Legislation Details

File #: HIST-3510    Version: 1 Subject:
Type: Historical Status: Action Item
In control: City Council Meeting Agenda
On agenda: 9/25/2006 Final action: 9/25/2006
Title: Appointments to the Homelessness Ad Hoc Committee and Consideration of a Related Budget Amendment.
Attachments: 1. A-1__06_09_25_PRCS_Homeless Ad Hoc Committee Appointments.doc, 2. A-1 Homelessness Ad Hoc.pdf
City of Culver City, California City Council Agenda Item Report RECOMMENDATION: Staff recommends the City Council consider the applications and appoint four (4) residents to serve as members on the Homelessness Ad Hoc Committee (“Committee”) for a two (2) year term and adopt a budget amendment related to the operations of the Committee. A budget amendment requires a 4/5ths vote. BACKGROUND: At its meeting on July 26, 2004, Council approved the formation of the Homelessness Ad Hoc Committee (“Committee”). At its meeting of April 25, 2005, Council appointed the ten (10) member committee consisting of four (4) Veterans Memorial Park neighborhood representatives, one (1) representative from the Culver City Chamber of Commerce, the Downtown Business Association and the Culver City Homeowners’ Association and three (3) City staff (Housing, Police and City Attorney’s Office). Appointments to the Committee were for a one (1) year period. These members were originally chosen to represent the community from a non- professional, local, residential point of view with City Staff members to assist in the beginning directions and procedural elements. At its meeting of July 10, 2006, Council approved to continue the Committee. Council agreed to maintain the four (4) residents from the Veterans Memorial Park neighborhood, the Culver City Chamber of Commerce, the Downtown Business Association and the Culver City Homeowners’ Association. They chose to remove the three (3) City staff members as voting members and directed staff to advertise Meeting Date: 9/25/06 Item Number: A-1 AGENDA ITEM: Appointments to the Homelessness Ad Hoc Committee and Consideration of a Related Budget Amendment. Contact Person/Dept.: Armando Abrego (Sr. & Soc. Serv. Mgr.) Phone Number: (310) 253-6724 Fiscal Impact: Yes [X] No [] General Fund: Yes [X] No [] Public Hearing: [] Action Item: [X] Attachments: [X] Public Notification: Each applicant was sent a written notice on September 6, 2006. Notification was also placed on the Master Notification List on September 20, 2006. Department Approval: Bill La Pointe (09/12/2006) City Manager Approval: Jerry B. Fulwood (09/20/2006) City Controller Approval: Marlee Chang (09/20/2006)City of Culver City, California City Council Agenda Item Report for the four (4) remaining positions. These are to be filled by community members who would each serve a two-year term and represent a wider range of community neighborhoods. It was hoped that there would be applicants from various sections of the community (i.e. the residential areas of generally the westside, eastside, Fox Hills, and Lower Crest/Sepulveda-Jefferson) in order that the Culver City community might be broadly represented by as wide a variety of neighborhoods as possible. Public Notification/Advertisement The deadline to submit an application for the Committee was August 29, 2006. Advertisements seeking applicants for the Committee were placed in the Culver City News and the Culver City Observer on August 10, 17, and 24, 2006. Additionally, a notice was posted on the City’s website. DISCUSSION: The Parks, Recreation and Community Services Department received six (6) applications to serve on the Homelessness Ad Hoc Committee. There are four (4) vacant neighborhood positions available on the Committee. The following persons submitted applications for consideration: 1. Nancy Goldberg (Lower Crest/Sepulveda-Jefferson Area) 2. Kimiko Kelly (Lower Crest/Sepulveda-Jefferson Area) 3. Emily MacRae (Lower Crest/Sepulveda-Jefferson Area) 4. Thomas McCabe (Lower Crest/Sepulveda-Jefferson Area) 5. Judy Scott (westside) 6. Elaine Struhl (westside) All applications have been reviewed by staff and their applications are included as attachments along with an applicant summary chart. No applications were received for the eastside or Fox Hills areas. City Council Action of July 10, 2006 With respect to the action taken by the City Council to renew the Committee, following is the transcription of the motion adopted by the City Council: “The City continue the Homeless Subcommittee, remove the staff members as voting members, maintain the four Vets Park residents who are currently members and the members appointed one from the Chamber of Commerce, one from the Culver City Homeowners, and one City of Culver City, California City Council Agenda Item Report from the Downtown Business Association, these seats would remain with four additional seats added with one from the east side, one from the west side, one from Fox Hills and one from the Lower Crest or Sepulveda/Jefferson area, each of the seats have two year terms – with existing members having served one year of their two year term and that the City Council invite the Parks and Recreation Commission to appoint a subcommittee of commissioners to work with the Committee to improve outreach to the Vets Park Neighborhood and direct staff to advertise for these appointments as soon as possible.” With the confirmation of the members of the Committee serving two year terms, the action of the City Council can be interpreted to elevate the Homeless Ad Hoc Committee to a standing Committee. Unless the Council should direct otherwise, the Committee shall be known as the Homeless Committee and be noted as a standing committee. With this change, the Committee shall be added to the list of standing committees. FISCAL ANALYSIS: As mentioned in the staff report of July 10, 2006, the following recommendation related to fiscal analysis was made: If Council takes action to renew the Ad Hoc Committee on the Homeless, staff recommends that Council consider a budget amendment in the amount of $7,550 to be appropriated from the General Fund (Fund Reserve) to Senior and Social Services ($4,500 to 10134100.411100 - Regular Salaries and $3,050 to 10134100.516600 - Special Events and Meetings): AMOUNT DESCRIPTION $4,500 Staff support 500 Miscellaneous meeting materials 550 Ethics training (as per AB 1234) 2,000 Committee’s Future Goals/Projects $7,550 TOTAL With the City Council’s action to renew the Committee, staff respectfully requests the City Council’s consideration of this budget amendment A 4/5ths vote is required for a budget amendment.City of Culver City, California City Council Agenda Item Report ATTACHMENTS: 1. Homelessness Ad Hoc Committee Applicant Summary 2. Six (6) Applications for the Homelessness Ad Hoc Committee MOTION: That the City Council: 1. Appoint four (4) neighborhood members from residential areas to the Homeless Committee to serve a two (2) year term, as follows: A. Appoint_______________ as a Member to the Homelessness Ad Hoc Committee to represent the Westside residential area. B. Appoint _______________as a Member to the Homelessness Ad Hoc Committee to represent the Eastside residential area. C. Appoint_______________ as a Member to the Homelessness Ad Hoc Committee to represent the Fox Hills residential area. D. Appoint_______________ as a Member to the Homelessness Ad Hoc Committee to represent the Lower Crest/Sepulveda-Jefferson residential area. E. Approve a budget amendment to transfer $7,550 from General Fund Reserve to Account 101341.411300 {Approval of a Budget Amendment requires a 4/5ths vote}. Or 2. Provide staff with further direction. MEETING DATE: 9/25/06 AGENDA ITEM: Consideration of Appointments to the Homelessness Ad Hoc Committee. ATTACHMENTS Pages 1. Homelessness Ad Hoc Committee Applicant Summary 1 2. Six (6) Applications for the Homelessness Ad Hoc Committee 2-26ATTACHMENT 1 2006 APPLICANT CHART CULVER CITY HOMELESSNESS AD HOC COMMITTEE WESTSIDE Judy Scott Elaine Struhl EASTSIDE FOXHILL LOWER CREST/SEPULVEDA-JEFFERSON AREA Nancy Goldberg Kimiko Kelly Emily MacRae Thomas McCabe 1.ATTACHMENT 2 CITY OF CULVER CITY RECE1V ED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA. 90232-0507 2006 . AUG 28 PM 1:20 CITY CLE:Ri APPLICATION AND BIOGRAPHICAL DATA CITY OF CULVEP CM. FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies City Conunissions, Boards. Advisory Committees or Task Forces. However, all information on this form will become a inublk record irid be available Ir public his cairn] or du plication as authorized b y law. Separate applications must be submitted for each body to which application is being made. General information 1. Identify the Cpmmission.Advisory Committee or Thsk Force to which appointment is desired: 40,7- If applying for a position on the Landlortirenant lvfedisiion Board, indicate whether you arc applying as a tenant. representative ( ), landlord repre.sonlative ( ) or member at-large representative ( ). Cail the Housing Division at (310) 253 -5780 if you have any queninnA regarding eligib$1ity for LantilEn-diTenam Mediation 13 Dad potion. 3. Name: Telephoac ( ) Address: Zip Business: Telephone ( ) Address: Zip E-mail address: Answer the pflrhving: ( Use additional sheets if ii.etessaly) 4. Community Service (List boards, commissions, committees and organizations on which you have served or ettnently serve; offices held and ía what city-) iv, CCA/Z4" 16Aral,7G11.2flar'271-5 iff 45 C/50 Le-Mr8t i.r11,14 -7Autt-ba-7:, A 15- eNcleye, koir /P9 ft" Le ,5-2C1-1.:'CCC. PAy-Af-/-_c_kt//-c_k_.;cpkve-C14-40g) .91 4-Aki 01-rA €,4-41 da °if/. ZX'8,/k 11/ 12lA'b/ 44/4 tj° h; Culver City Employees take prido In effectively providing the highest levels of service to amid? OW quality a life for the community by bidding on our tradition of more Mao seventy-Ave yews of public seruico, by our present commitment and by our dedication io meet Me challenges of the Mara 2. irrcmcai provarn17.11PPage 2 of Application 5. Employment (Title and duties/ current and past.) 1, -C Y A /I idisZej-10/ra-71 /ka-z--A A L 34 -5 /7 C.13-711 ;'/ 04,/ 6. Education (Include professional or vocational licenses and certificates.) /141 /-7,17 rCit G / r (4 /-6 11- t &.e-i-e-< fc:Ao / L A,2.4 C C c7/ ( eC )r)4 nid / 7‘14"irc'-C Cr „ fr-./61 C2J-7-7cl AO.c.)