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HomeMy WebLinkAboutCouncil Packet - 9/11/2017BOARD AND COMMISSIONS COMMITTEE September 11, 2017 5:05 PM Harold E. Getty Council Chambers Members Chairperson Jerome Amos, Jr. Vice Chairperson Bruce Jacobs Tom Powers Roll Call: Approval of Agenda, as proposed. 1. Precious Clark Adjournment Kelley F elchle City Clerk Page 1 of 3 CITY OF WATERLOO Council Communication Precious C lark City Council Meeting: 9/11/2017 Prepared: 9/6/2017 REVIEWERS: Department Reviewer Action Date Mayor Office Westphal, Michelle Approved 9/6/2017 - 11:10 AM Clerk Office Even, LeAnn Approved 9/6/2017 - 12:08 PM ATTACHMENTS: Description Type D Application Clark Cover Memo Page2of3 CITY OF WATERLOO, IOWA RECEIVED JUN 0 5 2Q17 BOARDS & COMMISSIONS APPLICATION Date: i0 /5/..20/ r/ i, -- rc ciovf s �I ark , request to be appointed to (state preference): 1. iYi'�mn�ld�� ga-[ l &0142.CsS1/12 2. �1� ONit/Mad CQ. W5 R --Oar Horne Phone: Cell Phone: 81(1-52°- 64222WorkPhone: 81(1.--t i 33-I 32, Home Address (36-0 0/1m _1 A v Zip Code 6 `]J / Employer Wale m/ ittu 1A/ ,3e_ioas Title ■ m ! 4 Employer Address /5J o Wash:cog w e.oJ How long have you resided in Waterloo?L-) years/ List current membership in organizations and offices held: AiDrrZ Zip Code 5070 I am available for meetings: I1] A.M. LI P.M. El Noon fiJ'Evenings 1 am available to serve on a Board/Commission the entire year: Ices [1 No If no, fist months not able to serve: Briefly explain your qualifications for appointment to a designated Board/Commission: 114.v / lied and YYYr 5 f -- CSA rnrnhJJl,i/ 7 ( in i years 1tjY,Q and enjoy Walerlo ar- e / wt M Additional information and comments that may not be evident from information already on this form: .,-' 1P.z p.opl.e a.d�uY h e./pe in gm/viaV 1 - • Om .' i 0-1Eo ho fd a , A A. 01 i llama"? ,- .aoe References (include phone numbers): 2 Y 4,3014411 31 q - L/8 `/906' o ). nr) (3)c) -22/-5(c20/ ) ketmanJ- Muhammad ,..- 9(o1 -2,00 I understand this application does not bind me to accept an appointment should it be offered, nor does it guarantee an appointment to a Board/Commission. if selected, I will be available to attend appropriate training sessions. This application will remain valid and on file for on calendar year fro bda d %-//-/7 t 171.4-1 I g. e/ 9-1/ - ZO • Signature RETURN TO MAYOR'S OFFICE, 715 MULBERRY ST., WATERLOO, IA 50703 Rov041412014 FAX 291-4286; EMAIL: mayorRwaterloo-ia.orq; PHONE 291-4301 Page3of3