'~ ~ ~~'~c ~ ~ x:'~r Ar ~~~~~~-.f~~~~.fi~~.` ~4ih~; ~ v~~y,~.~~'~~~~'N •. ~.'`q„~~ _-~ .s~,~! .. AS ~'~ ~' r rls th~re,any_~other~informationy~that~yhou;feel~wiould~be useful#o tFie~Crty#Cauncil in reV~ewing `y,our application~~}~ ~ w ~ ~~~ "s w ~~ i ~4 ~~7`t ~af ;~ ~~Y~~~~~ , ~r ~t'J'~ T~ ~ ~e i ~ s 'a ~ ~ ~ ~. ~ y- ~ af~ ~ F ~ ~,b,w~,M ~. r,~ ir ~~~~~ ~r ~. ^i 5r ~ ~.w~`,~f~ ~,'"'~~~ ~±;~~~"e'~ ~~ ~.~~ F -7... ~ ,~ r ~. k ~ ; fw „~.?e: .t, rv.-,.-,4` .a. '~ . ~ : ss..,~,. ~~.~. r..-:~- . ~. t, ,;~,,,s ~ .,.;7,~.;.~1 ~., ,~ ~:_ ~-¢us. ~TMY;.~.m ,u , , rr _ C.,,, •,5,~•;, ~t ~~ ~.s ~4 ti~ ~~:._.~t~Sa~#.~'~Y~~ ~~'~''~~: ~' ~6-~-~ ~ ~;~ Y`~i3~ ~~::`~~~~t"~a~~~~~ k~:''+~'~,Y,M~=~.t~ .~' ~~q ~r"t~~t~~°, a r~,~~w +~,y~' ~1`~~~~ > ~~ Yr{`~ ~h :,y'" ~i rt~ £ q ~' ~ ~ ~ t5 + A " _ . re~~r~ou a ssocia~e,~d w~ any~mOrgan~za fion/E rnploym ~ ent,~thafi might be~de~meci~o4 confiict of ~ ' ~ ~ ~ , ~ 4 ~r~ ~~ itrt~r~est on erfomtin a our c9uties if~a ~ ~~ `~ ~ °` ~~ te ~ o ~ th si aor ~ ~ ~~` ~ ~ ~ p ~i~ { Fk i°~ d ,~s~p~o~ ~ ~f~~ ~~ „ ~, ; t? ~~{ ~ ~~~~~-~~ ~~ ~ ggy~~ ~~~;~,~,-~~.~ ~~ ~~. ~~E~ ~:;` ~, 'r~ n1Y' F ~ k ~~ ' ' ~ ~ ~ ~ ~p ' . . .~ , a. . .:J.~ k Y_ ~ , . 41 .£ S75 p .w ~ 7 ~ n ~.i 3 , k .. ~~f , r ,.'si .,'r l ~i ~k ~ : * :,~~~ . ~' 1 . - - D YES ~ NO e~~:~K~ d~lS ~,j~ ~, ~..fiFx' ~ rv ak ~~. €:N'.wuW" -'- 6k5..`i trha' ~,Y ,M ~,~ ~. ~,t ~ .~ ~ . k'~i' ,~y ~ ~~ .~ s~ ~ F y '~ ~ ~ ~ 3`~ ~~,~'is3~, ' b.r7~#~r ~tg~ "~ -y~-Y~~~ }^,-i ~, 7~E",~,/~ .y 1y, '~ ~t~~ t ~ ` ~. r~ ~ ~ ti ~ +i' S~ ~. ~ i U } ~,~ ) F ~ f Y ~ '`~ `a«'} ~ ~~ q ~ °'E ~s~~°~ .~w r, i'YTMe~~ G .~r ~"~ `~'~''~h~GS 4h~v~'~ + %fC ~~~~ ~~y- P f ~ ~ "~ ~ ~ ~ ~ ~yes ~please ~I state name of~Orgarnzateon/Employment §~ ~ ~ , 4 ~ .~- ,.;~~ ,~ .. ~~ ;,~' rY 'i~",~x a ~, -f`'y_ r~-1'S''S'~`" .u ~ , Pa, k ,~~ ~ ~ k y ~ "'~ ~ ~' < < '~ '~ N ; ~'~ a ~ ~ r ~` ~ ~ ` °a~ ~ ' ~' r4"~ ~ ~ ~~ ,~ k ~. ~~a~ ~`,~ , _ ~ ~w y ~ ~~dl ~,~~~. ,~ s .. , .;~ n, . ..; . ~` ~ :~. %w ~~~:~:i~ r ~ ~* ~,~d'k . ,~.. , ~ 3 . :. } rr` ! ~ ~L ~- Y' t ~,~''-r+t 1 J,N,~.S1.S,5 j. ~. ~ ~ _ o ~ ~ `m_ ~~k rA ~~~ '' ~Y ~" !' j_d ~ #-~.. 0.1 'S' 'ht~ µ F. ~/ ~ f ~i'~` ,r1`~~~ Y "}z- ~ ~~ ~~~ t# 1`' S ? 1 S'~ d,~r ~ kl ~{ ~~ ^ Ue *S ~ . ~ , . '3-0 yF i ~ A _ ,~ K i. M ~ C~ty policy~direct s a9~ app omfed ~ac9Y~sory b dy~rv mbe ~not~to ~rmt ~on~n aiters where fihere~ _ ~ . ,~, } ~ o ~s ~e~ ~ e n . xists a potent al onfl~c4 of in e #~Wo d b il t ~ b c ' i~ ro o ' a° tt e , ~ c ~ t res ui ~ou~ e~wi mg o a st ~n ~ rr d tmg if such ~ j T ~ F ~ ~ ~ r ,~. ,~ ~ ~ conflict arises~ ~ U ~ ~ ~ _~ ~~~ 7 _ ~~-~~~~~~~- ~~ ~` , , x . ~~ ~~ { ~ , ,~~ ~~, x`^a ~ ~ .. ~ sw ~ ~~`n ~ '11 ~ ~'3~+ ~ ~ ' . ~}~ ~~^~~ ~ ~ ~~~ L `*~ { G d 5"~ ~'~ h ~'~` 4 ~ f + f 4 1. .F «f1 ~c ~ Y K rv , ,u 's „ ~~ . ~',p ' . --u:s k ~1 S _ 1 ,. .~ ... . . . ~ ~ i, ~, v ,r -h 4< ..~i~~,m_ i~ .c~n~ ,. '4.~.vv.. ~F! ~` - - u_. x . r k.:r ~ . _ . ~ .n... ..n ... ~ . . ~ ..~~~ e. . ~ ' i ~/ YES ^ NO I i ~`sC ' Y t } . T `' r r+~ S w *i~-~' ~ ~-F 3~, 4~' ~'~,~~' ~'.~'6~ ~ -d ~ *~1'~ ~~ -~:d ~ ~, ~, `~ ~~i,~'I ~~F'~ ~ : ~r° s [ { ~ -~m ~ -, i ~ .. 'i ~ 7 3 9 ~ H~k' - {, a l ~ ~h t' r ~" ~ ~ ~ '~ ~. . . H S" „u t Ho~i~tl~tl you hear~about~th~s`~openmg~~ ~_} '~~ ~~~~ ~'~ q ~~ ~ #!~ ~ ' t ~ "_ ~ t ~ ~ '~ t :~ ~~7~~` y "~ s_~ 4 ~r w, ~~l t h ; ~ ~ G ~ f a i', ~,~.~ tY °~-y ~~'w~~ ~ r"~~r ~+ ~~ ' r ~ ~ c } ~ ~~ ~ ~ ~s r ~ {; ~~ ~ ~ y~ ~ ~ ~~z;~~~~ ~ .~ ~ .. ..~ . ri n. A~....., fn_.-,..i. . A ~.. .::~_ ,~„~,.,_._ _.,~ ti._:,, ~,~~ d .w... ~1 h~~,^~ ~: ~_~. ~~, :{ fcom Dee Brillhart ~ ~ ` ~~.- -aA w -s.;~ ~,~ : ~ ; ~~ ~ i .: ~ ^~ ~ ~-a- - a " ` ir` ~ ~'-4 -~ ic ~ i ~ T„Q ~. `S ~ .; W ~# { ~-i ~C~cn 5 -6 5 _ ;pY ~;"~ 'r, ~ 9~'~M" 1'F- ~ ~' -Y ~~rlf~~ - 1 t ~M1 r~ a ~ ~ f ~t ah ~ L : . `rc R' 11 S ' "° i ~'i ~ ~ ~ ~ ~ ' y ~ S . S ' {~ 4 , 'k~„ . R r s 'd~~' lC# ' i - -h J rApplicantsSigndture ~ ~ '~~ ,-~~~~~~~n ` ~ ~~ Dote~4~`~~~~~ ~ `~f ~x i . _ ~ ~ , r ~~'~;~.. ~ '" + i ~ ,~~":3~ "~ -~F ~~',; % # ~.. ~fi'.M~ ~. s : ~'z„ ~ vY ~ ~` ~z ~' k -~ { ^"r ~ Y ~ ~ ~ ~ f ~. ^ ~ ` . . , s x ~ ~. u _ ~.. ~ ~~ ayw ~ ~ : 5,~ u' y - >.z ~ '-_5 . ~ v~ k~~ . , .. . .. , . , . ~ _,a .. ,... ,k.~ . , .~ .,. -. ., - a ~i ..:r7 c ,~~~~s. ~`~-~ `~ i -~:~ a~'` ~ ~s . ~. > , ~ „ , . . .. ~ , .w. < :. . ... . . _ ~ ' ~ ( ~~ ~ ~ ~ . . , . .. . ... ~ ~~ ~~lo Revised Aug~}~t 12, 2008 ~ /~ . ,,, . ~ 9~? ~ `'~ ~j ~ ~ ~~ ' ~ ar ~ ~ . ~ `~L~ .y 1 F ~ S~~'~y ~ S ~ ~ W~.~ ~~ ~ ~'~ v~'~ y~ '~ ~I ~-~ ~~ ~b~ "~16, ~" t/ ~~~ ~' ,~ a .Y r ti ~ ~ ~ ' ~ j . . ys o ~ ~~l~ f'o~' ~~ ~~ ~,~ ~ :.~~'tt f'Petaluri2~9~ ,u , , y , r~ x~~ ~ ~ ~ ~~ ~ ~.~~a~kk ~~ ,a ~~ ~ ~ °~ ~~ ~ ~ „~ ~ .: ~~ ..~ ~ ~~~„~ ommittee a c at'~ ~ ~~ ~ ommissior~ and C = t ~ - , City~Board, C 1`'• I F ~ ~ y P 2 ~ ~' r ~ n ~ ~ i.,... fl~ ~ ~ Ar N ~ ~ ~5 ~'~4 ik~ a '7 ~4 ~ ~£ . P N ~~ # ~~Ai34 ~ ~ ~ Z.