-4 CP /744 Totol -a-kV/ 4,b7,/f ie_cli/pA/ic /141 - 1.);:z- Q.11/1/A:t--4- Cek /-evE7 Personal 7. Are you a U. S. citizen? YES Y NO 8. Are you registered to vote in Culver City? YES )‹ NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO X probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO X names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO X of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES /K NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO /- voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek _appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO --;-"N PRINTED UN RECYCLED PAkER 3.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 1 5- HOU' many meetings or the Commission, Board or Commine.e to which you are interested in being appointed have you attended in the last year? 0 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at .meccings of the body to which you desire appointment? sLoi- A ct4) s- pier/4 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 71 4_ ir #e 1,141( 1 1-4-7/0s-eg AZ 7‘4. 0- Ccifv% 747 Al a 4- /ok 4Z-1,'IL" CI 1,5 .- CDA-C:7-1-* f Ao"eu, 18. What is there specifically in your background, training, education or interests which qualifies you as an aPPOingt,74? fE" Ginve__- - )e- e-r7Qiirc-fc ;A( de.of /11/r ,A-/-4 cti ,f/71 .47 if cl /00.0/3/1-• '711: 5 cti-e-, A0/11 °-.4-6s7 i1R-V ., id: 4;-; of, 471 41.- 1 ,s,a4 -11-1,-4-4/s0.t1 i.7 / 14.44.11 2-L2-lief/a CAfr 7 42'71 rocl ve-,fa 11-s .g y 0-7Lieetf . 19, What do you see as the objectives and goals of the body to which you seek appointment? / C-4/V 4 74 4 /4IJ2fr75 7L/1L4 CCM.% r 1 1 1 14.71 2 , PI 1 1 4 vr.e. cx.•/ -"iv. 1;4r/74j ri,760cA / • /17-0-444 C 0/4 -;-1T- Lj PA e 20. How would you recommend the objectives and goals of the body be changed or augmented? 7— A C / / 1 ,0 A-A?-0---d-- 4 pt.r1 / -R-- Ci/t / -5- 71- -rt`r 441A2- 747-1•:›74A-1-4; Af,L c 1/2f * 43 '1 Alh''12Tha- 4• -1 !V rfle_v C OA, 'le„...z-1-er j_ .c? "' /1A 11 '2— 740 711.03'‘"?1"7/7 j51,"1.9 21. How would you help achieve the body's established objectives and goals? j A ( 5-71,4 4/- i / ; Flo r- /v) a it <1;• ,- .5•44 r -71-Aa— Ai -li.27.1:1 P'6". 131 ,-,14 (. A1+;:aiLar_ MINI EU UN HECYCLED PAPERPage 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? /1. ill 04,7 C> a& Lieriikes rof ygbf < )0? i-Avy-. d.e.„ 7L I 5j ,'//5 -714/Yel .1 M1 -e 71Z,j_ )>A74- ,_141 474 At 3 2 xi) r ;42_1. e If; 741-,,,--/ 71 .eL ,412-- .01C bfr/ 7 // 2.-cl c /0-eciaj¢ 1 - aiog/ cle,jay,:7lon;, - 17 //g/7 - REMINDER: All information on ibis application will become a public record and be available for public inspection or duplication as antliorized by law. 1 hereby certify that the foregoing information is correct to the best of my knowledge Signature:_—;/_127 Da z-cr4i- '84‘ You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application_ Submit application(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council hi seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long? .1,44 If a City business owner/operator, for how long?_ Year of Birth. Male >Z. Female Ethnicity Si98:jhe PIN1FOk Re:WC:LED PAPER 5.CITY OF CULVER CITY RECEIVLD 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA . 90232-0507 VS AUG 28 AM 9 : 12 CITY CLERK APPLICATION AND BIOGRAPHICAL DATA ITY OF CULVER CITY. FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this forlp_aill two e i public rneard rnI be iirailable far public inspection or du plication as authorized by law. Separate applications must he submitted for each body to which application is being made, General Information I. Identify the Commission, Advisory comnailley or Task Force to which appointment is desired: Pca 46t, vNe eD VA PA(/tee 2. If applying for a position on the Landlordrenant Mediation Board, indicate whether you arc applying as a tenant representative ( landlord represonUni ye ( ) or member at-large representative ( ). - Call the Housing Division at (310) 253-5780 if you have any tineslionA regarding etigibility for Landlord/Tatum Mediation Board positiom. 3. Name: I CI) • I Telephone C. ) Address: Zip Business: Telephone ( ) Address: Zip E-mail address: Ansive r the (U. additional sherds Pieccssaly 4. Community Service (List boards, commissions, committees and organizations on which you have served or currently serve; offices hold and in what city.) Salver City Employees rake pride in effectively providing The highest levels of service to mien rho quality ot life tor the collirnoniot by bulking on our !tradition of more then seventy-live years of public soMc.o. by our present commitment, and by our dedloalion to meet the challenges of the future. 111WMCIIIIrC17.13117111, 6.Page 2 of Application 5. Employment (Title and duties, current and past.) Soo 1 1-7./L-t ker Cd Eaafe( (Ty Uo Se:Y\ 001 3S ies.vs 6. Education (Include professional or vocational licenses and certificates.) Lv, r- 01-Ey 14111 151-rtc, - UaLR Wn . P1/4 OCA-A KA OLT_ Personal 7. Are you a U.S. citizen? YES NO S. Are you regist red to vote in Culver City? YES 1./ NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO I,/ probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes list dates and YES NO / names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES NO (e.g. sources of income, loans and gifts, investments. interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO V/ voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO . PRINTED UN HENCLtD PAYER 7Page 3 of Application might reflect adversely on the propriety of your serving as a rnitrobar or any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? 375 \Ars. 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 'v-e_ e-,bseyve_ct INA n1 '5 1.V tiki SI LOCM y ittd daeicied kei 19 if- pDSSIble _ 18. What is there specifically in your background, training, education or interests which qualifies you as an appoi nice? DLO 1101,0 VtiOf 14 wtT 6114ers 19. What do you see as the objectives and goals of the body to which you seek appointment? Ft -41 .19 Sol \re Dor koel,‘ri .e j ec p 101-e VA. 20. How would yOU recommend the objectives and goals of the body be changed or augmented?|1010|21. How would you help achieve the body's established objectives and goals? .,b6feeril-i- 0 VI iP1surk PAIN I El.) HECYCLED PAPER \-) ck,rTi rpo,-t\'D 8.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? ct ss .,5-r 5obuT/OAS Wr(17 -e atedi,Lrki, devlse wctx t - 5 t--TvtiD le aleCt - 5o Lkiri 1/1, REMINDER: All information on this application will become a public record nid be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is -correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit appliestion(s) and attachments to City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the. City Council hi seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment, If a City resident, for how long? ="7-- -11: a City business owner/operator,' for how long? Year of Birth Male Female Ethnicity 5/RS:jhe PINTFlO NCLECI PAPER 9.RECEOJED CITY OF CULVER CITY zoo fi is 29 PM 2:56 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY, CA. 90232-0507 ca,f E CITY OF CULVF_P APPLICATION AND BIOGRAPHICAL DATA FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this form will become a public record and be available for public inspection or duplication as authorized by law. Separate applications nzust be submitted for each body to which application is being made. General Information 1. Identify the Commission, Advisory Committee or Task Force to which appointment is desired: c- 2. if applying for a position on the Landlord/Tenant Mediation Board, indicate whether you are applying as a tenant representative ( ), landlord representative ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any questions regarding eligibility for Landlord/Tenant Mediation Board positions. 3. Name: ,t1ri0 Telephone ( Address: Zip Business: Telephone ( ) Address: Zip E-Mail address Answer the followin,e: (Use additional sheets if necessary) 4. Community Service (List boards, commissions, committees and organizations on which you have served or currently serve; offices held and in what city.) 10.Page 2 of Application 5. Employment (Title and duties, current and past.) le irierfr? elkc 47216 e Cedrici— t;i4g-w- IhthetLisr- paha 14q.2 &h: gfse-11-gql “ivir 6. Education (Include professional or vocational licenses and certificates.) 1n441--cras tC pot-teD, uckk- g ,4- t6Th inAvne gahrix , The_ flien_mteFNI cr ii C0/44 14114 b Personal 7. Are you a U.S. citizen? YES 17 NO 8. Are you registered to vote in Culver City? YES 1// NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES 17 NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13. Rules or law and ethics prohibit members from participating in and YES NO V.- voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14 7-1n./F. thpre hppn nr nrp therp nnuf nn./ hncin pcc rirrnmctnnrpcPage 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? / 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? /0 — 2-0 A 41214— 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? AP eitht4,CTi raa 4F4-y1 c/rttude_i pemi-itipeatte`li /12.Pui, 1tA,4- fllex_fr- eø m4L1 t 4 0' 01-( 1,tare ifr?._ a /29 /2.1,drot ; C; rL 111 V tiri r14/1- 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee? Alik-C Sh Ade led ,i,;(4e at4441,4‘-d71-1 .