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HomeMy WebLinkAboutAgenda Bill 6.A 03/15/2004• is March. 1, 2004 CITY OF PETALUMA, CALIFORNIA MEMORANDUM Office: of the,City Clerk, II English Street, Petaluma, California 94952 Telephone 707.778.4360 Fax 707.778.4554 E-mail:, cityclerlr@cipetaluma. ca. us DATE- MARCH 15, 2004 TO: MAYOR AND COUNCIL MEMBERS FROM: GAYLE PETERSEN, CITY CLERK SUBJECT: DI<SCUSS'ION;AND POSSIBLE ACTION RWAR1DING CITY COUNCIL, APPOINTMENTS TO VARIOUS COMMITTEES' AND COMMISSIONS The City Clerk's Office has run an ad for the following vacancies and has' received the following applications of interest for appointment. Persons who had applications on file from the previous year were contacted to, determine �if they still wished to .be:lconsidered for appointment. The names of applicants who expressed interest in serving on these committees are provided for your review. ® Building Board of Appeals —one vacancy, to serve at the pleasure of Council. Applicants: Russell, Brent ® Personnel Board — two vacancies, to serve at the pleasure of Council. Applicants: Stokely, Linda ® Recreation, Music and Parks Commission (4-year terms)— one vacancy, unexpired term to June 30, 2004 Applicants: Noriel, Joseph ® Site Plan and Architectural Review Committee (SPARC) (2-year, terms)— one vacancy, unexpired term to June 30, 2004. Applicants: Rapp, David Reed, Lawrence Shearer, Mary A- • 'free Advisory Committee (2-year terms) — two vacancies, terms expiring June 30, 2005. Applicants: Meyer, James • 'Youth Commission (2-year terms)— Five vacancies, two 27year terms expiring June 30,.2004; three 2-year terms ending.June 30, 2005. Applicants: Eubanks, Deborah Hall; Whitney Hartman, Bill Herfindal, Pat Attached, ,,you. will find all the applications on file and/or received through the close of business, March 8'; 2004. cc: Michael -Bierman, City Manager Richard, Rudnansky, City Attorney • -2- I. Bodies/Elective..OfficeSi. you: hay-e.served Position%Office. Held ', : t_,, i . _ ... ..... .. L.`..... 0 C, C7 ave,,you attended a meefoc of fihis ` H iody? fc .�... ....... ❑ YES..,......., � . ... _ ..... _._ ...... I � . IVO ve ou served y' on, interviewed; or applies! this body.,'Previously�. . ❑ YES ),6.,NO Page 1 9' . r r RECREATION, MUSIC AND PARKS COMMISSION 0 0 p, L Caiy ®f Peialu aa, CalafoMia . ®®rd, C® tee ar�tl COMMISSIM 1)7S*Vc110ns Usettfiis fdfrry' apply .... to serve o ............ ............ �... .. ... .., n any of the City of ,P.,Ptalurna, California's a's Boards, Committees, or Commissions. Please fill out the form completely. If a question does not apply, type or write N/A in the space provided. When completed, please forward to the Office of the City Clerk, 11 English Street, Petaluma, CA 94952. All applications are reviewed by the City Council. Plarne: Joseph Noriel Hon1e Ac�dr ess, C'aty, `State and rlp:.Cdde. 1755 Stone Creek.Drive, Petaluma CA. 94954 resen mp�oyer• PETALUMA GCX O ORAT ONS PROGRAM (Petaluma Chamber of Commerce) Chairman, City of Petaluma 'T.ree Advisory Committee - Present Fire "Department Master Plan. Committee — 2000 . Tree Resources, Petaluma History,, Great Pyrenees Dogs Special Av�grds or Appointed Receoved • A ointed li peers to Chai PP Y m Y peers Chairmanof Petaluma s Tree Committee Citizens Advisory Committee to Petaluma Fire Department Master Plan Graduate Petaluma Police Department Citizens Academy Press Democrat — L.I.T.A Volunteer (Nursing Home Visitor) Carousel Fund, Auction Night Co -Chairman Comm ss on . nciudin hwh t s sec c b ecttves ou pro Id bewvorldn tovvmmrttee or ' Board; Co g: , P .1 Y . g and ®s a rriethber of this advisory' body; I feel my background with both the,Tree