~r• ~ ~ ~ ~ Sd NBk~4 d" "Pu.~S ~5 ~Cf R ~3 ~` ~Fq~• ~ ~ ~ H L J ~ . ~.. . t~ ~ ' -' ~~,4 r' {' i ~~, 3~. A x~` 4 ~ ~ '~~~.:~~` ^~''9"ti"*.~. '4~.~+'i 'w '~ ~4i S 5'~ 4 iF .~ `~ } ~, dT ~ '~ ~ .~. a.3? .~ `~u~ . u .~ • ., y 'v ~' ~ 9 r' , Lto serve on any of the City of Petaluma, ~~xlif,~r~~' ' oarcis, Insteuctions: Use this form to apply, Please fill out`the focm cornpletely. If q question do t ap~~e~or Commissions, oc Committees. . Office City 4' ; write N/A in the. space provided. When completed, please forward to the City CI 1~ Q 9'4952. Afl applicationsrare reviewed by the ~~~n ~~~~,~ Petaluma, 1 1 English Street, Petaluma, CA _ fiAF" ^c•~#'~~ ' ~ %' $~P~F~~^ ~ ... :. ..... 4. ,f `. .C . . .~ a5 52t~¢ 1 1 ~'.~a~ ~ . ~ , ~ ~~ ~..~ ~ i ~; :~ ~e ~- ~is~'~ ~ $ ~ ~~:~ r~~~ ~~ ~~~ Naroe~~ r ~ ~ ' ~ ,~, . ~ ~ ~. 4 a , r ~ _9 }' ? ~, ~.~ _ * ~-.,'~~.~~.~ ,~~_.ua 5. ~K. °~ ~,". ~~ .__.~-_~ _ _,, r~k . ~ ~ ~r ..,.~-~ ~,- ~~. Fr~~~~~~~...r. ~~~ ' ~ Donald Forst ~ ._ ~ _N+t~ Y ~ . r~ . .~y~ w4x ~ ~ eytx ~ ~ g-,~..4 "u. d' ~p, . ' ~ 4 l~ ,~ ~. ~ 1 ~.~' ~~~Y ~ ~f ~F ~ ~•~j 3 S~, 4 ~,` ~ ~ ~~A ~ ~~~ ~"-~i~ ~ ~~~~i~ ~ ~~ - ~ ~~ ~ ~ ~~~ ~~G ~ Home Address City S#ate and Zip:Code ~ ~ ~ ~k ~. ~ ~ ,~ ~ ~, ,~_ ~~ :. ~._ 271 Monte Vista Lane Petaluma, Ca. 94952 ~"._ ;'f` Gre.a ~~ ~Yi c4fs ~"-~_ ~ . Home~(p Phone (If appointed~do you wanfi~this ~ ~cLZ ~ ~ a~i '-~.,^ ~<e"~ ,r~' ~' ~ "~i - a -.~ 4 ~ e, 3 a -tl y~y^- `~""~4 ' 'Ml.--" .~ '~ ~ .. x~'::i ~" '? ~ ~ ~,~ ~ ~ ~ _°:~ ~ ~~`~ ~ e& ~ ~ ~ '°U ~F~ ~~ ~ ~`~f " `~ a a?r ~ ~ ~ F< ~ 1~ .,.r Y~ 8~ ~€` i,x ~ ~ ~,~•`4 hF'~s ~ ~, ~*~`z'~ ~Y~ " " number fio~beravailabie to the5public?J a~- ~ . ~ ~ ~ ~ ~ ~ ~ , ~ 7 ~ ~-~ -~ ~ ~~,. ~- ~ .~ one• ~ ~ ~~ 3 ~ ~ ~ ~ ~ .~- Work Ph e~ ~+, ~ ~~~'&} '~1 ~ c.ESs p ~=:k ~o~' SQ:i~lk 4,_+1h3 3a~. S ~ ' ^/ ^ ' r~ ~' "^ .i `S 4'A d~ A .t ~Y~ tR:~~~~ , ~a ~sf~.'E~' ~ - '~' ~~ ~ ~ -T~ f ' ~~ ~ ~r~'~: N ~ 4 y ' "A " 'f d kQ'f ~y 9' r ~ ~ ~YES°~ PIOY ~ ~~ v~ s 4 j5 ~d~, ..:1~ y ~lY ~ .~ ~ C15 ,~ ~ • ~` ~ ~ ~ ~, ~ y ~ ,. ~x 2» ~ _ ~„ . .....~.,. < - . . ~ r n _ _., . _ 5> x ....., st.i=e~ .d ~~ ir., t ,...,.3 &-. ~ 6 . . m . m E .. i .,~ + YS.. . .,. ._F , _ ~i t _~_~ ~ F;.. _ ~.. ~dG_m,. . .. .. .. ~E...c m. ~ 707 ~ 775 _ 4705 ~ ( 707 ~ 547 _ 4628 w ~ "~~ ' ~~ ~^~ ~% ~' `~ ~ ~ ' ~ ~'- ~ ' " s ~ t ~` ~' ~ ,. ' E flAail M(if~appointed do you want ttiis address~to ` F Jk ~ 3 - ~ d~ ~ ~ ~ ~, - ~'°~* d e~ `~ FAX ~.,~ ~ ~ ~ , ~ y~ ~~ ~ ~~ ~~ ~~ ~~ ~~ ~~ ~ ~~~ ~ ~ ~ ~' . . n 6 r °r z` . ,.~ . . ~ ~ ~'s-.~i~ i = ~,~~ ; ~,~ ~~ ,k ~ ' >~ ~ ~ ~,~ ~ ~ ~ ~-~ ^ O ~ ~ ' ~ . , , °~ ~~ ~ ~:~~-~ { ~ ~~ § N F~YES~~ ~~ ~-~; ";toath e~pub6c?)~ ::be available , ,.~ ~ ~ ~ __ _ _ f l p.a.s.education @ gmail.com ~ e~di'~ ~ L y7~ S°'c 1 y s .r &' a~' ~ ~~ ~.i ~y ~' ~ ~ ~y' a ~ o .wl~^ ~ .~ . ~, ,a.'~'F.rY ~ ~ '. '~ . =~i4' `5'~~y ~ u4'u'S _,.} _" fr y, ~.~~ d ~ l tf f ? R ~ ~~~ ~ ~ ~ h luma ~ ter in Pet ~~~ ~Are`tyouSa~6registered or ow ong ~ ~ z~~ x~ ~~w ~~~~ ~ . so,~ 4 Y g ~ ++~i ' tX' ~.~ H p N ~.e4 'I°LV.w~ 2U,,."}r' 6~ ~. .-.~ '3_'A~ _.~~ .y. n e-.~W . . t"`-. ~.P. N..._.~ .el_. ~¢ X,b6~, ' S _ ~-Si'i.~~. Jl ~ ,~_^eN.~ ~~~1.~~ ~^s3' A .`.e +.A,y_ ~:.. l~.d.~.-ei ~ YES ` ^ NO 2 years b ~'a~a ~~ ~'bK' q~~1~~z ~i'~ ,6 ~... ~,~P~P .`' •C ? yi •._~ d ~~`i'~ ak ..~' *Y ~ ~"i^ ~~„r~~6~ ~ ~''+~' ~~ K~'~t~ae y'~d H,~.'~•6 ~ y~~V~~ ~`6f~ ~r~ ~. t*: '" ~ ~~ ' ~ ~ ~ ~~ ~~ " fJ s ~' interes ~ ~ ~, _ ~~ ~ ~ ~~~ ~ o ) ~Board(s), ~Comm~ssion(s), or Commrttee( ~. ~~~ t . ~ _ ~ ~ ~, s a u C_i .S~F~~.sa~~.a ~'~..E`i~.~..'~ y....,:..~._ t, .5~,.~~.a..> ~4:.lv.. ,_.., i::t_ ,...:~3~« ~ ,~_ ...~+~d .,.~~'~:z. ..'~;..z,~ ~,s+~'s'= m~. ._. 3.'Sm~~~i Petaluma Anirnal' Services Advisory Board ._ _ _ _ *iVotec To ~serve~ on the Senior Advisory Committee, you must, be age 55 or above. d'{~,'' y~ ~.F v7' .. ~ ;~" g9 ~ '.n ~ 9 ~'4 Ts ~- attended ~a meet~ng ofMfFiis ~~ Hav~~ u; ~' :_+~ ~G .-' ~y~' ~ ~fi. x'v'~' 4~~:f~'`Y~' ~ a,B +'~' 3~': T~~ ~8~ applied for~~~'~ d on, :interviewed,; or rve e you s ;Ha ~~ - yo . µy ~ ~, ~~ _ ~~ ~~ ~ ~ ' ~ , b'od ~ ~ ~ ~ ~ ~ e ~ ~ ~ ~ ~ ~ ~.~ ~ u, _ ~ ti ' 4 thi`s~bodj%prediously~` ~~ ~ ~ ~ ~ ~ ~ y ~ ~ wi.,a` `. = a;'k ~~f _..4.~3a ~. ., ~S ~~ ~i _~~~ ^c ~' Sh.l - ~ i4~,, "~ _ .~'. a' ~ - ~~' e _. '~ -. ~ i ~ _ -'%~ ,A ~ ~~_ . .. . ._ . 0 YES 0 . , . NO ~ ~ ~ ~ ~~ .. ., ~~ - .~ . ~ ~~ ~^ YES ~ R10 ~ ~ ~s ~ *i ~' r ` i Forst, Donald ~ ~ Animal Services Advisory Committee , . ., -. ~ ~ ~~ : _ °. ', ~ ~}, ,~r ~ ~ ,r, ,rt . . ~ ~ Fr - '~"z r s .'~ ... _.._ n y~,` _ ~..g ~ ~ ..2~ '~, k ~ : ~' ~.-~ ~-4 ; '~,. : .y4lls.~, . ~z -i , € i. ~ '€ ?~dc..Y~ }. ~ ~~ ~ ~ at~ ~ .'.~a°r'~` ^e.'h i'S .- '~' ~,i ~' ~~.. 