--a MAAJAA: aiW Cr/14-- rw6-4i- /2.6443,y 1-7) v s i4(4.0tel lA-4e Sil4A4P5 r /&A2- / hIAA'C ti, et- / 61vvii/AF12- aria& de-rn-tr-r-tjokt,C )-Leffivt-S cfm+ke ,OeNivr iti-frh 6atfts-141,frt w) .1;: i 4144-40 4-et, 19. What do you see as the objectives and goals of the body to which you seek appointment? / k--6-4 114A-e )1 1‘.e (1141 716-41, ps- lbaceiL4-1 -kap 614A ( -691/1.411A4-714-79C0 aviL,of etyt- (4-4, g-er')-Nt -ec/;44 j;if-hvir441-x-, fJte1 ILJ cu T -Gti 4od.40- ectic.ct .04e4a4 ow a-n_A 20. How would you recommend the objectives and goals of the body be changed or augmented? ItAn.le"-e ati1/114'1117 67.10, 12. 21. How would you help achieve the body's established objectives and goals?Date: es7(7,5-/04 Page 4 of Application 01., a,a,AA-t 22. What special qualities can you bring to the body to which you seek appointment? wk 4d& 1.1=v_e , .„p 4 eAp 44 114,1,6z," c-o-ut-IzA, 644 ,kzP--n%Q-1c-i -e 01, fiAD -/ry-t:L 6.e Ltarzr, REMINDER: All information on this application will become a public record and be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit application(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council in seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long? ;- VI-CIO/3 If a City business owner/operator, for how long? Year of Birth Male Female Ethnicity Al hfl"- 5/98:jhe 13.CITY OF CULVER CITY PECf:IVED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA . 90232-0526a A 1113 28 P11 1:08 CliY CLERK APPLICATION AND BIOGRAPHICAL DATA OF CULVEp ci FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to IA VileaileiCS on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this fa...„ 111_21Lhecon "hfic rreoa p :t_mt 14 .9_1 ,1ynilaWn , ittmestii_g_ m do notion as authorized b v law. Separate applications must be suhmitted for each body to which application is being made. General information 1. Identify the Commission, Advisory Committal or Task Force to which appointment is desired: 1-10mar-&sr,15ss A ocCAMI If applying for a position on the Landlord/Tenant Mediation Board, indicate whether you arc applying as a tenant representative ( ), landlord rcpmsontaiive ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any quesiionx regarding eligibility for Landlord/ream Mediation Board poNitions. 3, Name: En/tIa_ IMptc_Rhe Telephone ( Address: Zip Business: Telephone ( ) Address . Zip E-mail address: Answer alse, a(iditional sheets if necessary) 4. Community Semite (List hoards, commissions, committees and organizations on which you have served or currently serve; offices hold and in what ay.) 200 (- 2006 OfNie-n• krecxo G)G052-Gcki bYiPPRK CDMailfl MO -II OC., 5PtIv Pict-12.tc CotAkth0 it 1 / 41 Cb4.31-07_, A- pDppttsuoc Gobutunrce- Nwov agar Cily Employees take pride in effectively providing The highest levels of service lo emich the quaiity of fife tor the Commit* by bulking en OW luidikon of more lhan seventy-live years of pobtio SerVi40, by our present commitment and by opt dedication la inset the chal lenges of the hallm nwincnnmemcnrx1P 14.Page 2 of Application 5. Employment (Title and duties, current and past.) 05(C )1-10 R Co (Z-R6O -V 041=Lo VE-1) cb c1 ?AR-1601.001\T ?Ca) I9I 1 — 200(Q 6_ Education (Include professional or vocational licenses and certificates.) NOin eoz4k-L- kR--c-5 P ORGIZ-erl I) L-3 AT6 Dt,7-e- PEE- ksoeD x1 o'oczmflercb Personal 7. Are you a U.S. citizen? YES NI NO 8. Are you registered to vote in Culver City? YES V NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NC) \/- probation for a felony or for a misdemeanor involving fraud? 10 Have you ever worked for the City of Culver City? (If yes, fist dates and YES NO names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO V" of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES V NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest, which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential. conflicts.) 14_ Have there been, or are there now, any business circumstances which YES' PRINTED UN RECYCLED PAPER 15.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15- How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? • 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? 17, Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 1-ktimut, ss).y5s t ReS Li GPrTre-Kir (5) . 166 r 1PG-g6 -ss t\Ak) N.) lc( PAUrtf , 13E,uEo• Ci L. n)-a__ (-5 1 1\-) rOSt`ripic-) 'TV ixeV--rit.5 i\)(37Ecs crs miaLc---ss 1=‘) (is m /DK) ( k)00Q Art 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee 16' tS0 PG- 0( K.)C. fru) N-fg- ZC S Pt1QD CD/Lk-OF-IQ • 1 Ce_ OF VV01 injel at{ g pizs. 91-ROEr. 19. What do you see as the objectives and goals of the body to which you seek appointment? kkoP6 -tv ol 2-&riAls.b (46 L)frTt 2)/Q kt-11) riNR:ck.c terfre- tU tw3C- 0 tA-U-1 "St0,)6e) Al., SO L-011 270-3 Co w ccrq 1cpio tT's ttz) iktELJ S' t ønrc. 20. How would you recommend the objectives and goals of the body be changed or augmented? I pak viDoEu u-Y f (2_4,01)s . 21. How would you help achieve the body's established objectives and goals? wbo (4) u n‹ rales (k) ',KIN I ED UN HECYCLED PAPEn Cb Ak331.4-ri v.< A-11Pc 5 AIRS 16.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? cotalow g i DJ REMINDER: All information on this application will become a public record and be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is correct to the best or my knowledge You are invited to attach additional paps, enclose a copy of your resume, or submit supplemental in rorrnaliOn which you feel may assist the City Council in its evaluation of your application. Submit appii e a 1 ion(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (3 I CI) 253-5851 OPTIONAL in order to assist the City Council hi seeking to balance appointments in term of geographic location of residence and/or business: ethnicity, gender and age, the following information is desirable but not required for application submission Or appointment. If a City resident, for how long? i2d- 5 If a City business owner/operator, for how lone Year of Birth Male . , Female, V Ethnicity CA0.---• 5/98:jhe PRINT 014 RECYCLED PAPER 17.PF.0 Ei VED 2006 AUG 24 PH 3:50 CITY CITY OF CULVER CITY OF CULVER CITY 9770 CULVER BOULEVARD R.O. BOX 507, CULVER CITY. CA. 90232-0507 APPLICATION AND BIOGRAPHICAL DATA FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this form will become a public record and he available for public inspection or duplication as authorized by law. Separate applications mast he submitted for each body to which application is being made. General Information 1. IdentAche Commission, Advisory Committee . or Task Force to which appointment is desired: - I tie, 0 ,Lip H oe- cervt If applying for a position on the Landlord/Tenant Mediation Board, indicate whether you are applying as a tenant representative ( ), landlord representative ) or member at-large representative Call the Housing Division at (310) 253-5780 if you have any questions regarding eligibility for LantilordiTenuat Mediation Hoard positions, 3. Name: i•- /. -/ /12e 6.-' 7-g., o ii- L- Telephone 1,- ) Address. Business: p t7-7 i ) c b Telephone ( ) Address: Zip .........„___ -.....__, E-mail adclrei7C Answer the plitewittg: (11se sheets ifiteeessaty) 4. Conummity Service (List hoards, commissions, committees and organizations on which you have served or currently serve: offices ljeki and in what city.) NT7 I Li 41 rE-ie 7 )/v 10 Pe c-P /)1 7-14-t- LV 612 edy i9 b L salt ete y kir / /e19-,/1/,b,s-e rv5 5 t/-- ;)/ C( i) Li) Cuivar City tmployaos (aka pride in effectively providing die higtre$1 of servic# to emich (he q ' Imlay a life for the cancnonity by building on our C 173/ Iradllion of more Man seventy-Live years of public sen/lco, by our present commitment, and by our drollcalkm In 11k101 Mu challenges al the fultitv 18. V 0-- (10,17 ov37 muS-E141A6. 6. Education (Include professional or vocational licenses and certificates.) 4. L 057 i-77„e Eotle DiV Cd Arc Eiv rir YES NO 1/ Page 2 of Application 5. Employment e c_ Gticyee (Title and duties, current and past.) A -112-Ellniq e"" NJ //7 7 - "I'S' 7 61 ”,s- I ,A) @AI/ gG)5 1-/26-4- 464D viv-r- f- 6 ,p eezz,, 19' 74, Personal 7. Are you a U.S. citizen? YES NO 8. Are you registered to vote in Culver City? YES NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO____ probation for a felony or for a misdemeanor involving fraud? 10 Have you ever worked for the City of Culver City? (If yes, list dates and YES NO K-- mums of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (T1 ,:zes, indicate name and relationship.) gRO — 14--(4i1J)) R l' Es - - A C&' A ife_44- Al /14 ( / YES NO 12. Are you aware that financial disclosure may be required annually? (e.g. sources of income, loans and gifts. investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO PIM C/N f4tcYCLE1) PA,-'Eft 19.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 16. How much time, on a monthly basis, do you anlicipate spending on preparation for and attendance at meetings of the body to which you desire appointment? S 7-779 e /4-/14 17. Why are you interested in ppointment to a City Commission, Board, committee or Task Force? /q Mc /S, /11,-- hT 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee? r4L e ff A-fr 19. What do you see as the objectives and goals of the body to which you seek appointment? e frit / 2-1-Erut- 20. How would you recommend the objectives and goals of the body be changed or augmented? /--77— .4-C /74m el\ii 21. How would you help achieve the body's established objectives and goals? ,47 774 ow MIN I ED Uhl MECYGLED PAPER 20.Date: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? 4- II 4-0' /31 REMINDER: All information on this application will become a public record and he available for public inspection or duplication as authorived by law. I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit application(s) and attachments to: City of Culver City Attention; City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council In seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If City resident, for how long? . raj If a City business owner/operator, for how long? / Ethnicity CA-0 0 AS- 7 64) 5/9&jhe Year of Birth Male Female FANTFOOlAECYCLED PAPER 21.August 24, 2006 Elaine Struhl Attachment to Application (The Homelessness Ad Hoc Committee) 16. All the necessary time required completing the task. 17. My career has been in social services. I have concern and empathy for people struggling with issues of mental health, poverty, and homelessness. 