Committee and Petaluma Visitor's Program will offer a unique depth in knowledge of Petaluma's parks and recreational endeavors. I would like to offer myskill sto protect and expand our parks and provide recreational activities that will best benefit all of Petaluma's residents. Is there an other anforrn®fwn that ;ou feel wo y y uld be use to t6te City Council m revIeWinq you jplic®fion� I was born and raised in:Petaluma and have had the opportunity to use and enjoy all of our wonderful parks. I can truly appreciate the necessity of having a well planned community parks program. A strong- ground in Customer Service has given me the communication skills to work well with diverse groups. Page 3 SITE PLAN 1 �' � 1 � �� ARCHITECTURAL I�' l... r �` L E �� i ('y f d f y 0 0 • .;1 L U i ! ' a��A 9M'reJ ,; _, ;� . City of'P'etalum California CIT j.�, IqI Board, Cornnnittee_und Commission ylwl Application 1t 3 strucHons: Use this form to apply to serve on any of the -City of Petaluma, California's Boards, Committees, or Commissions. Please fill out the form completely. If a question does not apply, type or write N/A in the space provided. When completed, please forward to the Office of the City Clerk, 11 English Street, Petaluma, CA 94952. All applications are reviewed by the City Council. Name: i -D �• C P i ............... . ._...... Home Address, City, fate and'Zip Code: �w �. Y ell lv w" a� this number to be p o the public?) Work Home Phone: (if a omted,. do you want available t Phone: � ❑ YES 4?f NO � blelto the ' utbld do PPP ) ,� you t ❑ s address .._... , FAX: E-lea' • s to be availa Page 1 Civic or Charitable Organization to which you havebelonged, fti belon edPosition/ , y g O ce held, and Dates:" zoo3 UO f. A Special Interests/Hobbles/Talents: ��=.►i.......,.,.. S��.o�J Kok....... g ssional, Vocational. Schools Attends . Colle e,, Profs ... - - d (Major Subject, Dates; - Degeee%Date): S ASV MA ,g�...._.....-.. �b Page 2 • -Special Awards tpultecognii ... .. .... _ w ..- - - . on Received: i -- Please state reasons wrhy, . ....... want.............. _ _.. .. _ ..........._ you ant to become .a member of this hoard,, Committee or Commission, including whaf specific objective`s you wouBd be wording toward as a member of this advisory body: Go d t, is Page 3 City policy directs all appointed, advisory'body members, not to vote, on matters where there exists a potential corifficd of interest.. Would you be Willing to abstain from voting N such a c'*nfflcUaris*s9 2r YES F-I No .Novo :did yoti.he,at�dbout�thl-sbp'e�'niiiig,?,'" Revised June 3, 2002 Pag6A • February 16, 2004 City of Petaluma 11 English Street Petaluma, Ca 94952 To Whom It May Concern: Throughout the 1950's and 1960's I .visited Petaluma on a regular basis as my grandparents and great �grand parents lived here. My mother was born in Petaluma and my family spent holidays and the Like visiting. I grew up throughout California, but after studying the history. of Petaluma Planning at the Harvard Graduate School of Design, I developed an appreciation for the individual stance that Petaluma planners took during the economic boom ,of the 1960's and 7'0''s. I began to understand how Petaluma was able to maintain its architectural and agricultural heritage, while other towns close by -were succumbing to the pressures of residential development. Petaluma thoughtfully envisioned its own future and I realized that I wanted to be part of that. I returned to Petaluma in 1984 to raise my family. I opened a business in Petaluma in 1987 with my partners Sandra Reed and Stephanie McAllister. We all experienced the energy in this town and felt in touch with the community values. We worked