3-~ ~"; ~Present Emplo~yer ~~~ ~~~ ~ ~~ `-, ~ ~;~ ~ ` ~ ~~~~ rs ~~~ ~ ~~ ~ ~~ ~[F ~ ~ „~~ ~~ ~ ~ ~ ~ ~'~.,~~5~ ~~„~~ ~~° y ~.~~ ~.~_~~~. ,_ ~ ~. .~ :.a:~a. ~. -~ ,~ ~ .~~.. ~,_v~_~ - ~~ ~ ~~ ~_ Si' Joseph Health System = Sonoma Co;unty . ° ~ ~a . j,C+- ,y~~.~~ijo- ~ ~ ~ ~ ro~ ~.: ~ '~r •a-nx c ayr ~ ~?''~,Y 1 ~.~` ~: ~r~ -:~"+.~, ~+ ~„ ~~s:~~. ~ .: y d+~'T,y ~ ~ ~ 4 -i `~ d 5~, ~. ~` ~x~ ~" '1' r r ~' 4' ~ ~ ~ ..~' ~ ~ ~ _ ~"-~~. rc ~'~y5. ~-ti z ~ E s ~ _ t J~b:~ 111'e'~sey~e ~,~' `f" -rv x- ~ ;r ^~g ~~j .~ S ~~~.~ ~ ~` 4 T~~ ~' ~9 ~ ~ i ~~' '~~'? ~ -~, W,~ ~~ r `b ,~i~ ~`~' , ~a.~~~~~~~e~~-,a~'~~~'~s_„ r:~~~':~,~ ~;~'/ ~,n~n~-~...~`~:~,n~ ~~''~4 ati~u,. ~.~~~~~ ,~':r~..~?~*,.~4,~£.~ ~.,.~~~~-~. ~,.~~~a`~~,.~_ Area Director Patient Financial Services ~` ;~~~~`a,a,~'r ~ r ~` ~.~.,t~ ~ - ~, ~, ~~ ~~,L-arr ~~ ~~__ _4. '_"' ,~ ~"' . a:,'s' ~.::- ~ W~-~ ~, m ka« ~: ~ . r i ~.'~'~'i~ ~ 's~` ~'^~~'~r ''~. Pre~ious~Governmental'Botlies`/~Elecfive~Offices you~have senred; Posrtion%Office Held~and~ F~ .~. +-a a g7~r~_a ~n.. i~{~'"q~; 7k~aY' .~v !. ."_ n ~_,~ `t~ r~x:- "'-~ '~"'°1~ Y~` .~' ~'P~ r+~i~ ~.~ .`.' t~ '!~. +~.~~''` ~~-y ~.. 9~QIQ..S ~ 6~ '~, .-a ~~~~~ ~ ~' .m x'ar~~, 3 ~"~a s ~,.~ ,ss~y .,.~.~~ ~'~`~,fi~s-=~.ia ~~`p~~ f-s~~~~ ~'.~"'~ti,.~t~ : . ~a~~.~,. ~~.~'~ ~ , t~t -s„ ~;> ~- ~T~ a}r: ~ e _~'~ ee,.~ ~ ~ ~s ~f ~ ~ .k~~ ,.x _ None g-vY"a ~-...., "~ ~ _ .~ }rg ~i~f+t 1t ..'I~y§ ~C .r'~.~ ~'. k ,~ ~' ~,~ ~ F , ,_~ 8... ,~ ~,~,~'4a~ 's_""`'~! ~~ ~'~;. s ~~ ~° cg~ ~ . Cn%c or Charrtable O~garnzdtion tou-0Fw~hich"you have~belonged; Position/~Office~Held~and~ ~~ ~~ Dates ~i 4: ^" ~^~FlLa.`k" ~' ~~r, ~~ ro ~ '~ ~ ~ • ~` S ~ ~ ~m 'd. S ~'f r~ P ;^~ TM4 ~~~ ~ i~ a ~a~` fl a Y~ y ~'-~ '~ ~ `~ ~ 'N'~s'r ~ ~ J~ m' .". ~.r.~~'" n.a ,-~~NZw'S.~ .`~=_~ ...~, . _.,~°"-tr - - AS`~. -.+~C. -,_'~ , -.."'~,.'~ i .~ E-. ~''~ e. _F.u~. ~ ..~n.~~~...,. .~,.i ^ ~:.~ rs - ' P ~ .. ~~~ ~ ~~ ~...~' c, None ' ti~a .s ~` ~s '~ ~e'~a^ # -' „ts ~, `~ ff -r.sm ~.- -~,~ ~,, r r~ra~ ~r~"T ~.. r .?C ~.'~~,."~ ~ ~ ;-~ , ~ ~, ~'~~ 1 . ~__ ~ ~'~ . ~ ~ a L ~ w - ~ ~ " _ ~ wz e~ ~ r „~ ~~e r `m F. ~ ~~ a~ ~ ufi ,1 ~ ~„ -~. ~~+t~'ra '~'r ni'~-~'~ k ~ ~ ~Wh,at~Special~lnterests%Sk~lls/Talent°s~vvould you~bring to thisiBoardr;Comm~ssion,~or„~Comm~tee~ ° . . ~~Lt ~ ~ z ~,, ~~ ~ : , r '~F ~ wr 8 ~ ~ 'r~'ir- r u v~. ~"` '~ ~"~ ~ "~-t ,~' ,. W s ~„F~ 3'' ~~^ ~> ~ _ °~r'~ ~srv, ,ff"~ s~ , t: ~"; ~: ~~ - -_ ~ _ - ?''~ u 9' E~1P. _ ~, , i ~' 3 ,r~ '~ ~ .: ~ ~. .~~ _ ~-~s _ ~,~ i~. .k~ L have a background in wonking with people as well as,planning and implementing projects. I am an experienced public~speaker and educator. I also have experience in decision making, budgeting and prioritizing fcom my 30+ years as a director•for various healfh care organizations. ~~, ~k':Yf~~;~""' sd' "'~w"'~,~ I `_ ~ d' ~~.~~~i~Ya'.~, ._ ,~ - ~y -w ` ~ ~..'~cr~'sik~ ~~ ~ '~° ~ g;~ z~'~•~ z~:$~ `~,~c:c '~~.:~. c ~ ~ ~- 4~ ,~ t u.~'~ ~,~,` 3 F ~.l«$ S~~t"~p_ « ~v +~ w ~w'; p~v -_, ; a ~ ~, . ~F-n'~r! : ~ -d-"" ~, ~ ~'. ~ .~~ ~ ~ u'1 ~ ~7 ~ ~a ~ ~Coll~ege~~Professional; vocat~onal Schools~Afitendetl (Nlajor~Sub~ect;~D~.a#es; Degree/Date) ~~r~~ ,~ _ - GP^~ ~ spt _ ~iya,,l~ 4 ..o ~ .r~ ~ . ~' ~ M~='~ S $ - n ">"~ 5 ~ Y . ~ ,~ ,~ ... kfw„~, a 97h ~~ . ~. -1'3i ~y ~3 4~ ~....., k _,.. ~.,.-< .. _ ~,,. „~~ m ....~ ,.. :. ~ ~ , ,,. ma,e ~m:e., e~i;3. _ . ~M . ,.. .: =n. . ~::. ~i~ ar..,.~,.. ~im,~7-^l`%' ~.~.t ~,-~.- _ Galifornia; State University Northridge - Master of Scienee` in Health~ Administration - June ~ 1'~97~8.~ ~ ,~ ~ California, State University Los Angeles - Master of~Science in"Rehabilitation Counseling - J'un~ 1970 California State University Los Angeles - Bachelor of Science `in Business Administration (Personnel Management) - iVlareh 1968 °E y '~y~.~~ I~ ~~ yabe ~ ~ 7n-^ ~ f ~ K~ ~~* '~v ~ e ~ . ~s ; ~ sn _ 'i '~ x ~"-4 a"~ ~.`~.~a t`a14~ .~rr ~ ,}° x~ s ,` ~'~° t # ,~ a ,,c, .,~ §~-c' ~ ~, '-s ~ t~ r - ~, ~ ~~ ~ ~ ~,~ ~ ~` :~ ~k'~ ~s .R:~' ~ ~=~~m,a § ~ ~ ~'k E ~y e k;. «~~~,~ ~ Spec~al,~Awarda,~s~or~Recognrtion Received:~~~ ~ _ ~ ~ ~ ~,;`~~ ~ ~~ ~y e~e~ ~, ~ ~ ,~~ ~~~s~,~,~~~~:. ~ a , v'r~~u~ °~'~-~.at d~ ~ ~ 's'1'^F~s~ ~, '~, x~~~ k ~ i~ . ~'" ~. ~ ~, ti S,. ~;~ ' - ~ ,~'--s~., n a , ,n° ~ ~'~ So' , '? 1 ;?~~ -~_` _ ;9 i 4 ~ 'cs~ t' w-~n ~ ~ ~ i 3.~, r 9twq .. ~ `~ ,¢ ~~ P ' J §~ . ~ ~ ~ ~~ ~.~ ~ € ~ r 1~`:"_ 5~,~'vl~ ~ .. L'~ ~ . s~, ^~ .~ ~ ~ ~ R 1 r~ ~~* f .~. ~ .h h ~Please state reasonsfi~why you want to become,a member of this~Board, Commission~or~{ ~~ ~~~ dE $«. ~; ~' '~~ a~.m ."r7i ~ ~ ~ ,va a ~ ~r C~~ ~x~ v ~ ~P a~ ir - ~ ~, ~.~d ~ - ~ ~~ ~ ~ ~Commrttee,~mcluding;what spec~ic obJectives:you~would be~gworkmg towardzas~a~member of~~: ~ :"¢, ~ -,au~ ~' '~ ~a ~.::1° - , ~'r~` 9~ -~ qR ~. ~ ~ ~"~i~ `~" ~<k1t' v~ .`'~'31 ~4 ~ !