18. My education and experience in counseling troubled families would be useful in dealing with the challenges to Culver City of its homeless population. 19. To look at the challenging issues of homelessness in our city, and to try to seek solutions. 20. A thorough assessment of the problem in Culver City, and a review of how this challenge is being met in other cities. 21. I would bring my experience to the exploration of possible solutions to this very challenging problem. 22. My empathy for people dealing with issues of poverty, mental health, and homelessness, as well as my long term concerns for our community. 22.CITY OF CULVER CITY RE CE VED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA. 90232-0507 2006 AUG 28 PM 4 : 29 CITY CLERK APPLICATION AND BIOGRAPHICAL DATA ITY OF CULVER CFR FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please typo or prbd) The information contained on this form is for the use of the City Council in order to nil vacancies on City Commissions, Boards,. Advisory Committees or Task Forces. However, all information on this form will become i Judaic record and he available to uthhc ins ection or du &anon as authorized by law Separate applications must be submitted for each body to which application is being made. General Information I. Identify the Commission, Advisory Commit "c or Task Force to which appointment is delired: A-6 l-14=•c-- yvVIO 40--yNamdS: La6,/ IA, If applying for a position on the LandlonifTenunt Mediation Board, indicate whether you are applying as a tenant representative ( landlord representative ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any queslionA reprding eligibility for Laittliordirenunt Mediation Board positions, 4,A C_c, -0- Telephone. ) 3. Name; Zip Telephone r„ ) Zip Answer the figialving: (Use addition I sheets if neeessary) 4. Community Service (List hoards, commissions, committees and organizations on which you have served or currently serve; °Ian held and in what city.) r Nr- J-4.1 og. (Pek,4- C .0 . ',nevi-yr, V) -1-11 I—, Irk . . C441 r-&-,r 4.4 ( .0 -Lis 6 le‘ (A) ak4-c11_, Address: Business: Address: E-mail address: Cigar City Employees take pride in effectively providing The highest ievelS Of service to winch ftio quality of fife for the community by butroYng on our tradition of more Than seventy-live years of public $011.4CO. by our present commitment, and by rvir detliceitoti to meet We chatte.nges of the kite* 113,17M C111 Prc ru 17.111 23.6. Education (Include professional or vocational licenses and certificates a-yoj|1010|.1 14.--,r Page 2 of Application 5. Employment (Title and duties, current and past.) CD R-1 wt4a-1-,-n4 C:{1y,c,,e ID, 1- Td.t„,t: ) sA r im 1' S ce-;kc-e_ A W:t- ttvi,v-e-4J7 I NO /41en V Personal 7. Are you a U.S. citizen? YES X NO 8. Are you registered to vote in Culver City? YES )( NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO '‹ names of departments.) 11. Are yon related to any current City employees or appointees of the City YES NO °C. of Cu Ivtr City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES °c (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and Y voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or :financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14_ Have there been, or are there now, any business circumstances which - YES NO . PRINTED ON RECYCLED I-'AFER 24.Page 3 of Application might reflect adversely on the propriety of your serving as a mernber or any body to which you might be appointed? 15. How many meetings or the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 1,1 4-4-4--,- Ctic, 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? I D ^ g.A7 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force?' 1/4 :3 I"( -1)0 4 t41 / 4-Z-r.s I o'c„e 18. What What is there specifically in your background, training, education or interests which qualifies you as an appointee? cal t-A4 VA+) t 1/4.1-4.41 +1, 44-5 1e,L 4j J L, gryz, ‘ Te-to 19. What do you see as the objectives and goals of the body to which you seek appointment? r•-44 '--c-& o c... 44AL r-1-2.4-1A."-c_e.a.- 4-0|1010|-- 4--t-e. t)17. s' A-ryv.t.144s , ri--2e4--t;L. i l AI S' ;1"`s... 4":1 ir1 1.4 •••••n 4A(----, CO-r -4 -"y - V -4 rrl' r-o--w.--S) LI e4"-- 20. How would you recommend the objectives and goals of the body be changed or augmented? vv 0 1-* a c73-1 v-e_ &A pal) vt ot, — I 0c,L4 21. Now would you help achieve the body's established objectives and goals? 'REStL cJL ‘s ci,s_g s-u-42.. PRINT ED ON RECYCLED PAPC-11 . kj_i_k_ 114 e4o./6-t--)--S 6-1->Q1 °3 GAR csre—T-;:,ttr, 25.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? AA-0-t--- I 4A--tit_e Iftsg—c vv.\ ,s‘ REMINDER: All nformation on this application will become a public record and be available for public inspection or duplication as authorized by I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your =SWIM, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit upplication(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council in socking to balance appointments in terms of geographic location of residence and/or business. ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long ? 14 If a City business owner/operator, for how long? Y ear of Birth Male - Female Ethnicity 519S:jhe PAIN1F(3 Oi AEC:WILED PAPER 26.MEETING DATE: 9/25/06 AGENDA ITEM: Consideration of Appointments to the Homelessness Ad Hoc Committee. ATTACHMENTS Pages 1. Homelessness Ad Hoc Committee Applicant Summary 1 2. Six (6) Applications for the Homelessness Ad Hoc Committee 2-26ATTACHMENT 1 2006 APPLICANT CHART CULVER CITY HOMELESSNESS AD HOC COMMITTEE WESTSIDE Judy Scott Elaine Struhl EASTSIDE FOXHILL LOWER CREST/SEPULVEDA-JEFFERSON AREA Nancy Goldberg Kimiko Kelly Emily MacRae Thomas McCabe 1.ATTACHMENT 2 CITY OF CULVER CITY RECE1V ED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA. 90232-0507 2006 . AUG 28 PM 1:20 CITY CLE:Ri APPLICATION AND BIOGRAPHICAL DATA CITY OF CULVEP CM. FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies City Conunissions, Boards. Advisory Committees or Task Forces. However, all information on this form will become a inublk record irid be available Ir public his cairn] or du plication as authorized b y law. Separate applications must be submitted for each body to which application is being made. General information 1. Identify the Cpmmission.Advisory Committee or Thsk Force to which appointment is desired: 40,7- If applying for a position on the Landlortirenant lvfedisiion Board, indicate whether you arc applying as a tenant. representative ( ), landlord repre.sonlative ( ) or member at-large representative ( ). Cail the Housing Division at (310) 253 -5780 if you have any queninnA regarding eligib$1ity for LantilEn-diTenam Mediation 13 Dad potion. 3. Name: Telephoac ( ) Address: Zip Business: Telephone ( ) Address: Zip E-mail address: Answer the pflrhving: ( Use additional sheets if ii.etessaly) 4. Community Service (List boards, commissions, committees and organizations on which you have served or ettnently serve; offices held and ía what city-) iv, CCA/Z4" 16Aral,7G11.2flar'271-5 iff 45 C/50 Le-Mr8t i.r11,14 -7Autt-ba-7:, A 15- eNcleye, koir /P9 ft" Le ,5-2C1-1.:'CCC. PAy-Af-/-_c_kt//-c_k_.;cpkve-C14-40g) .91 4-Aki 01-rA €,4-41 da °if/. ZX'8,/k 11/ 12lA'b/ 44/4 tj° h; Culver City Employees take prido In effectively providing the highest levels of service to amid? OW quality a life for the community by bidding on our tradition of more Mao seventy-Ave yews of public seruico, by our present commitment and by our dedication io meet Me challenges of the Mara 2. irrcmcai provarn17.11PPage 2 of Application 5. Employment (Title and duties/ current and past.) 1, -C Y A /I idisZej-10/ra-71 /ka-z--A A L 34 -5 /7 C.13-711 ;'/ 04,/ 6. Education (Include professional or vocational licenses and certificates.) /141 /-7,17 rCit G / r (4 /-6 11- t &.e-i-e-< fc:Ao / L A,2.4 C C c7/ ( eC )r)4 nid / 7‘14"irc'-C Cr „ fr-./61 C2J-7-7cl AO.c.)-4 CP /744 Totol -a-kV/ 4,b7,/f ie_cli/pA/ic /141 - 1.);:z- Q.11/1/A:t--4- Cek /-evE7 Personal 7. Are you a U. S. citizen? YES Y NO 8. Are you registered to vote in Culver City? YES )‹ NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO X probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO X names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO X of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES /K NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO /- voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek _appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO --;-"N PRINTED UN RECYCLED PAkER 3.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 1 5- HOU' many meetings or the Commission, Board or Commine.e to which you are interested in being appointed have you attended in the last year? 0 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at .meccings of the body to which you desire appointment? sLoi- A ct4) s- pier/4 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 71 4_ ir #e 1,141( 1 1-4-7/0s-eg AZ 7‘4. 0- Ccifv% 747 Al a 4- /ok 4Z-1,'IL" CI 1,5 .- CDA-C:7-1-* f Ao"eu, 18. What is there specifically in your background, training, education or interests which qualifies you as an aPPOingt,74? fE" Ginve__- - )e- e-r7Qiirc-fc ;A( de.of /11/r ,A-/-4 cti ,f/71 .47 if cl /00.0/3/1-• '711: 5 cti-e-, A0/11 °-.4-6s7 i1R-V ., id: 4;-; of, 471 41.- 1 ,s,a4 -11-1,-4-4/s0.t1 i.7 / 14.44.11 2-L2-lief/a CAfr 7 42'71 rocl ve-,fa 11-s .g y 0-7Lieetf . 19, What do you see as the objectives and goals of the body to which you seek appointment? / C-4/V 4 74 4 /4IJ2fr75 7L/1L4 CCM.% r 1 1 1 14.71 2 , PI 1 1 4 vr.e. cx.•/ -"iv. 1;4r/74j ri,760cA / • /17-0-444 C 0/4 -;-1T- Lj PA e 20. How would you recommend the objectives and goals of the body be changed or augmented? 