on • many projects in town including the Foundry Wharf and the Petaluma Factory Outlet Village. Through this process I began to appreciate the passion that the citizens of Petaluma bring to the planning process. In 1997 I joined the Central Petaluma Specific Plan to help articulate the vision for the downtown central core of Petaluma. The energy and interest of the committee members helped to realize an innovative contemporary plan for our downtown. I see my commitment to community service as an extension of my desire to help Petaluma maintain its architectural history while implementing the collective vision of its citizens. While I have worked. professionally on many international, national and local development projects and I am especially intrigued by the individual opportunities we have herein Petaluma. I am excited by the tremendous change occurring in our town and look forward to participating in its development: With due respect, I submit this application for member of the Site Plan and Architectural Review Committee. Si ely, CL rence Reed February 16, 2004 City o.f.Petalum'a Committee Application Site Plan ;and Architectural Review Committee Lawrence Reed 217 Liberty Street Petaluma, CA 94952 Brief resume: Currently I am employed at. SWA .Group, an urban planning and landscape architecture firm in'Sausalito. I am currently, working with Chong Partners Architecture on-the.'new Academy of Sciences in Golden Gate Park as:we;l;l as,the new Petaluma Town Center Parking, Garage. All the,projects that I am currently involved with deal with contemporary urban design issues as well as'innovati,v.e ideas,regar,din,g sustainable environments. Prior experience, includes design for the Foundry Wharf. in, Petaluma as Well as the Petaluma Factory Outlet Village while working with ZAC Landscape Architects. Work Experiences: SWA Group, Sausalito, CA, 1997 — Current. •' ZAC'Landscape Architects, Petaluma, CA, 1987 -.1997 Chimera Agricultural Associates, Santa Rosa,, CA 1986 -1987 Peter Walker, Martha Schwartz Landscape Architects, 1984 —198.6 S'WA G„r.oup, Boston, MA, 1982 - 1984 Education: Associate, of, Arts, ,Li.beral Arts, Fullerton College, 1974 Bache)or of Science; Landscape Architecture, CA State Polytechnic Univ., 1978 Master in Landscape Architecture, Harvard .University, 1982 Special interests: Masters Swimming, Tomales Bay Sharks Awards - American Society of Landscape Architects, Certificate of Honor, 1978 Penny Wright Scholarship, Harvard' University, 1981 ,• r R _41 -d luma,' ��alif®�°n�a 4-� 11)s1ht1c#b,7s.- Us6 this form to apply to serve on any of the City of Petaluma, California's Boards, Committees, or Commissions. Please fill out the form completely. If a question does not apply, type or write N/A in the space ,provided. When completed, please forward to the Office of the City Clerk, I I English Street, Petaluma, CA 94952. All'applications are reviewed by the City Council. M­ Address, -`CiVX dm& ,­ .? State an 4, 11 217 1--1k5ERTY,nrAEF-.7 jr-;F7)0tW/K4j 6ef` qW 6711— Ho V4 -70 7 745 -4 0­15107- _b&,��dht; to be _, elf Z'ij;iEl* V"QVG1. 66116 FAX: 7, FT.,%F 4t5 5r37, o07P7 Aoa5p g'SWmr:rwary clom Are you a IST-dre if ............... ... ....... . ... . .. YES El mo IrIN er ^f 77-66 mmee ngbf; p d-46-you,b en e`d"�`­1"!' ve:,yo,ui�ser.ydd�"bti��,,Ihtdry _jdw!qd;: rapplidd,:.: YES EI NO I El YES NO Page 1 �nt e n m- p- I' �Pre's' t' . ..... qyer,:� 5A* W rV q 49 6 in' d D'd 4 a 1,7 1 Held; Pagp,2 0 Council I �Tev levwng,your p bh . . . . . . . . . . YES ❑ NO Page 3 'K YES NO =yovearga outhi p- el- h" "t sC o"" 7, wr oaow;�� tu 0 7- e. K Revised June 3, 2002 Page 4 14D r March 3, 2004 Mayor and Council Members City of