~ s s "~'~~ ~*r'~-~~ t ~ ~ ~ „Y~~~' ~~ ~this~~vadvisgry'body, _ ~ s ~ ~ ~ ~} ~ ~ ~~ ~ ~ ~ , ,_~~~ ~ n ~ s ~ ~~ ~ $ ~ ~~3 ~ ,~t~,~ . ~,.~~z}~, o .,.~ ~. _ _ ~~-~~ ~,_~ ~ z ~~~_ ~ ;;: ~ ~ ~ ~ ~~~'~ - - - ~' ~~g -~ .~:'~ -~ _ My;wife is currently the volunteer director of Humane Education `for Anirimal Services and she and I have discussed her work,and the'fqcus on educating the community about the humane t~eatment of animals. I would like an opportunity to further this'work' and the othec functions of the Animal Services for our city. ~~~ t h~ ._~~ a;~ ~.: ~ ~, 'Y . h ~ ~ j,~,s ~ 4~ ~ .~ ~ _.~ e ~~~^ '~`~ ~~, ~~°~ $ .7 ~ ~~ .~'=s"~ *~` ~ aw~ ~ '^~. , ~ ~~ .I `Is~th~er~e~any~,other=information thatyou feelawould be:useful to~the:Crty~Council~mdreviewing ~-~~ ~yourapplicat~ori~ n~'S-~ ~ ,~ Du_ ~o- ~? ~ ~ ~~,m~~m ~~C~'v~~ ~ € ~~`~~~~~ v~~X~ ~~+'~6 ~a a,. ~ ~ ~r ~~~~~ ~,~~ ;~ .'tE~ `,i-'~ fl ~. ~~-'~ ~ ~ a ~ ~~.~~ ~~ ,~"~ '~cs~~? ~' F ~~~i e`"- ..,q~ ~ ' €a ^~ ~ ~ ~ ~ ~.~ g ~ ~~;'~~~ ,. 6 - ~.,., ,_ , . -~ ~ : : , '~~'~, ,....~ ~~_~-~.ra _~. ° I am an active memb"er of ~St. Uineent'De Paul Catholie Church;, I serve as a lector, eucharistic minister and along with,my wife we coordinate°the ~marriage preparation program • for• the PetalUma panshes, . My wife and I have been teaching ,communication and relationship programs more than 35 years throughout soutNern and northern Califomia. 1~ ,~ a+~ ,~ ~~r«~° ~ . ~ ° ~o .-- ~ - -+a . - n - x ., ~p ~~ ~-°~~~fT - . ~ ~.. ~ r : "# . ,v~ :~x ~'e ~?,s.+Y~.• I ~ ~3fi ` ' ~~~ ~ ~~ ~ ~ '~ ~ ~ ~~~' J ~~ ~' -R ~ ' ~` ~~"'~ ~ ~ ~~ : t { . A ~ J: P s ~ ~~ deemec! a con l ct~of any Orgarnzation/Employmentsthat migFit be ou~a`ssociated w~th Are` ~ ~ ~ ~ , y to this position our duties lf a ointed ~ A _ , ~ ~ N ~ interest m " erfo mire : G ? ~ : ~ x i ~ u , ~~~ ~3 ,~ ~ p r g y ,, pp 2 ~ 3 i! . ~ F .~. ~" A f ~#p'~ ~ ~.- , 4 r~ ~ ~ ~ '+u' +! ~ i{' . '~T ~ ~ ~ ~ c .n l ` : ' j L .. .~R ~, ,(y Y ~1"~i . , iiS.u +Pkr a ~.n~~'M w ~~z... ~ ~n d i ~3' . u' . b ! ~. ~P"~' ~ifJ~ 4 ~ . ' ,~~ ,YES ~ NO a y ~ ~ ~ ~ ~~-- ~ ~~ ~ se~. ~ .. ,~, ~+a '.: ~ ~~ ~'" : ~ ~~ ~ ~ ..r M R ~ ~ ..' 1 1 F g~ ~ ,~ ,u„ ~1 ~ .~. ~ ~ .~, "l"_ T+ ,,,7 t~ ' ' 7 ~i ~' ~ ~ ~ h ~ b 4 ~ ~ ~ t ~ ~ A " ~H . ii V .,.w -,!R ~' k ? S Qi-.~ . l P : ~., ~E3' 3 `. i d 4 ~P - ~A ~' 4 1 ...2= '~si t~i9. 6 9f "ts " 2 ~ ~ }F $ y ~. ~ 'ti ' . ~ If yes,Rplease state~~name of Organ¢at~on%Employment ~ ~~ ~ ~ ~b ~ ~r ~ ~ ~~ ~~~ ~ -~ ~ ~n ~ ~ w - '' ~ `~ ~ ~ k ~ ~ ~ ~ ~,".. . - T .~a:~ ~ ~, ~rr ~.~ ~'r~. . ~ ~'"=5 d : ~ ~ '"~ + r ,.~~ 2'-~~,~~ 'r k 9 ~ ~ ~ ~ ~'ti @ ~ . -~ . - ' ~~ ~r =~ 'g < ~ ' " ~ ' ~ a ; . , <t ~: x„ i. .: J . `~. a _ i ~,~ .._;R, , x~. a - ~ '. m~ '" ..~` e ~ ~tb.G , ~, .~ , ...„x.~F. , a .&,r..- ... .. . ;. ". y. ~. „ ~ .i~l~-. .1 ~ +~~Z -• a ~ ]`i ~x r ~.~ 9~ ~ ~~ ~.v .. ~~, .~ ~ ... „~ ~_ s, .. g~~ „k~~ ~ . ~~ } ,,~£gb ~~.,~ ~ .. ~ ~ f fs J " :'4} 1• ~..a, ~a~. ~~ r ~~~ xb ~, ~ :, ~ ~ ~~ ~ ~n a~, ~ ~ ~ ~; ~ ' s where~there~~ ~ not to~~.ote,~on matter body mem b ers ts all appointed~advisory City~poAic y, direc ` ~ a ~ ~ ~ Y _ such a~~~. ~~ exists a potentialuc~o flict~of`interest Woultl you,:be~willing~to~abs#qin,~from,voting>~f ' ~ ~ ' -y°'r~ ,~ .x . ~ ~ m ~ ~ ~"-u~=d. m~ ~ ,~.'iIR ~~p ~g. `S ~-, -y ~"' ~ F f ~ _ ` +r ~, s y, r r l s ~Y ~ ~ i ~?i ~, r ~ , _ ~ ~~ ~- .~ ~. ~ 9 confhct 6nses~ ~ ~ ~ ~ ~ ~ ~ `~ ~ ^ ~ E ~ , } µ~ -' ~ ~, .s~. z ~ ~ ~ ~ ~ ~" d "4 s' _;.~. ~ ~ ~ r~ .~ ~> ~~ '_.- ,~ t ~ ; u y~ I~." . ~s n~#~: ~ . E ~ ~~ ~ ~ _~: e ~:r r.ftJ; '.~ .hzs~ - ~~..I~.S'RWee~~~'~~-~,` ~S.~y,~..;.-,i 5 __t._.~_ Eu m a~'y1.~1. .~v~.~Yt`'~IMrs c"..ES ~"e_~ va ie..~~a1..v ~;k`,;.~Y -e v'_,{ ^/ YES ^ NO _ ~ ~~ - ~ ~ t .- j ~ . . -~ . -~,a - ~ ~ M; ~~: .,~ ,~ ..s. ' ~~st"^ r*, ~ , '~-~ ~ ~ ~ ~Eki ~~~~~~ ~~~ ~° ~5~~ ~ ~~~'~ ~ ~~ ~`~~ ~~ '~-'~ ~ a ~r~~ ~~ ~~ ~ ~~ras~ ~,-~~ is How'clid you h~ear, about thisoopernng~ ~ ~ ~ ~ ~ ~ ' ~` ~' ~ ~ ~` "~' ~ ~` ~~=~~"~ , ~ ~ ~ _~~ ~~ 4k. F~ ~ ~' ' ~ ~'d~'^ ` q 7 ~ 3 .. y _ r . - ~ . z ~ ~ . > 3a~ . _: -a. v Y ~v ~., ~,xs ~ ~ ~ 9 ~ } , ' ~ e .~ E'd'~' ' °Y' Y ~t a~ ¢~ ° ~ ~~ '~~" z A S JG 'A - ' ~ ~ 4 ~ ~ ~ ~ ` ' V . _. . _ ~ " § ~ ~ ~ t M1 r +, ,~ w+r. _ _ ~r'p 'm~ ~'~I 1 ~ ~"~~-'~x ~~~ ~a ~.'~aY ~ ~1.~`~`~ ~~-..f, .._x~' r ~~ ~ fi t~ <. ~ ~ ~eu~,~t ~ `. ~'.,a , s'a~° _ g ~_.~.-.:~ _ ~~_~ . a~'._~~~r An article in the Argus Coucier. ~ ~'~~~: ~ ~'~ ~ ~~ ~ ~~,. ~ ~, - ~" II E "- - ~ '~.. -~,e.. ~ ~ °d 6 ~i '. ~ n . ~ ~ ~.~ 'i ~ J` ~`' m -~~ . ~ ~ " ~,3 " ~ `~ ~' ~'~i ~:,-~-e ~` ~-~.js,~.'' ~~ xhl ~ `'~ i ° b "a* ~I ~~ 6 ~`'D rT, 1 2 ~ ` `~ Ar y ~,~ .. -~'n ,~ s ~ ' t "f ~ nature A phcant~s S~ ~ xt ~~ z -r ,~. ~..~~T'~ 3~ ~, ~ti u ~• ,~ Dcte ~! ~ ~- ~ ~ - ~ -~' ~ P ~ g ~ ~ ~ ~ ~~ ~ ~~ ~ .