7— A C / / 1 ,0 A-A?-0---d-- 4 pt.r1 / -R-- Ci/t / -5- 71- -rt`r 441A2- 747-1•:›74A-1-4; Af,L c 1/2f * 43 '1 Alh''12Tha- 4• -1 !V rfle_v C OA, 'le„...z-1-er j_ .c? "' /1A 11 '2— 740 711.03'‘"?1"7/7 j51,"1.9 21. How would you help achieve the body's established objectives and goals? j A ( 5-71,4 4/- i / ; Flo r- /v) a it <1;• ,- .5•44 r -71-Aa— Ai -li.27.1:1 P'6". 131 ,-,14 (. A1+;:aiLar_ MINI EU UN HECYCLED PAPERPage 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? /1. ill 04,7 C> a& Lieriikes rof ygbf < )0? i-Avy-. d.e.„ 7L I 5j ,'//5 -714/Yel .1 M1 -e 71Z,j_ )>A74- ,_141 474 At 3 2 xi) r ;42_1. e If; 741-,,,--/ 71 .eL ,412-- .01C bfr/ 7 // 2.-cl c /0-eciaj¢ 1 - aiog/ cle,jay,:7lon;, - 17 //g/7 - REMINDER: All information on ibis application will become a public record and be available for public inspection or duplication as antliorized by law. 1 hereby certify that the foregoing information is correct to the best of my knowledge Signature:_—;/_127 Da z-cr4i- '84‘ You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application_ Submit application(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council hi seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long? .1,44 If a City business owner/operator, for how long?_ Year of Birth. Male >Z. Female Ethnicity Si98:jhe PIN1FOk Re:WC:LED PAPER 5.CITY OF CULVER CITY RECEIVLD 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA . 90232-0507 VS AUG 28 AM 9 : 12 CITY CLERK APPLICATION AND BIOGRAPHICAL DATA ITY OF CULVER CITY. FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this forlp_aill two e i public rneard rnI be iirailable far public inspection or du plication as authorized by law. Separate applications must he submitted for each body to which application is being made, General Information I. Identify the Commission, Advisory comnailley or Task Force to which appointment is desired: Pca 46t, vNe eD VA PA(/tee 2. If applying for a position on the Landlordrenant Mediation Board, indicate whether you arc applying as a tenant representative ( landlord represonUni ye ( ) or member at-large representative ( ). - Call the Housing Division at (310) 253-5780 if you have any tineslionA regarding etigibility for Landlord/Tatum Mediation Board positiom. 3. Name: I CI) • I Telephone C. ) Address: Zip Business: Telephone ( ) Address: Zip E-mail address: Ansive r the (U. additional sherds Pieccssaly 4. Community Service (List boards, commissions, committees and organizations on which you have served or currently serve; offices hold and in what city.) Salver City Employees rake pride in effectively providing The highest levels of service to mien rho quality ot life tor the collirnoniot by bulking on our !tradition of more then seventy-live years of public soMc.o. by our present commitment, and by our dedloalion to meet the challenges of the future. 111WMCIIIIrC17.13117111, 6.Page 2 of Application 5. Employment (Title and duties, current and past.) Soo 1 1-7./L-t ker Cd Eaafe( (Ty Uo Se:Y\ 001 3S ies.vs 6. Education (Include professional or vocational licenses and certificates.) Lv, r- 01-Ey 14111 151-rtc, - UaLR Wn . P1/4 OCA-A KA OLT_ Personal 7. Are you a U.S. citizen? YES NO S. Are you regist red to vote in Culver City? YES 1./ NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO I,/ probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes list dates and YES NO / names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES NO (e.g. sources of income, loans and gifts, investments. interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO V/ voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO . PRINTED UN HENCLtD PAYER 7Page 3 of Application might reflect adversely on the propriety of your serving as a rnitrobar or any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? 375 \Ars. 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 'v-e_ e-,bseyve_ct INA n1 '5 1.V tiki SI LOCM y ittd daeicied kei 19 if- pDSSIble _ 18. What is there specifically in your background, training, education or interests which qualifies you as an appoi nice? DLO 1101,0 VtiOf 14 wtT 6114ers 19. What do you see as the objectives and goals of the body to which you seek appointment? Ft -41 .19 Sol \re Dor koel,‘ri .e j ec p 101-e VA. 20. How would yOU recommend the objectives and goals of the body be changed or augmented?|1010|21. How would you help achieve the body's established objectives and goals? .,b6feeril-i- 0 VI iP1surk PAIN I El.) HECYCLED PAPER \-) ck,rTi rpo,-t\'D 8.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? ct ss .,5-r 5obuT/OAS Wr(17 -e atedi,Lrki, devlse wctx t - 5 t--TvtiD le aleCt - 5o Lkiri 1/1, REMINDER: All information on this application will become a public record nid be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is -correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit appliestion(s) and attachments to City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the. City Council hi seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment, If a City resident, for how long? ="7-- -11: a City business owner/operator,' for how long? Year of Birth Male Female Ethnicity 5/RS:jhe PINTFlO NCLECI PAPER 9.RECEOJED CITY OF CULVER CITY zoo fi is 29 PM 2:56 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY, CA. 90232-0507 ca,f E CITY OF CULVF_P APPLICATION AND BIOGRAPHICAL DATA FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this form will become a public record and be available for public inspection or duplication as authorized by law. Separate applications nzust be submitted for each body to which application is being made. General Information 1. Identify the Commission, Advisory Committee or Task Force to which appointment is desired: c- 2. if applying for a position on the Landlord/Tenant Mediation Board, indicate whether you are applying as a tenant representative ( ), landlord representative ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any questions regarding eligibility for Landlord/Tenant Mediation Board positions. 3. Name: ,t1ri0 Telephone ( Address: Zip Business: Telephone ( ) Address: Zip E-Mail address Answer the followin,e: (Use additional sheets if necessary) 4. Community Service (List boards, commissions, committees and organizations on which you have served or currently serve; offices held and in what city.) 10.Page 2 of Application 5. Employment (Title and duties, current and past.) le irierfr? elkc 47216 e Cedrici— t;i4g-w- IhthetLisr- paha 14q.2 &h: gfse-11-gql “ivir 6. Education (Include professional or vocational licenses and certificates.) 1n441--cras tC pot-teD, uckk- g ,4- t6Th inAvne gahrix , The_ flien_mteFNI cr ii C0/44 14114 b Personal 7. Are you a U.S. citizen? YES 17 NO 8. Are you registered to vote in Culver City? YES 1// NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES 17 NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13. Rules or law and ethics prohibit members from participating in and YES NO V.- voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14 7-1n./F. thpre hppn nr nrp therp nnuf nn./ hncin pcc rirrnmctnnrpcPage 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? / 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? /0 — 2-0 A 41214— 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? AP eitht4,CTi raa 4F4-y1 c/rttude_i pemi-itipeatte`li /12.Pui, 1tA,4- fllex_fr- eø m4L1 t 4 0' 01-( 1,tare ifr?._ a /29 /2.1,drot ; C; rL 111 V tiri r14/1- 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee? Alik-C Sh Ade led ,i,;(4e at4441,4‘-d71-1 .--a MAAJAA: aiW Cr/14-- rw6-4i- /2.6443,y 1-7) v s i4(4.0tel lA-4e Sil4A4P5 r /&A2- / hIAA'C ti, et- / 61vvii/AF12- aria& de-rn-tr-r-tjokt,C )-Leffivt-S cfm+ke ,OeNivr iti-frh 6atfts-141,frt w) .1;: i 4144-40 4-et, 19. What do you see as the objectives and goals of the body to which you seek appointment? / k--6-4 114A-e )1 1‘.e (1141 716-41, ps- lbaceiL4-1 -kap 614A ( -691/1.411A4-714-79C0 aviL,of etyt- (4-4, g-er')-Nt -ec/;44 j;if-hvir441-x-, fJte1 ILJ cu T -Gti 4od.40- ectic.ct .04e4a4 ow a-n_A 20. How would you recommend the objectives and goals of the body be changed or augmented? ItAn.le"-e ati1/114'1117 67.10, 12. 21. How would you help achieve the body's established objectives and goals?Date: es7(7,5-/04 Page 4 of Application 01., a,a,AA-t 22. What special qualities can you bring to the body to which you seek appointment? wk 4d& 1.1=v_e , .„p 4 eAp 44 114,1,6z," c-o-ut-IzA, 644 ,kzP--n%Q-1c-i -e 01, fiAD -/ry-t:L 6.e Ltarzr, REMINDER: All information on this application will become a public record and be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit application(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council in seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long? ;- VI-CIO/3 If a City business owner/operator, for how long? Year of Birth Male Female Ethnicity Al hfl"- 5/98:jhe 13.CITY OF CULVER CITY PECf:IVED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA . 90232-0526a A 1113 28 P11 1:08 CliY CLERK APPLICATION AND BIOGRAPHICAL DATA OF CULVEp ci FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to IA VileaileiCS on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this fa...„ 111_21Lhecon "hfic rreoa p :t_mt 14 .9_1 ,1ynilaWn , ittmestii_g_ m do notion as authorized b v law. Separate applications must be suhmitted for each body to which application is being made. General information 1. Identify the Commission, Advisory Committal or Task Force to which appointment is desired: 1-10mar-&sr,15ss A ocCAMI If applying for a position on the Landlord/Tenant Mediation Board, indicate whether you arc applying as a tenant representative ( ), landlord rcpmsontaiive ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any quesiionx regarding eligibility for Landlord/ream Mediation Board poNitions. 