Petaluma 11 English Street Petaluma, CA 94952 Enclosed is an application forthe opening on the SPARC commission. It is my understanding that the appointment will be made at the March 15; 2004 evening meeting. Unfortunately, I will be in Sacramento .that day and the next, and not able to attend the meeting. I hope that you will consider me to be an earnest applicant, and will favorably consider my application that evening. Sincerely, Mary G. Shearer 40 Mission Drive Petaluma CA 94952 Residence: 707-763-1646 Business: 916-617-4555 is City of Petaluma, California City Board, Commission and Committee Application Name: Mary Shearer Home Address, City, State and Zip Code: 40 Mission Drive, Petaluma, 94952 Home Phone: (707) 763-1646 Make available to public: YES Work Phone: None E-Mail: Maryartly@aol.com Make available to public: YES FAX: (707) 658-1435 Are you a registered voter�in Petaluma: YES: XX 1965-86 and 1996 to Present Board(s), Committee(s)„of.Interest: SPARC, Planning Commission have you attended a meeting of this body? YES have you served on,* interviewed, or,apphed for this'body previously? YES, served in 1980-4981 Present Employer: City of West Sacramento Job Title: Program Manager Previous Governmental, Bodies%Elective Offices you have served, Position Office Feld and Dates: ® West -Sacramento Housing Development Corporation, Board of Directors, Member, 1994-2000 ® California Association of Enterprise Zones, President/Secretary 1990-93 • Petaluma Planning Commission (PPC), Chair 1982-83 and member, July 1977-1983 ® Site Plan and Architectural Review Committee (SPARC), PPC representative, 1980- 1981 ® Growth Management Committee; review and ranking, during PPC term • Petaluma Unified. School District, Chair, member, Chaired Tax Election Revenue Committee, Growth Management of residential development committee, 1973-1977 Civic or Charitable Organization to which you have belonged, Position/Office, Held and Dates: • American Association.ofUniversity Women, member, 2000-02 • Crocker Art Museum, member, 1997-present ® De1ta,Gardens Homeowners Association, President, 1988-91 • Legion of Honor, 20.02-present Special Interests/Hd b bies/Talents: Art, history, reading, exercise, museums, theatre, travel 0 College, Professional, Vocational Schools Attended (Major Subject, Dates, Degree[Date): • National Development Council, Economic Development Finance.Professional, Finance, 1991 • Sonoma :State University, Enviroririient.Studiesznd Planning, BA, 1983=86 • Santa Rosa Junior College, Business; 197043, AA, 1983 Special Awards or Recognition Received: 1986: Graduated Cum Laude from Sonoma State University, Urban Studies and Environmental Science Awarded Executive Fellowship_ to Center for California Studies in Sacramento,1986 Please state reasons why you want to become a member of this Board, Committee or Commission, including what specific objectives you would be working, toward as a member of this advisory body: To, incorporate my long term knowledge of Petaluma's historical growth to promote. and maintain a desirable living and working environment for residents and visitors. My objective would be to strive for consistency in. the application of Petaluiria's General Plan -and ordinances to projects under review. Another objective would be to insure that applications are sensitive to the existing neighborhood and uses currently in place. I would like to see new buildings and remodeling projects compliment the existing neighborhood, and environs. Is ,there any other information that you fell would be useful to the City Council in Reviewing your 'application? ., While serving on'the West Sacramento Housing Development Corporation Board of