~r ;; ~ ~,~ ,~~ < s ~ ~h ~., ~~ ~ ~ ~ • ~- 3~ q~ V(51 ^ ~ ~ ~ ~ ~P _ ~ ~ ° ° ~ ~ i ~ ~,~:. ~ , ~,~ ~ ~ ~ ~ ~ ~,~ ~ .x Ik ~ h . L .= $ ~ ~ a~~ ~ ~ _ ~~ ~p ~ ~ . , ~ s ~ ~ ~ ~ . ~~ ~~'_ ~` .,~3.:L li '~.Ck e.~FdC~~:rt +~ a /_~_,~ii „ ~, ~ . . ~ r~,~ ; ~S'_.' 6. 3~' ~~ .I. ._~~t . ~ _ ~ September 7, 2010 ~ ~~. ~..~ • ~~_ Revised August 12, 2008 ~~ a. . .. r _"~~ ~ Instructions: Use this form to apply to serve on any of the City of Petaluma, Califor `~~ oards, Commissions, or Committees. Please filf out the form completely. If a question does not app , ~~ write N/A in the space provided. When cornpleted, pleose forward to the City Clerk's Office City of Retaluma, l 1 English Stree#, Petaluma, CA 94952. All applications are reviewed by the City Council. Lynn Richardson 259 Photinia Place, Petaluma, CA 94952 ^/ YES ^ NO ~ 707 ~ 763 _ 4549 ~ ~ _ N/A larichardson2 @ comcast.net at least 30 years (can't recall exact) mal Services Advisory Committee *Note: To serve on the Senior Advisory Committee, you must be age 55 or above. I 0 YES ^ NO I ^ YES ~ P!O ~ ~ Richardson, Lynn Animal Services Advisory Committee ~~ Retired Legal'Assistant None Sonoma County Master Gardener., 2001 to current; was on board several years, have held many positions of Project leader,. no space for details here. Avon Walk for Breast Cancer, team member, 2007 raised $75,000 +f=, 2008, raised $50,000+/- ; Relay for Life, team mem6er & captain 2008& 2009, raised approx $10,000 total. Trapper & Volunteer for Forgotten Felines Spay/Neuter Clinic & Spay/Neuter Clinic volunteer for Petaluma Shelter I have experience in organization of workshops, educational outreach information and comnnunicating with the public and would appreeiate helping in that way somehow: I also have experience: in fundraising. The Shelter is doing great things in the fundraising area and I would like to help. I ~. I hav~: no college degree at this point. I am currently working on a certificate in horticulture at `the Santa Rosa Jr. Gollege. Currently. l'have completed approx. 2 ysars of college. Sonoma County Master Gardener, Received the "Golden Hoe" Award in 2004. This award goes to one person yearly who gives over and above to many areas of the organization. 2005 earned Outstanding Volunfeer award for over 1,000 volunteer hours from 2001 to 2005. I am interested in'helping Jeff Gharter and the currer;nf staff at the Petaluma Shelter continue on its path of growth and community outreach of education in spay/neuter of pet dogs and cats and feral cats. I am dedicated to helping animals and very much want to gi~e my time to the Petaluma Community. I consider myself:responsible and reliable and once I take on a positioin, I do my ~ery best fo complete the duties with ;integrity. I work well with people and I also am able to take on a project on my own #o its completion. o~ ; .'~ ~.°~@~',~`~ ""„~~N'','~Fq~ ~"i.a'~~ -3:~'~~"~ - z :?'l ~,~ ~'"~,~ ,~~ ,~'''t~.'e', y'~.ia~,"„ -s •~ ~'~.: ~ :%n.x.,.~",..>.,,'~t~ra `~; '~ "~;~~'~ ~~ , ~' z mf' ?. .,., ~A~re;~ya~u,~ass~~o~c~a#ed~w~h any~Organ,izat~on/Empl~oymeYnt,that~migh# be tleemed a confhct of $intere~t~in'performing~your duties~if appointed~to~this~pos~tion~ ~~d ~ i ~ g. *a f" s'S ax :~ X a+~ '~ ' u'~r ~'~~ ~. . ~. ~ Y ~"~s, ~ ~,~ ~"~^''~~is~' .[ C'~',~ ~ +~ ~ ~~ t3 ~'^ ~ft yP~ ~.~,~~~ :e "~#,~~"a 'reY4~ ~". . » z. .~ - ~ ~ ~^.~ ..d .r...r.~*d. C'~, a.~s~ ¢~-c _~, . .~~.a3e ~ YES ~/ NO : am; u ~ '° ~, ~~. ~`~ ~5~ A ~~~'~ . I .y ~ 9 °'"ac~k'd~ i~~',~`SY~ ~ ~~V'''`~,~ ~ ~~' yy~r ~ r ~ [~ . ~u , '4 ;~'r'~ ~ e t' S IH r.~ -. ~ r~ T~ s: a a~`~N''~ ,~ ~~W" 3'~} s'*~"~..„a ~ z~ v~ ~ 1 L i.~ ~ ~-1f§yes{please state"ncime of Organization[Employment aF ,~ ~` ` ~ ~; ' ti ~ 2~ T"s~ `W 5~, s.' ~, ~ .;; y, rC `t , , , ~~ u _ .r ~~ ~2 3~'~} ~ w ~ ~ ~~ ~~~ ~ `~ ~a: ~ , , ~ = :- - - . ~.~. .~ ~,. ,_~. ,~ .~~ ~. ,~ , ,~, ~ : I am not aware of any conflict }f~, ;~~ ~ , _. t -: 2'U;~ ~ ~a l~- "~'~ ~~~~~;~'*~a ~a.~~ ~~ ~ v 1`~ : ~ ~i ~~j'~~~ ;. i ,., ~~ .. R`~City pohcy directs aIl~gNppointe~d ~ad~isory~body,~~members not~to~vote{on matFers~where there '. ~exists~a~`potential~confllct of~~interest ~Would you;be'willing to,;abstain~from~voting ~f such a' ' .~"'¢` i~,~ £ ~ .} p -€' q Y ~v ,+- y :t av p . ,~s ;~ ?~ '~ S ~. - Y F `'conflict arises~ ~~ , ~ ~ ~ ~ ~:' :~r ~ i ~ ~~i~ ?i 'q~ t -+2 A~ ~ ~,n ~" i ,~ , k'~ e ~`}' Ri`s- N~ 3 ~ i~ ul .,_.. ~ ~s~ c . ~,~.~<.~ ..n~.:_ .~ .> ., a..i.. ....w._..:.h,~ „.~ , :.r >.z.a ..~ . . ~d .N^ _ ~ YES ^ NO ` ti '~ . ~,Y ~ } ~, g (~ ~ x ~ ~~ x ~ ^~ : ~~ ', s ~'s , ~~°"~~" ~ ~ ~'7 ~ ; ~ r a , ~"How c9id you hear about this opemng ~ ~ ~ s~ t ~ t r~s 3 ~, ; F~" ; ~` ~ `~ a r~'"~~'~-l',,~ - {~z r '~a; -~ 3 u -~ ; ( . n i ~ _ ~ ~ ~..1 ~ .,5.,-~ - ~, .r~:, t w ~ e A vk , K~ Q~ ' - ~1. _ ~4 - At the Petaluma Shelter Spay/Neuter Clinic on June 19th ~~ ~ ~ ~ ~' ~~, ' ~~' ~~ ~ ~', ~. , ~ , ~c .