3, Name: En/tIa_ IMptc_Rhe Telephone ( Address: Zip Business: Telephone ( ) Address . Zip E-mail address: Answer alse, a(iditional sheets if necessary) 4. Community Semite (List hoards, commissions, committees and organizations on which you have served or currently serve; offices hold and in what ay.) 200 (- 2006 OfNie-n• krecxo G)G052-Gcki bYiPPRK CDMailfl MO -II OC., 5PtIv Pict-12.tc CotAkth0 it 1 / 41 Cb4.31-07_, A- pDppttsuoc Gobutunrce- Nwov agar Cily Employees take pride in effectively providing The highest levels of service lo emich the quaiity of fife tor the Commit* by bulking en OW luidikon of more lhan seventy-live years of pobtio SerVi40, by our present commitment and by opt dedication la inset the chal lenges of the hallm nwincnnmemcnrx1P 14.Page 2 of Application 5. Employment (Title and duties, current and past.) 05(C )1-10 R Co (Z-R6O -V 041=Lo VE-1) cb c1 ?AR-1601.001\T ?Ca) I9I 1 — 200(Q 6_ Education (Include professional or vocational licenses and certificates.) NOin eoz4k-L- kR--c-5 P ORGIZ-erl I) L-3 AT6 Dt,7-e- PEE- ksoeD x1 o'oczmflercb Personal 7. Are you a U.S. citizen? YES NI NO 8. Are you registered to vote in Culver City? YES V NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NC) \/- probation for a felony or for a misdemeanor involving fraud? 10 Have you ever worked for the City of Culver City? (If yes, fist dates and YES NO names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO V" of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES V NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest, which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential. conflicts.) 14_ Have there been, or are there now, any business circumstances which YES' PRINTED UN RECYCLED PAPER 15.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15- How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? • 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? 17, Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 1-ktimut, ss).y5s t ReS Li GPrTre-Kir (5) . 166 r 1PG-g6 -ss t\Ak) N.) lc( PAUrtf , 13E,uEo• Ci L. n)-a__ (-5 1 1\-) rOSt`ripic-) 'TV ixeV--rit.5 i\)(37Ecs crs miaLc---ss 1=‘) (is m /DK) ( k)00Q Art 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee 16' tS0 PG- 0( K.)C. fru) N-fg- ZC S Pt1QD CD/Lk-OF-IQ • 1 Ce_ OF VV01 injel at{ g pizs. 91-ROEr. 19. What do you see as the objectives and goals of the body to which you seek appointment? kkoP6 -tv ol 2-&riAls.b (46 L)frTt 2)/Q kt-11) riNR:ck.c terfre- tU tw3C- 0 tA-U-1 "St0,)6e) Al., SO L-011 270-3 Co w ccrq 1cpio tT's ttz) iktELJ S' t ønrc. 20. How would you recommend the objectives and goals of the body be changed or augmented? I pak viDoEu u-Y f (2_4,01)s . 21. How would you help achieve the body's established objectives and goals? wbo (4) u n‹ rales (k) ',KIN I ED UN HECYCLED PAPEn Cb Ak331.4-ri v.< A-11Pc 5 AIRS 16.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? cotalow g i DJ REMINDER: All information on this application will become a public record and be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is correct to the best or my knowledge You are invited to attach additional paps, enclose a copy of your resume, or submit supplemental in rorrnaliOn which you feel may assist the City Council in its evaluation of your application. Submit appii e a 1 ion(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (3 I CI) 253-5851 OPTIONAL in order to assist the City Council hi seeking to balance appointments in term of geographic location of residence and/or business: ethnicity, gender and age, the following information is desirable but not required for application submission Or appointment. If a City resident, for how long? i2d- 5 If a City business owner/operator, for how lone Year of Birth Male . , Female, V Ethnicity CA0.---• 5/98:jhe PRINT 014 RECYCLED PAPER 17.PF.0 Ei VED 2006 AUG 24 PH 3:50 CITY CITY OF CULVER CITY OF CULVER CITY 9770 CULVER BOULEVARD R.O. BOX 507, CULVER CITY. CA. 90232-0507 APPLICATION AND BIOGRAPHICAL DATA FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this form will become a public record and he available for public inspection or duplication as authorized by law. Separate applications mast he submitted for each body to which application is being made. General Information 1. IdentAche Commission, Advisory Committee . or Task Force to which appointment is desired: - I tie, 0 ,Lip H oe- cervt If applying for a position on the Landlord/Tenant Mediation Board, indicate whether you are applying as a tenant representative ( ), landlord representative ) or member at-large representative Call the Housing Division at (310) 253-5780 if you have any questions regarding eligibility for LantilordiTenuat Mediation Hoard positions, 3. Name: i•- /. -/ /12e 6.-' 7-g., o ii- L- Telephone 1,- ) Address. Business: p t7-7 i ) c b Telephone ( ) Address: Zip .........„___ -.....__, E-mail adclrei7C Answer the plitewittg: (11se sheets ifiteeessaty) 4. Conummity Service (List hoards, commissions, committees and organizations on which you have served or currently serve: offices ljeki and in what city.) NT7 I Li 41 rE-ie 7 )/v 10 Pe c-P /)1 7-14-t- LV 612 edy i9 b L salt ete y kir / /e19-,/1/,b,s-e rv5 5 t/-- ;)/ C( i) Li) Cuivar City tmployaos (aka pride in effectively providing die higtre$1 of servic# to emich (he q ' Imlay a life for the cancnonity by building on our C 173/ Iradllion of more Man seventy-Live years of public sen/lco, by our present commitment, and by our drollcalkm In 11k101 Mu challenges al the fultitv 18. V 0-- (10,17 ov37 muS-E141A6. 6. Education (Include professional or vocational licenses and certificates.) 4. L 057 i-77„e Eotle DiV Cd Arc Eiv rir YES NO 1/ Page 2 of Application 5. Employment e c_ Gticyee (Title and duties, current and past.) A -112-Ellniq e"" NJ //7 7 - "I'S' 7 61 ”,s- I ,A) @AI/ gG)5 1-/26-4- 464D viv-r- f- 6 ,p eezz,, 19' 74, Personal 7. Are you a U.S. citizen? YES NO 8. Are you registered to vote in Culver City? YES NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO____ probation for a felony or for a misdemeanor involving fraud? 10 Have you ever worked for the City of Culver City? (If yes, list dates and YES NO K-- mums of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (T1 ,:zes, indicate name and relationship.) gRO — 14--(4i1J)) R l' Es - - A C&' A ife_44- Al /14 ( / YES NO 12. Are you aware that financial disclosure may be required annually? (e.g. sources of income, loans and gifts. investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO PIM C/N f4tcYCLE1) PA,-'Eft 19.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 16. How much time, on a monthly basis, do you anlicipate spending on preparation for and attendance at meetings of the body to which you desire appointment? S 7-779 e /4-/14 17. Why are you interested in ppointment to a City Commission, Board, committee or Task Force? /q Mc /S, /11,-- hT 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee? r4L e ff A-fr 19. What do you see as the objectives and goals of the body to which you seek appointment? e frit / 2-1-Erut- 20. How would you recommend the objectives and goals of the body be changed or augmented? /--77— .4-C /74m el\ii 21. How would you help achieve the body's established objectives and goals? ,47 774 ow MIN I ED Uhl MECYGLED PAPER 20.Date: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? 4- II 4-0' /31 REMINDER: All information on this application will become a public record and he available for public inspection or duplication as authorived by law. I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit application(s) and attachments to: City of Culver City Attention; City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council In seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If City resident, for how long? . raj If a City business owner/operator, for how long? / Ethnicity CA-0 0 AS- 7 64) 5/9&jhe Year of Birth Male Female FANTFOOlAECYCLED PAPER 21.August 24, 2006 Elaine Struhl Attachment to Application (The Homelessness Ad Hoc Committee) 16. All the necessary time required completing the task. 17. My career has been in social services. I have concern and empathy for people struggling with issues of mental health, poverty, and homelessness. 18. My education and experience in counseling troubled families would be useful in dealing with the challenges to Culver City of its homeless population. 19. To look at the challenging issues of homelessness in our city, and to try to seek solutions. 20. A thorough assessment of the problem in Culver City, and a review of how this challenge is being met in other cities. 21. I would bring my experience to the exploration of possible solutions to this very challenging problem. 22. My empathy for people dealing with issues of poverty, mental health, and homelessness, as well as my long term concerns for our community. 22.CITY OF CULVER CITY RE CE VED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA. 90232-0507 2006 AUG 28 PM 4 : 29 CITY CLERK APPLICATION AND BIOGRAPHICAL DATA ITY OF CULVER CFR FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please typo or prbd) The information contained on this form is for the use of the City Council in order to nil vacancies on City Commissions, Boards,. Advisory Committees or Task Forces. However, all information on this form will become i Judaic record and he available to uthhc ins ection or du &anon as authorized by law Separate applications must be submitted for each body to which application is being made. General Information I. Identify the Commission, Advisory Commit "c or Task Force to which appointment is delired: A-6 l-14=•c-- yvVIO 40--yNamdS: La6,/ IA, If applying for a position on the LandlonifTenunt Mediation Board, indicate whether you are applying as a tenant representative ( landlord representative ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any queslionA reprding eligibility for Laittliordirenunt Mediation Board positions, 4,A C_c, -0- Telephone. ) 3. Name; Zip Telephone r„ ) Zip Answer the figialving: (Use addition I sheets if neeessary) 4. Community Service (List hoards, commissions, committees and organizations on which you have served or currently serve; °Ian held and in what city.) r Nr- J-4.1 og. (Pek,4- C .0 . ',nevi-yr, V) -1-11 I—, Irk . . C441 r-&-,r 4.4 ( .0 -Lis 6 le‘ (A) ak4-c11_, Address: Business: Address: E-mail address: Cigar City Employees take pride in effectively providing The highest ievelS Of service to winch ftio quality of fife for the community by butroYng on our tradition of more Than seventy-live years of public $011.4CO. by our present commitment, and by rvir detliceitoti to meet We chatte.nges of the kite* 113,17M C111 Prc ru 17.111 23.6. Education (Include professional or vocational licenses and certificates a-yoj|1010|.1 14.