Directors I reviewed site and buildingrplans for residential development often making suggestions to improve the function of the. project. Tam accustomed to, visualizing the completion of plans presented` on paper. Are you associated with any Organization/Employment that might be deemed a conflict of interest in performing, your duties .if appointed to this position? NO X_ XX • • City Policy directs all appointed, advisory body members not to vote on matters where there exists a potential conflict of interest. Would you be willing to abstain from voting if such a conflict arises? YES XXX How did you hear about this opening? From a council member. Applicants Signature: _ Date: . ... .. .... ...... . a '. Present'Employer: , ... ... - .. - .. - ' * ..,...i . , q .�� . � . . :.,,�., . � . --,s�-, �-�.. 1-a ��e- ,��i .�TT��q,l,'�'.. �,,, -.'�1 �,,,;, - �. I � . . ,. . � .4 . . I - ., . ���-� :�—, ., .. .... .. .. . Job Title c ' ©4 .-,,�.:,._.�� .,, .�,::."�-! �,,' f," '�"; ,,,.� :,-., ...�,.I _ . . � .. , ' .-t - �,f-�. '. �',, -,,, ,,, ,'— ,,,�".,, iz- .�,,,%,''' - '.. 1 .� -',. %�41 I ��s �,; ,,-, �---�, -L��.t' -%�-.-,. ,.,;�, �":,��,��,��� j ,7i: °l,c.J ;w ski - ,F, :'- �,,.:,1 v� .:_ ;--!' . i'.i--.::s.... 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I '� V "1, -, ,! ,1, .,- ",� ,-I�1-", �,,,,-, ,? ,� -i'-I :,I1,, "��,�r.� -:,--.`,�\ -. -,�.,-,l5 � ,,., :5: .-,�- I. . .. ,:,�,I', .;;-� I'.�� -,',., .'.. .. .' 1.I- ,- 3 .-, . . - . .. .I .I� .,`,- ­�: ",. I,, :-,, :�� ,,: ',L"i ,�, ,,-,,;,- .;!-�I, .,1�1 :�.-,,' i1I"�,: -�,'��, �,,�,�,,.; ,,�-", ',1,,.:I:,".' ,'-:v,-�-. ;,1- t;,: -t zz ,m�I4��-I��-,�.��,..-��., -�, ,,1,t":- -,i.� .. . : ;.. " - '' I,,: .,��.. 1;.-,,."I..:,.- I,1"' .. ., . . . .. I �. I - . ..�-�-". � �%� �--: .'"- .,-: .. I, . - - . --.*,'7 , . . � . . I;f- . . .- . �! - . . I I . . -. . . . . I.Page 2 . - I I � 1. : - . Page 4 V tf VV �s� VV, I ew al e nTS T74 777 Vocational: Prb.dttidndL 6cd i6hd ,- ft "' li" en ed (Major , dibeiSQj D NAME: Deborah Eubanks . ADDRESS . 1112 East Sunnyslope Rd CA 94952 TELEPHONE (707)-778-7016 cell 707477-6851 e mail debedjem@pacbell.net EDUCATION: 1970-72 Norwich College, England Humanities and Social reform 1972-82 Norwich 4-Cambridge,England. Trained and worked as.a registered nursing tutor in the following areas; Burns & Plastics,emergency,midwifery",hospice and teen psychiatry/substance abuse 1982-83 Suffolk College . Teaching Diploma in Clinical nursing(RN curriculum) 1985-88 University of East Anglia, Harold Pinter Studios,England BA;in Drama & English Literature WORK EXPERIENCE 1970-72 Casual, work whilst at college, taught fitness class and waited tables. • 1982-85 Norfolk Hospitals Clinical°'Tutor in ICU, Burns and plastics.and oncology, 1986-87 Formed Hidden Risk 'Theater Company. Gained a,:government grant Directed andperformed Alan Bennett's:AWoman.of no Importance.Toured London teaching hospitals and chaired a discussion with medical students and health care providers: Produced Horace's Satires for stage. 1987-88 Covent Garden Arts Center,Cambridge. Ran Shakespeare and Restoration workshops. Libra 'Theater (Stephen Hawking) Guided physical improvisation sessions for physically handicapped teenagers. All Hallows Shelter for abused teens. Drama workshops. Staged Proverbs 1988-89 Age Exchange,London. Produced, compiled and directed a living history /drama/music project. Dramatic interpretation of interviews with senior citizens and lyrics from wartime .songs and poems. USA 1989-90 San Anselmo Campaign.for Healthy Community for Children. Drama program for at risk teens. 1990-96 Kaiser Hospital San Fransisco.Dermatology & H.I.V. Vascular Surgery. 