~ ~ ^ 4~r, ~. ; ~ .~ k ~ ~ '7 k `~ r y ~, y- s ~-Applicant's Signature ,` '~` ~~,~ ~`, r i Dcite ~~{ ~x~ C~.~ ~ ~~p ,~ ~.t~-r d ~ ri'~. '`7 vk c. i t , ~ .: ~ `.-,,...., ~~ i sa a , u ra-.~,a . "'.,,_, . ~ . ..,~,_ ~. ,..,.~_3,..,.. ,..,~.., d4 ,r _p ~, . . ,,.s ^- ^' i .,,;`r .r ~ +.P.~ . , ..„.`k" , _ _•k J~~ / ~--- June 23, 2010 /' « Revised August 12, 2008 ~` ~ S ~ ~~~ J ~~~ L~U < - . 'r~ ~.~ e ~t , \~ t~ ' ' I a ~ N ~~ , . . E Cal~ o~nta ~~~;r' ~ ~;_ ~4 F~ C'~ty of :Petalr~ma f , , , _ y : ~ ~~ ,: ; u ~ _ : ~ ~Ci 'Board,yComrnission and~Committee Applic ^rn~, ~ ~ ~ . ~ ~ ~~ ,~ Zg $. ~ ~ ~ - ~ - r ~ ~ ~. . - ~ y ` ~ ~ , -._ _ ~ .. _. ~:. ~~~_~ a =~ E ~.= . ~~_~:~: ,~ ~ ,: < Instructions: Use this form to apply to serve on any of the City of Petaluma, Califor Boar , Commissions, or Committees. Please fill out the form completely. If a question does not ap t pe or write N/A in the space provided. When completed, please forward to the City Clerk's Offic ~~f Petalurna, 1 1 English Street, Petaluma, CA 94952. All applications are reviewed by the City Counci. i~ ^",y. ' W . _ 4 g.x_" ~ ; I- ~ - , - x' ~' - ' 2 ~ . `: e ~'~ ~ ~ z ~ ~ ~ ~~'ida ~ ~ ` '. ~ 4 . m ~r - - _' . ' ,~ .~ . ..,. -- ~ ,.. ~.-,:. .. . . > >, ~~.'_ .. _ .: , . . . ?.. _;r,e..._t.. ,-,._ ,~. ~. _.' 4.^' _ .-a ~ -~ :-- -: _~-- :.: .. Denise Sperling u , , - _ _. _ , .~ _. ... ~ ~ ~. ~ ~ : ~ ~ ! , rHomefAcldress, City~State and Zip'Code - ~- - -- - ~ ~ ' ~.:i~, r ~... .~..^. ., i ~ .•.. c~6~,..' . .. ,r_ :. ~ .. . y . -. ~x . . . . .. . ... ._< <~ t ~~:. - ~ ~ . 1 " fl._ _ n: - ... -. r 1425 Elizabeth Drive Petaluma, CA. 94954 ,Home Phone (If appoin~ed do"you want this ~ _ ` ^ ` °°'' - ' - ~~~ynumber~to be available to~~the public~)~ ~~ h x ~ ~ - - - VNork Phone . , ` ~y~°' ~ ^ .. ^/ {~~ _~ f - - YES :E m ~ O ~ r_. ~_ ; _ , ~ ; ~ 707 ~ 778 _ 8676 ~ ~ n/a _ ; =< - - ~' ~y1 ;; ; ~~ a ~~ " ` u wan`t this address =to E=Aflail (If appointedrdo yo . _F,AX - _ ` ° ' .~ b - - ~ } , = : bl '' ~ YES ~ NO ~ ql bl to h 'be ~ ;,~ ic?) . la t e p.u ay e ( ~ _ denisesperling @ comcast.net ; , ~ . ._ yoter in,Petaluma~ ,x ~" :Are ou a registered" y . , , .~ _ ~ ~ _ ,~ If;so, fo~ how~long~~:'~ ` - r - . ~~ ~ <~ z ._s ~ _ n n P,_, . .: . .. ._._.~ v - _ . ...=. ~ ~~, . U ~.. ~ ~~. , '~" ~ ~ ~ . , _ .. ~,. ..: ~.~ _ , _ _ ~~ , _ : ~ _. . _ . ~~ _ ~r ^/ YES ^ NO 18 years ~...-L - ~~. ~X ,~ Y y~~ . ` 1 ' . LBoard(s), Commission(s); or~CommitFee(s)' of~lnterest* ' - . .. _ 6,•,,~fi ,r+. .r ., . ' I' :,} +t ~ r ~ ~.{~' ,~d . ~Y'. ~ -r . Animal Shelter Advisory Committee *Plote: To serve on the Senior Advisory Committee, you must be age 55 or above. ~, ~ ~F ,.~x ~r ~' , . , ~> p „ ~ .Have :j+ou .dtFended a rr"ieeting of~ this~ v 6 ~,~ ,. r ~ ~ ., . ~ Have~you;served ~on, interviewed;~or applied fo`~ ~ , .~ _ ~body? ~- - ~~ ~ - fr~ a~~~' ` ~~; . this; body ~prev ously~,:~e ` ~ ~ ~ - ~ ~ v..~ r 3:.~ A - ".. 1 L _..-~u... "e, ! . .^ .~ .. .n.,. , . .- _.. +r`,.3 .r/~fi~.~v ^ YES ~/ P10 ^ YES ~ NO Sperling, Denise Animal Services Advisory Committee ?D~~ ~ ~ o~ ~.~ ,. ' ia-~n ~.~ ~ ~~ ~ _ ~~ . _ . ` _ " - 3 ~Presemt~Employer ~,~ ~~ r ~ 4 = ~~~+ r~. - ~ f~~ ~ ~t - ,~ < ,"'„ wp,~ ~ ~ 5 ~y ;?h . ~, ,-. ;„i~, . ~~s : g m~ ^-, „,~, _ . _ _ ' ~a _ _ - _ Sperliing Real Estate • - - . _ _ _ __ . _ _ , _. , - - ~'e ;: - :. ~. _';. ~ ' c- -~.. . .. . `- ~ .~.7:. " ' . . '. . _ . . " .. _ Job°~Title. - _ , ° - _ ~ _ - - -. ,,. _. _. ,_,~ ~ _ --~ ;-. _ , : - - _ _ _ , _ ~ . .: . . _ - - - ' _ . ,~ . ._. _. °, = . :: ~,~r Owner _ . _ y ,4 .r ~ ~~ .~ ~ ';Previous Govemmental,:BotliesjElective Offices you haveserved;~Position%Office Held`:and :' . , ~Date's: ~ - ' " ~~~~- ~ ~ - t ~r~~ ~ _ . - , . ,, . ~_ , . = .., _ _ ~- -~ ~- ~, _ ~ ~ _:~y ~- - -- , ., ; ~ ~ : ._ ~- ~ _. . , n/a ~. ._ ~_ _ , _, ; = ~,rt.-= t._ .,- , ` ~ ~__ _ - wCivic~~or Charitable Organization~to vlrhich;you have belongec! Posrtion/Off~ce,Held, d"nd ~_ v Dates:~ . '" t ;, - - - - - ~ n/a ~, ~ y `- F, ~ . ~ - ,, . . ,~•_ ; ~ : ~ ° . , _ _ _ - ~ - _ ,What:Special Interests/Skills/tTalents;would,you bring to~'th~s B'oard, Commission,:or Committee? a : ~ ~ .,. _~~~ ~ ~~ , , . .,,.- ~ ~., ,~~ = ' ~ - ~ . ;, . : ,. ~ _ a ~ ,.. _ . ~. -~ , - - ._,. ~,v. .- _. ,_~.. ~ j, ~._. - Special Interests include: A lifetime love of animals. I currently own & foster cats. Volunteer monthly at the shelter's Spay & Neuter day. Skills & Talents include: Customer service skills with over 30 years of successful business and management experience. Skilled coordinator, highly focused and results driven. Self-starter with high energy. Good listener with a creative mind. Problem solver, organized, efficient, and detail oriented. Hard working, quick learner, and enjoy a variety of responsibilities. My people skills are well-honed; my personality is positive and friendly. ~ ~'-e~,al~ ~u S~ 'i.. ~i~~- ~ ,~~' ax ~~ u' i„ F i 6.': ~ , . . ry n .' ~`' .