--,r Page 2 of Application 5. Employment (Title and duties, current and past.) CD R-1 wt4a-1-,-n4 C:{1y,c,,e ID, 1- Td.t„,t: ) sA r im 1' S ce-;kc-e_ A W:t- ttvi,v-e-4J7 I NO /41en V Personal 7. Are you a U.S. citizen? YES X NO 8. Are you registered to vote in Culver City? YES )( NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO '‹ names of departments.) 11. Are yon related to any current City employees or appointees of the City YES NO °C. of Cu Ivtr City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES °c (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and Y voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or :financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14_ Have there been, or are there now, any business circumstances which - YES NO . PRINTED ON RECYCLED I-'AFER 24.Page 3 of Application might reflect adversely on the propriety of your serving as a mernber or any body to which you might be appointed? 15. How many meetings or the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 1,1 4-4-4--,- Ctic, 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? I D ^ g.A7 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force?' 1/4 :3 I"( -1)0 4 t41 / 4-Z-r.s I o'c„e 18. What What is there specifically in your background, training, education or interests which qualifies you as an appointee? cal t-A4 VA+) t 1/4.1-4.41 +1, 44-5 1e,L 4j J L, gryz, ‘ Te-to 19. What do you see as the objectives and goals of the body to which you seek appointment? r•-44 '--c-& o c... 44AL r-1-2.4-1A."-c_e.a.- 4-0|1010|-- 4--t-e. t)17. s' A-ryv.t.144s , ri--2e4--t;L. i l AI S' ;1"`s... 4":1 ir1 1.4 •••••n 4A(----, CO-r -4 -"y - V -4 rrl' r-o--w.--S) LI e4"-- 20. How would you recommend the objectives and goals of the body be changed or augmented? vv 0 1-* a c73-1 v-e_ &A pal) vt ot, — I 0c,L4 21. Now would you help achieve the body's established objectives and goals? 'REStL cJL ‘s ci,s_g s-u-42.. PRINT ED ON RECYCLED PAPC-11 . kj_i_k_ 114 e4o./6-t--)--S 6-1->Q1 °3 GAR csre—T-;:,ttr, 25.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? AA-0-t--- I 4A--tit_e Iftsg—c vv.\ ,s‘ REMINDER: All nformation on this application will become a public record and be available for public inspection or duplication as authorized by I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your =SWIM, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit upplication(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council in socking to balance appointments in terms of geographic location of residence and/or business. ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long ? 14 If a City business owner/operator, for how long? Y ear of Birth Male - Female Ethnicity 519S:jhe PAIN1F(3 Oi AEC:WILED PAPER 26.MEETING DATE: 9/25/06 AGENDA ITEM: Consideration of Appointments to the Homelessness Ad Hoc Committee. ATTACHMENTS Pages 1. Homelessness Ad Hoc Committee Applicant Summary 1 2. Six (6) Applications for the Homelessness Ad Hoc Committee 2-26ATTACHMENT 1 2006 APPLICANT CHART CULVER CITY HOMELESSNESS AD HOC COMMITTEE WESTSIDE Judy Scott Elaine Struhl EASTSIDE FOXHILL LOWER CREST/SEPULVEDA-JEFFERSON AREA Nancy Goldberg Kimiko Kelly Emily MacRae Thomas McCabe 1.ATTACHMENT 2 CITY OF CULVER CITY RECE1V ED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA. 90232-0507 2006 . AUG 28 PM 1:20 CITY CLE:Ri APPLICATION AND BIOGRAPHICAL DATA CITY OF CULVEP CM. FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies City Conunissions, Boards. Advisory Committees or Task Forces. However, all information on this form will become a inublk record irid be available Ir public his cairn] or du plication as authorized b y law. Separate applications must be submitted for each body to which application is being made. General information 1. Identify the Cpmmission.Advisory Committee or Thsk Force to which appointment is desired: 40,7- If applying for a position on the Landlortirenant lvfedisiion Board, indicate whether you arc applying as a tenant. representative ( ), landlord repre.sonlative ( ) or member at-large representative ( ). Cail the Housing Division at (310) 253 -5780 if you have any queninnA regarding eligib$1ity for LantilEn-diTenam Mediation 13 Dad potion. 3. Name: Telephoac ( ) Address: Zip Business: Telephone ( ) Address: Zip E-mail address: Answer the pflrhving: ( Use additional sheets if ii.etessaly) 4. Community Service (List boards, commissions, committees and organizations on which you have served or ettnently serve; offices held and ía what city-) iv, CCA/Z4" 16Aral,7G11.2flar'271-5 iff 45 C/50 Le-Mr8t i.r11,14 -7Autt-ba-7:, A 15- eNcleye, koir /P9 ft" Le ,5-2C1-1.:'CCC. PAy-Af-/-_c_kt//-c_k_.;cpkve-C14-40g) .91 4-Aki 01-rA €,4-41 da °if/. ZX'8,/k 11/ 12lA'b/ 44/4 tj° h; Culver City Employees take prido In effectively providing the highest levels of service to amid? OW quality a life for the community by bidding on our tradition of more Mao seventy-Ave yews of public seruico, by our present commitment and by our dedication io meet Me challenges of the Mara 2. irrcmcai provarn17.11PPage 2 of Application 5. Employment (Title and duties/ current and past.) 1, -C Y A /I idisZej-10/ra-71 /ka-z--A A L 34 -5 /7 C.13-711 ;'/ 04,/ 6. Education (Include professional or vocational licenses and certificates.) /141 /-7,17 rCit G / r (4 /-6 11- t &.e-i-e-< fc:Ao / L A,2.4 C C c7/ ( eC )r)4 nid / 7‘14"irc'-C Cr „ fr-./61 C2J-7-7cl AO.c.)-4 CP /744 Totol -a-kV/ 4,b7,/f ie_cli/pA/ic /141 - 1.);:z- Q.11/1/A:t--4- Cek /-evE7 Personal 7. Are you a U. S. citizen? YES Y NO 8. Are you registered to vote in Culver City? YES )‹ NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO X probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO X names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO X of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES /K NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO /- voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek _appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO --;-"N PRINTED UN RECYCLED PAkER 3.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 1 5- HOU' many meetings or the Commission, Board or Commine.e to which you are interested in being appointed have you attended in the last year? 0 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at .meccings of the body to which you desire appointment? sLoi- A ct4) s- pier/4 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 71 4_ ir #e 1,141( 1 1-4-7/0s-eg AZ 7‘4. 0- Ccifv% 747 Al a 4- /ok 4Z-1,'IL" CI 1,5 .- CDA-C:7-1-* f Ao"eu, 18. What is there specifically in your background, training, education or interests which qualifies you as an aPPOingt,74? fE" Ginve__- - )e- e-r7Qiirc-fc ;A( de.of /11/r ,A-/-4 cti ,f/71 .47 if cl /00.0/3/1-• '711: 5 cti-e-, A0/11 °-.4-6s7 i1R-V ., id: 4;-; of, 471 41.- 1 ,s,a4 -11-1,-4-4/s0.t1 i.7 / 14.44.11 2-L2-lief/a CAfr 7 42'71 rocl ve-,fa 11-s .g y 0-7Lieetf . 19, What do you see as the objectives and goals of the body to which you seek appointment? / C-4/V 4 74 4 /4IJ2fr75 7L/1L4 CCM.% r 1 1 1 14.71 2 , PI 1 1 4 vr.e. cx.•/ -"iv. 1;4r/74j ri,760cA / • /17-0-444 C 0/4 -;-1T- Lj PA e 20. How would you recommend the objectives and goals of the body be changed or augmented? 7— A C / / 1 ,0 A-A?-0---d-- 4 pt.r1 / -R-- Ci/t / -5- 71- -rt`r 441A2- 747-1•:›74A-1-4; Af,L c 1/2f * 43 '1 Alh''12Tha- 4• -1 !V rfle_v C OA, 'le„...z-1-er j_ .c? "' /1A 11 '2— 740 711.03'‘"?1"7/7 j51,"1.9 21. How would you help achieve the body's established objectives and goals? j A ( 5-71,4 4/- i / ; Flo r- /v) a it <1;• ,- .5•44 r -71-Aa— Ai -li.27.1:1 P'6". 131 ,-,14 (. A1+;:aiLar_ MINI EU UN HECYCLED PAPERPage 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? /1. ill 04,7 C> a& Lieriikes rof ygbf < )0? i-Avy-. d.e.„ 7L I 5j ,'//5 -714/Yel .1 M1 -e 71Z,j_ )>A74- ,_141 474 At 3 2 xi) r ;42_1. e If; 741-,,,--/ 71 .eL ,412-- .01C bfr/ 7 // 2.-cl c /0-eciaj¢ 1 - aiog/ cle,jay,:7lon;, - 17 //g/7 - REMINDER: All information on ibis application will become a public record and be available for public inspection or duplication as antliorized by law. 1 hereby certify that the foregoing information is correct to the best of my knowledge Signature:_—;/_127 Da z-cr4i- '84‘ You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application_ Submit application(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council hi seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long? .1,44 If a City business owner/operator, for how long?_ Year of Birth. Male >Z. Female Ethnicity Si98:jhe PIN1FOk Re:WC:LED PAPER 5.CITY OF CULVER CITY RECEIVLD 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA . 90232-0507 VS AUG 28 AM 9 : 12 CITY CLERK APPLICATION AND BIOGRAPHICAL DATA ITY OF CULVER CITY. FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this forlp_aill two e i public rneard rnI be iirailable far public inspection or du plication as authorized by law. Separate applications must he submitted for each body to which application is being made, General Information I. Identify the Commission, Advisory comnailley or Task Force to which appointment is desired: Pca 46t, vNe eD VA PA(/tee 2. If applying for a position on the Landlordrenant Mediation Board, indicate whether you arc applying as a tenant representative ( landlord represonUni ye ( ) or member at-large representative ( ). - Call the Housing Division at (310) 253-5780 if you have any tineslionA regarding etigibility for Landlord/Tatum Mediation Board positiom. 