19.90-96 Mill. Valley Middle, School.. Artist in residence. Poetry of Dylan Thomas, Shakespeare, Voice and speech. Narrative to action ( Oscar Wilde, and Dickens) Simple costume building and body painting. 1996-2002. Cinnabar Theater. Performed Director in residence for "Ouicksilver 11 Educating Rita Willie Russell Three Tall Women _Edward Albie La.Bete David Hirson (at playwright's request) Henry IVth Part One. (Student and -adult collaborative) ,Masque of the Red Death.(Student and adult collaborative) As You Like It (Teen' Shakespeare Ensemble) A. Midsummer Night's Dream (Teen Shakespeare Ensemble) .Macbeth (Teen Shakespeare Ensemble) The Winter's Tale - (.Teen Shakespeare Ensemble) The Tempest (Teen Shakespeare Ensemble) Strewth, a play for coarse actors. A Lady of Letters,Alan Bennett. Classes Taught Shakespeare Voice and Speech Samuel Beckett. The Monologue. The Audition.(URTA and UCCA) From Narrative to Action.(Explored truth to text collaboratively). Images° in Action=(Improv class using photographs).' Inner -visions - (Improvised movement based on images, music and dreams.) • • • American Conservatory Theater 2001 Advanced Intensive (Savages Christopher Hampton.) Acting technique 2002 Intensive Albie and Pinter(American Dream/The Room) Voice and Speech Dramatization of Jabberwocky and The Snark( true to text collaborative- choric extemporary) 2003 Shakespeare in Performance Hastings Theater Voice and Speech 2003 S.F Shakespeare (Eureka 'Theater) Edited Love's labour's Lost. Advanced intensive " Love letters sighs and Disguise" Dramatic montage of scenes from Love's labour's lost, As You Like It, and Twelfth Night. Early English Folk songs and ballads. The Sonnet August 2003 Harold'Pinter. Studio. University of East Anglia-ENGLAND Designed Fall `workshop for undergraduate program. Works produced and created Swallow's 'Tale -Librettist Operetta'based.on Oscar Wilde's tales and poems of Keats and Yeats Composer Jason Sherbundy Wild Wood-Libfettist Musical/dance based:on The Wind in the Willows Christy Brown Comes to Town Covent, garden Arts center Cambridge, England Play written after interviewing Christy's widow. _Published Articles 1987 The Guardian The Shamerof Olde England 2003 May Callboard ( www.theatrebayarea.org, May 2003 archives) "We hate Hamlet or something's rotten in the state of California" Current Cinnabar 'Teen Ensemble • Directing Love's Labour's Lost Sheriff's office and COTS Designing and implementing rehab program with homeless Designing and implementing rehab program with.inmates Writing three plays. • re 2% r '� 1' /�R�(l:�L!�'°��P"`jam.- 'd=L �•. ,��a ,„1".. ;,•;;= r' cial Interests/Hobbies/Talents /\`eh/dt'`:•.-i"Oi'' ;'.. '=P�.r`iN'��' SC�®t?�� �y,�c 61 3�p��M�;:`;��` ,�;.�° inxtif age, Professional Vocational Schools Attendec9 (IVla�or Subject, Dates; ree/Date) t,... . . • Whitney Hall Present Employer: Retired Job Title: n/a Previous Office: Director, Petaluma, Health Care District, 1996-2004. 2 terms as President Civic or Charitable Organization: Hospice of Petaluma Advisory Board, 1996-2002. 2 years Co -President Teen Substance Abuse CAP, HC2, 1998� 1999 Founder, Petaluma .for Active, Healthy Kids CAP, HC2, 2003 ongoing Petaluma Rotary Club, 2000 ongoing President, Pacific Coast" Immigration Museum, 2004 - ongoing Past President, Fort Point and Presidio Historical Association, 1994 -1998 Past District Commissioner, Boy Scouts, San. Francisco, 1981-1984 Special Interests: Mentor for McKinley Elementary School for eight years. I still help three of theme in high school.. Fishing, foreign affairs, immigration, soccer Degrees: B.S., United States Military Academy, West Point, 1957 M.A., Georgetown University, 1964 