~ a, N' " ~ :. . : ' ' _ a. '. fi~ r ~" ~ ~ z ' o- a n ~ -~ . ,I~ s ru ' ti -k~ _ ~~Colleg~e, Professionaf, Vocational Schools AtFended (Major3 Sub~ect;, Dates,~Degree/Ddte) h': - ,. ~ ,~ - , _ ~ , ~ , ~ ~ ~ . .. v ~.. ~ ~ ~ _ 3 "'~, J •., y . - ' -. x:.~~ ,:_~ ~.~. Tk w.' rv~' ~t, ,•:~ °,~.s, 3. ,;. +• , ~_n .. .. .~ ., .. .. .,....w _ _._~ .~ ._ ,..... ..~ ...: ..-:~' -... _._ . ._. F .._~. ,. ...; ~ ,. ~~- 1) Pac;ific Fashion Institute, San Francisco (1973-1976) 3 year Professional Course in Fashion Design, Textiles, Tailoring, and Pattern Making 2) College of Marin, Kentfield (1998-1999) Architecture 3) Keith Cunningham, Austin TX (2002 - 2006) Business courses and mentoring 4) California Department of Real Estate Real Estate Sales Agent (2004) Real Estate Broker (2007) , y : ~, ,~, ~ ,~ .~ , a .~ . ~ ~ a~ : ° A - ~ ySpec~al Awards or„Recognition;Received ~ - _ ~ _ s~ ~„- -~ ~.. ~ o- ,; ~ ~" r ~ r ~ 1'' ~°~ _ , _ r ~ '~.. _ 3 ` .._. " . ;: ~' -. _ . ~... °_ . .._ ,> _. 1~.'..`'~~a( _.' ..,.4 _ ._,: ~.,' ,. . ..:e. s2 _... ~;.,. _ _,..~ _ .. , ,o,. . S. ~ ;. ~-~ .. : ~. `~Please,state reaso;ns;why you~want to~become a member of this Board, Commrissionfor ;~^ - t : , ~, ~~ ~ , ~ ~.. ~ , ~.L ~,~s ~_Comnvittee ,;includmg,what specific'ob~ectives y,ou would be;working toward as a member of ' . _ :'4this atlvisory body: _ ~ ~ - ~ ~ ' ,~ ~ ~ - ~ _ ~~ , ,, _ .• , _f~ _< ~ _. . .... :, _ , .. ~ .,, . . .. .~ _ ~ .. . . r, . _ - _ . . u. . , .. _ _ - 1) To bring awareness to the community of the importance of spay & neutering dogs and cats, including feral cats. 2) To bring awareness to the community of the many services the animal shelter provides. 3) To put together creative fund raisers for the animal shelter. 4) To involve the community 8~ business owners in sponsoring spay/neuter clinics 5) To make a difference for all the animals. _ ~6 ~1,~ ~ ~ ~ ` 1 J Hw ~I~ ~ '~~ a~ ' ,~ ~,. ~F d~ , . ~ ~ ~Rh- y'" . ~ , ~ _ s .~ _ . ,. . r . . 'Is there~any:other information~that yo.u f.eel~woulcJ be useful to^the City Council in re~iewmg z- ~ , ,. , ~ r ~,your ap~plicat~on~ ~ _ ~ _ - - - W ~ ~ ~ ~ ' . - ~a , _, _ . " ~_ ,-, - '. ~ .. ~: t~ ~ R~ I,... :: ~ 9 n' . ' A S - " ` - a~ ~ 's~ p . ,: ~ ~., ~ ~' : .. } .:^ F S ~` .-. , ~ .:.4 ~ ~ ~ ~, ~.'k ~ ~ ~ ~ L ~., i ~ .: "A I' ~ ~' %q ~ u~3 ~ : ~ ~ ~i4re you,associctec9~,with ae~y Organizati'on%E mployment lttiat~might~be~deemed a~;conflic$~of ~ , -~ ;g T @ ~~4b,.~ - - -Y .~ C ~`~ 4~' i ,~ ~S " ~'2 '4'* pn"' ."f J.'.H ~i.K6''$ p g~~ y 'e~ i..,.~. ~ ~ i ~ ^~ f~.i 3 '$'~ 4~' N~ ~ ? N .. f 4 p +! ! A.F 'm~~" ^i`~ ~ ~p~'"" ~ ~~$ .: ~ ~~ ~ ~ $f ~? ~°y»~. interest~in erforrriin r cl ties if int ecl t this= osi io ~~~~ ~-~~~ ~- ; ~ ~~ ~ -~ ~ -~ = o p g y u ~ ; p, t n , a ~~ .~ ~ , ,e a . ~ ; -~ u appo o .. 'l . a , , ~ m,.~ ~ e a n ~ .~'~,i,-r~ ~" 'F '2 K ~`'TS _~'~,+.d L~ °nv ~ 5.~. u. .~ ~rv ~,r~~ ~ , , ;~ .,, q.v . mk. .. m . . ~i ~ I,~ . J. '4- 'S,~ ' ` 1~ X ~ "h'~~ a, _ . ~. . . ~ .: ' . "' . Y.22~v.' ~c. .. e, ... ._ .r. ~ ~ , w~ 'S... ~a.:T ~' ..Y~ Ita'~:.~L . ... ~ 4. ~ ~,. h ~' ~ ' . ^ YES ~ NO . *~ ` ~t~',~ ~~ ~~€~~ „r ~ ~r _ ~ ~w s ;. ~~~ *`~ ~~ ~'~ ~ ~ ~~ ~ r - a .~ S ~ 8 I : ~ e ~ ° " ~~ ~"• ' . ~ ~ ~ 6 e ~ ~d . : : ~ ~ p~ ~i s _nq ~ fIJ q k „ _ a~~". ~t~ ~ ~~,~,~~"~~ . ;+I 4 1 :,. 9 ~ 4b '£$Y ,~"'~ -'i3,4 ~ ~ ~"~ ~.., «~k'~ of rg nization/Employment ~ , ~ ~~ ~ ~~~°°~ ~, @ ~ ~a , ~ ; ~~ If yes, ~p lease state name O, ~ ~a~ ~ ~~ ~~~~ ro ~ ~ ~r ~ ~ ~ ~ ~ ~ ,~,.~~s . ~._a~ ~ ~~.~. ~. ~m~ ~~,~~~ 3 ~:n,,~. fl ~ ~ ~~~ ~ ~,~. '~~.-A~k~~~ ~`~ ~,g ~~ '~" v.t y e ~" ~-.. c ~ 1 '#"`Y@~:`.~ .. ~~ ~ ~' ; s~'~~'9~ ~, +~~'.,r 7 d~',~4~e~° ~i~~~ r" ~„'~f' ~rJy4v ~'~"`~~r4"+t~" ~ ' ' "s s^ 'i 1 ~ ~ "u ~ ~'" ; ~ ` ~ ' ` ~ ' ~ ` ` ~ ' ~ , ~ r' t „} . s e. y~--m M1 ' s $ As d, h.. ~ A~nkC ~ ara. a ' ~ ; h i- z=-"d N° d' ~City~.policy directs, all appointe~d, adVisro,ry~body~memb~ers not~to dote on~mat~ers~~where:there,~~~~ est'~~W uld you be viiilling~to~abstain from~~voting if~such~~a,~`~~~~ ~:= ~ezists~"a~^potential~conflict~of~int'e~ j ~ ~.~ ~ ~ ~ ~r . ~. ~ ~ ~ ~ ~ ~ ~ ~ x ~ ~ff~~~'~ ~ ~ *~ ~ ~ ~ _~ ~ ~ ~ , ~~ ~~ ~ ,~~q~ -~ ~ d ~ ~~pq"^a ~ ~ ct arises~ ~~ ~~~~ ~: ~- i ~confi 4~ ~ ~ ~ ~ ~ g~ ~ " ~ .e :+~~ ~ ~,, yp . p,"3 "€ 5~.'~a ~e'2~' j~ $ 4 ~ - o..~ ~Y R ~q ~1~ YS '-~ d~~'~ ~ ' ~ h ~~'~.~~ {~ ' ~ ~ ~~ ,.g' F ~n $ k ' ~ ~ ~~ ~ 1 ~ ~~~ i'x 1 3.. ~ ~ yi`...~ , Y ..~' ' „ ^q~„a`~k ~"t~ 4~ ~ ll .~ '~ .v.~.. ~~ ._ ~,,,Y `~ »'9k~~., _ ,-, *.- ~ ~.~s'~~ $"Z~ t ~ F ~I~ YES ^ NO ~~~ s ~ ~ ~ ~ ~g ~ ~ ,~„~~ ~ ~ ~~~ ~,~ ~r a F~ ~~s, ~ ~~ . ,1, I ~t.~,~ 4I 1 ~ ~ ~~. 7"~' ~ 4 ~" ~~~ '~ ~ HS°~ ~ ~ ~ ~E~~. JG E~ F A ~'~ ~ ~ f : 'V°"'t~ ~ ~ ~~~~ p6 ~ .,,. ,: ~~ ° : ~Mow~clici~you hear~~about~this~opening~~ ~ ~~~~~n ~ ~~ ~ ~~°~ S `~~~ ~ ~ '~ - ~ ~ F~~~ ~~ ~ ~ ~ ~ d _ t .~~. ~ a '~ ~,~'~ -~m~ ^~ 4 ~1F,. °S 5 ~ ' ~ -c Y~ v ~ ' ~ ,K,_,.+r, :ii `~ wt Y 3 k ,. S k eK ~.,~ ~t4'd v~ `~ ~ X ~ ~{1~~' ~/~v/ ~~~~`11~~\~1~~~~~ ' - W ~ -•` d ~~, ~ 4. 7 { ' dv? 2 T ~~w ~ { 3 S ~ .. .~ q' I r ~ ~ ~ " ~ ~ ~ ~ : `~ ~~ ' IF,. µ~ ~ „G~ «.f~, ;S~ "h ~~ ~"0~'aY ~ ~rr T 9 P ; 9 . 9 A"c . ~~fC n "~ ~ H °' ° `" { r az ~ . T dL~ F ~w. ~ ~k" ~v n ~ A +k s.~ ~ ,,,~ ~ '"u ~~-PPlicant's~Signature ° ~ ~ ~ ,~~ ~-~ ~;~ ~~ ~,~ -~ ~ ~ ~ . : ~ ~ : vw :~ a a s S.. ~ t~ ~ _ .t ~ ~~ ~Date~ ~~~; ~~~ ~ ~ ~~. ~~, ~ ~ ~ ~ ~ ~ ~ { ~ ~~,~ I~Hg. ~ ~k~ ~-w ~ ~~~ ~~ ~~~~'~~qy,~ ~ ~~~ ~ ~~~~~ ~ ~~ „ ~ ~' d ., e4~3~;:'~~ ~~-.`_~u ,.'ff°~~a:. ~ 3C ~~ ~ ~ ;~ ~~ ~ '~ t ~~~~ ~~.~ ~~ ~-,~ ""` 8~- ' S-, q... .a..fi~.x .....~ .''~" ~. ~ ..% J;,C;`1.I~C~~~~y~'i' ~-f . 0. ) ~, ~ / . . ~ ;~a 1_~ Revised August 12, 2008 O~ , ~ . •~~ A L'U~ < _ ,. ~ R~ . ~ C'~ty of'Petalu~aa, C'alif'oa~ ~~. ~. City Board, Commission; and Committee _°- ~ j85$ ~ Instructions: Use this form to apply to serve on any of .the City of Petaluma, Cd~~r ' Commissions, or Committees. Please fill out the forrim completely. If a question does not ap~ or write N/A in the space provided. When completed, please fonvard to the City Clerk's Office City of Fetaluma, 1 1 English Street, Petaluma, CA 94952. All applications are reviewed by the City Council. iVame: ~l -e. ~~. l S 5 ; Home Address, City, State and Zip; Code: ~ ~ C9 ~~-Ch~I o~ ~P~ifc'~C Q. ' ~~-~-~'t ~~,~y~~ ~ ~ /~ ~ 'nl ~ !' SZ Home Phone: (If appointed, do you want this number to be available to the puplic~J • Work Phone: ' ^ YES I~. ,NO ~ (~~~- ~~~~ ( ~ - E-flflaiL (If.appointed, do you want this address to FAX; ^ YES ~ iV0 be available to. fihe public?) ~ ~ - 11~-+-le I ~ @ .s.b~,41o b~ L , ne,~- Are you a regis#eced voter; in P,etaluma? If so, for how long? ~ ~.~... ~ ^/ YES ^ NO ~:Boqrd(s), Commission(s), or Co_mmitFee(s) of lnterest*: ~n~ nna ( 5~~~ `u S ~-d~~ ~o ~ ~vn rv- c ~-~~~ y *iVofe: To serve on the :Senior Adviso .ry Co_mmitFee, you must be age 55 or above. Have you.attended a:meeting~of this Have you served,on, interviewed, or applied for bodyr? ° ' ' this body previously? . . _ ~ I~" YES ^ NO • ^ YES ~ iV0 . Weiss, Leslie i ` ;; ~ i Animal Services Advisory Committee ~ ~ . 0~~0 ;, Present Employet:, ~Q,,tSCX ~f.'.fYY1~'~ e,1~1 ~ Job Title: ~~ ~~~ . Prev.ious Governmental $odies/Elective Offices you have served, Position(Qffice Held and Dates: ~, ~~ ~ ~~ ~~ ~' ' g' "which you have belonged, Position/Office Held, and ~ Civic or Chantdble Or arnzation:to' Dates: ~ ~~~ `Whaf Special Interests/Skills/Talents: would you bring to this Board„ Commission, or Commiitee? I~ ~cx~ ~ ~ i n A-~n~~,1 4~r J~~ ~~~ ~~,~,~~;~ ~ ~~~n~z~ ~ s~ ~~ ~~ n~~~ ~~ Coll~ege'; Professional; Vocational. Schools Atfend`ed: (AAd~or:~Subject, Dates, Degree[Date): Sonom~ ~~ ~~-- v~1~V. ~M.~A ~ ~ ~%1. ~o~~sc (1~ Sa~n J os-~ ~'~~~ f3 s'~ ~n IN ~~ s i~ S o~no~- S~+e.. ~~ ,~~1 l~s ~chv l o~ ~•- So~~v~~y Special Awards or Recognition Received: ~ . ~f~ ,Please state reqsons why you want to. become,,a member of th'is.Board, Commission or ~ J Committee, includin whbt specific objectives you would be working toward as a member of this advisory body: ~ ~ v.~~~`d~ c~ ~~ I~ Pa,,~ ~ o~ -~ c~~~.~~~ ~ C~,L~,.~lt~i-e-S ~ ywa,k-c. l.c,~-s ~d~-r -~ -~G..e., ~v~rvv~sc,~ ~ i o~ o ~ ~ ~,~vw~`~ . ~ P~ ~ ~ ~-1 ~ c~v-~.w~. ~ ~ -I ~- . ~ ~ ~ ~ b~ e c~r-!r~e-s ~ w a~~ o~ ~w~e -4~ ~Cye- v~- o~ ~ c~ j; s ~~-e:~-'' ao~° h~ c~~P ~ t~~ ~~~ ~ 5k ~ c,~,~~ RJa- ~i~ c~ ~~`~- ~ o ~ ~ C;arv~o~wun i~ a.o~ ~'~a~s . I . y ' y „ ., ul to the Cifir~Council in reviewing Is ere an o e? in orma_ ion , a. ou ee wou e - our a hcation. use , _ Y Pp~ , _ _ -_ _ _ Iv~~~ . ~ Ow ; . , , , . .~ , , .. „ . ~ Are you associated with qny~Organization/,Employment that might be deemed a conflict°of ' interest; in performing your duties •if appointed to th,is~~position? ~ r ` ^ YES ~ NO. If yes, please stafe name of Organization/Employment: ~ a~ f ~ ~ ~ City~,policy directs all appointed; adviso,ry b.ody members not;to vote on matters where there exists a potential conflict of inferest. Would you be willing to abstain from voting if such a conflict arises? ~ YES. ^ NO How~ did you hear about this opening? ; }- a ewv`rr.,~ -}~ r1~,Nt . . Q- a-~ ~ol ra:~,~, ~~ sl ~c. i,~ v- ~e. d-M:e.. -~ C~-~.d~. v~ '~--+~.e. c o AppiicanYs Signature Date W,~,~, ~:I Z 11 O Revised August 12, 2008 ~. . ~ ~~