M.B.A., Golden Gate University, 1982 Awards and Recognition: Various military awards and decorations. • Various certificates of .recognition and appreciation - McKinleySchool, Hospice, Boy Scouts., soccer coach, etc. Reasons for Applying for Youth 'Commission: I believe that Petaluma is uniquely well;suited for raising kids....ALL kids. Progress made by the Youth Commission has been commendable. The asset -based approach applied now is far superior to the demonization of teens and alarmist response to drugs that existed in Petaluma when I arrived here in 1995• I realize thatmany challenges still exist, including drugs andgangs, but the prom,iwALL young people offer ist far greater than the problems they may cause. The Youth Commission 'I 'visualize .will be an advocate for young people and. a voice in :the community. My specific areas of concerns will be (1) to build, the ability of the Youth Commission and Teen Committee to represent ALL youth ift.Mal'uma to the City Council. From my experience at McKinley School, I realize that many youth grow up on the fringes of the larger community. (2.) to increase to opportunities forALL teens to be engaged with at least one club, organization or activity other than sports, with an emphasis on healthy mentoring relationships. . (3.) to raise community awareness of the growing role of immigrant youth. One estimate from S.S.U. is that 25% of Sonoma County high.school students will be latino. by 2010, much more than that.;by 2020. Positive ,efforts, now to develop and include these kids.in Petaluma community life will help them to become productive and constructive citizens, despite language. and cultural difficulties. Avoid. problems later by proactive measures now. Other Information: I believe that I can contribute directly to the community and to kids by service on the Youth Commission. Conflict of Interest: NO •. -.� ..- ,�.., .... ,.� ,., t a f 'r .. � ., ., � - 4 . ., ! . . Ci policy:directs alFapp'oirited5 ad"visoPy body members not to vote on'matters Where'there°exists a::potential conflict of interest. Would you be willing to abstain from . ' •Vo#irig'- su - hid conf�lict..arises? .-- - _ ti DYES • ❑ N:O = 0�- .< . . , .. . „ , ,. I .' .. How:d�d: hear about this opening? . . tiQ ? . �. ..:..:, -:, _ .. , - ; . I . . `,.. -II , _ 1. AppUcant.t Signature 1.I: bate. uI' ;. 1. . -/_114�_�I/ 1'- "_ , J / ! 1, 1. j a�`._ r1.' -- - - . . s. „ - ,'� _ _ _.. ,,.. - n I )l . ;,C t it-. t- —.,�.,2�':t,. 1 t', s .,, l -1 -•t_ 1' l _ - _ x fi y l`. J - I. tq , . I na r. 4., i i , r ~ry1 F Revised June,`3 2o02 ;, ''; l Y' R 4 rk 1 ,,i• - ^tit '?�` ' ''� ` ` x f � � , -,, � rft,� p ' i ,t '. _,, " �, f r' _ rn ,'.,;. _' 4i t a 1 ti . tEi _ - ma's,,. ' 1 . luf;.� 1, !s t 5 h' y - ... x" - -' r4 L �M - v r i 4 Z,, t,- .- - -11.1 .4- •` .. \ .f aqv i ..-.,.:, r .. ,. c 3u n . 'Spiv -, . , y vnrr , ,x - ,. _ %.. - .,,f .. . ..,. .. d .i, .,il J . _ -. ..s: :. ,. ,::'. ,i_ ,., >. ,: . .. ',. - - ! ; ' . . � 1. n . t - • 4 1 '• - • i '. - - _ . -. .. - . . . g - ous Governmental Bodies%Elective Offices you ,have served, Position /Office Held Page.2 . HOm,e Phone (If appointed do you wanf •this number to be available to the public?) ;Work Rhone ❑ YES IVO } FAX E-Mall (If a ppointed do you want this ddress to be 4 avbHoble to.the, public?) 17- Are you a registered voteran Petaluma? Jf so, for how Ion 9. YES' .❑ , N.0 Board(s),,Committee(s), or Connmission(s) of Interest O11S5:a Have; ou attended a meeting of this y Have you served .on, in'erviewea, o`r applied dy. . .:__ :.._.. ....._. for this body pcevi,ously. ,.., _._.. .: ........... .... _ . ...:.._ .::... _....... � . •,.. ,❑ YES L J nN O ❑YES NO Page 1