3. Name: I CI) • I Telephone C. ) Address: Zip Business: Telephone ( ) Address: Zip E-mail address: Ansive r the (U. additional sherds Pieccssaly 4. Community Service (List boards, commissions, committees and organizations on which you have served or currently serve; offices hold and in what city.) Salver City Employees rake pride in effectively providing The highest levels of service to mien rho quality ot life tor the collirnoniot by bulking on our !tradition of more then seventy-live years of public soMc.o. by our present commitment, and by our dedloalion to meet the challenges of the future. 111WMCIIIIrC17.13117111, 6.Page 2 of Application 5. Employment (Title and duties, current and past.) Soo 1 1-7./L-t ker Cd Eaafe( (Ty Uo Se:Y\ 001 3S ies.vs 6. Education (Include professional or vocational licenses and certificates.) Lv, r- 01-Ey 14111 151-rtc, - UaLR Wn . P1/4 OCA-A KA OLT_ Personal 7. Are you a U.S. citizen? YES NO S. Are you regist red to vote in Culver City? YES 1./ NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO I,/ probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes list dates and YES NO / names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES NO (e.g. sources of income, loans and gifts, investments. interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO V/ voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO . PRINTED UN HENCLtD PAYER 7Page 3 of Application might reflect adversely on the propriety of your serving as a rnitrobar or any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? 375 \Ars. 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 'v-e_ e-,bseyve_ct INA n1 '5 1.V tiki SI LOCM y ittd daeicied kei 19 if- pDSSIble _ 18. What is there specifically in your background, training, education or interests which qualifies you as an appoi nice? DLO 1101,0 VtiOf 14 wtT 6114ers 19. What do you see as the objectives and goals of the body to which you seek appointment? Ft -41 .19 Sol \re Dor koel,‘ri .e j ec p 101-e VA. 20. How would yOU recommend the objectives and goals of the body be changed or augmented?|1010|21. How would you help achieve the body's established objectives and goals? .,b6feeril-i- 0 VI iP1surk PAIN I El.) HECYCLED PAPER \-) ck,rTi rpo,-t\'D 8.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? ct ss .,5-r 5obuT/OAS Wr(17 -e atedi,Lrki, devlse wctx t - 5 t--TvtiD le aleCt - 5o Lkiri 1/1, REMINDER: All information on this application will become a public record nid be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is -correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit appliestion(s) and attachments to City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the. City Council hi seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment, If a City resident, for how long? ="7-- -11: a City business owner/operator,' for how long? Year of Birth Male Female Ethnicity 5/RS:jhe PINTFlO NCLECI PAPER 9.RECEOJED CITY OF CULVER CITY zoo fi is 29 PM 2:56 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY, CA. 90232-0507 ca,f E CITY OF CULVF_P APPLICATION AND BIOGRAPHICAL DATA FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this form will become a public record and be available for public inspection or duplication as authorized by law. Separate applications nzust be submitted for each body to which application is being made. General Information 1. Identify the Commission, Advisory Committee or Task Force to which appointment is desired: c- 2. if applying for a position on the Landlord/Tenant Mediation Board, indicate whether you are applying as a tenant representative ( ), landlord representative ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any questions regarding eligibility for Landlord/Tenant Mediation Board positions. 3. Name: ,t1ri0 Telephone ( Address: Zip Business: Telephone ( ) Address: Zip E-Mail address Answer the followin,e: (Use additional sheets if necessary) 4. Community Service (List boards, commissions, committees and organizations on which you have served or currently serve; offices held and in what city.) 10.Page 2 of Application 5. Employment (Title and duties, current and past.) le irierfr? elkc 47216 e Cedrici— t;i4g-w- IhthetLisr- paha 14q.2 &h: gfse-11-gql “ivir 6. Education (Include professional or vocational licenses and certificates.) 1n441--cras tC pot-teD, uckk- g ,4- t6Th inAvne gahrix , The_ flien_mteFNI cr ii C0/44 14114 b Personal 7. Are you a U.S. citizen? YES 17 NO 8. Are you registered to vote in Culver City? YES 1// NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES 17 NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13. Rules or law and ethics prohibit members from participating in and YES NO V.- voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14 7-1n./F. thpre hppn nr nrp therp nnuf nn./ hncin pcc rirrnmctnnrpcPage 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? / 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? /0 — 2-0 A 41214— 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force? AP eitht4,CTi raa 4F4-y1 c/rttude_i pemi-itipeatte`li /12.Pui, 1tA,4- fllex_fr- eø m4L1 t 4 0' 01-( 1,tare ifr?._ a /29 /2.1,drot ; C; rL 111 V tiri r14/1- 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee? Alik-C Sh Ade led ,i,;(4e at4441,4‘-d71-1 .--a MAAJAA: aiW Cr/14-- rw6-4i- /2.6443,y 1-7) v s i4(4.0tel lA-4e Sil4A4P5 r /&A2- / hIAA'C ti, et- / 61vvii/AF12- aria& de-rn-tr-r-tjokt,C )-Leffivt-S cfm+ke ,OeNivr iti-frh 6atfts-141,frt w) .1;: i 4144-40 4-et, 19. What do you see as the objectives and goals of the body to which you seek appointment? / k--6-4 114A-e )1 1‘.e (1141 716-41, ps- lbaceiL4-1 -kap 614A ( -691/1.411A4-714-79C0 aviL,of etyt- (4-4, g-er')-Nt -ec/;44 j;if-hvir441-x-, fJte1 ILJ cu T -Gti 4od.40- ectic.ct .04e4a4 ow a-n_A 20. How would you recommend the objectives and goals of the body be changed or augmented? ItAn.le"-e ati1/114'1117 67.10, 12. 21. How would you help achieve the body's established objectives and goals?Date: es7(7,5-/04 Page 4 of Application 01., a,a,AA-t 22. What special qualities can you bring to the body to which you seek appointment? wk 4d& 1.1=v_e , .„p 4 eAp 44 114,1,6z," c-o-ut-IzA, 644 ,kzP--n%Q-1c-i -e 01, fiAD -/ry-t:L 6.e Ltarzr, REMINDER: All information on this application will become a public record and be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit application(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council in seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long? ;- VI-CIO/3 If a City business owner/operator, for how long? Year of Birth Male Female Ethnicity Al hfl"- 5/98:jhe 13.CITY OF CULVER CITY PECf:IVED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA . 90232-0526a A 1113 28 P11 1:08 CliY CLERK APPLICATION AND BIOGRAPHICAL DATA OF CULVEp ci FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to IA VileaileiCS on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this fa...„ 111_21Lhecon "hfic rreoa p :t_mt 14 .9_1 ,1ynilaWn , ittmestii_g_ m do notion as authorized b v law. Separate applications must be suhmitted for each body to which application is being made. General information 1. Identify the Commission, Advisory Committal or Task Force to which appointment is desired: 1-10mar-&sr,15ss A ocCAMI If applying for a position on the Landlord/Tenant Mediation Board, indicate whether you arc applying as a tenant representative ( ), landlord rcpmsontaiive ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any quesiionx regarding eligibility for Landlord/ream Mediation Board poNitions. 3, Name: En/tIa_ IMptc_Rhe Telephone ( Address: Zip Business: Telephone ( ) Address . Zip E-mail address: Answer alse, a(iditional sheets if necessary) 4. Community Semite (List hoards, commissions, committees and organizations on which you have served or currently serve; offices hold and in what ay.) 200 (- 2006 OfNie-n• krecxo G)G052-Gcki bYiPPRK CDMailfl MO -II OC., 5PtIv Pict-12.tc CotAkth0 it 1 / 41 Cb4.31-07_, A- pDppttsuoc Gobutunrce- Nwov agar Cily Employees take pride in effectively providing The highest levels of service lo emich the quaiity of fife tor the Commit* by bulking en OW luidikon of more lhan seventy-live years of pobtio SerVi40, by our present commitment and by opt dedication la inset the chal lenges of the hallm nwincnnmemcnrx1P 14.Page 2 of Application 5. Employment (Title and duties, current and past.) 05(C )1-10 R Co (Z-R6O -V 041=Lo VE-1) cb c1 ?AR-1601.001\T ?Ca) I9I 1 — 200(Q 6_ Education (Include professional or vocational licenses and certificates.) NOin eoz4k-L- kR--c-5 P ORGIZ-erl I) L-3 AT6 Dt,7-e- PEE- ksoeD x1 o'oczmflercb Personal 7. Are you a U.S. citizen? YES NI NO 8. Are you registered to vote in Culver City? YES V NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NC) \/- probation for a felony or for a misdemeanor involving fraud? 10 Have you ever worked for the City of Culver City? (If yes, fist dates and YES NO names of departments.) 11. Are you related to any current City employees or appointees of the City YES NO V" of Culver City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES V NO (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and YES NO voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest, which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential. conflicts.) 14_ Have there been, or are there now, any business circumstances which YES' PRINTED UN RECYCLED PAPER 15.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15- How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? • 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? 17, Why are you interested in appointment to a City Commission, Board, Committee or Task Force? 1-ktimut, ss).y5s t ReS Li GPrTre-Kir (5) . 166 r 1PG-g6 -ss t\Ak) N.) lc( PAUrtf , 13E,uEo• Ci L. n)-a__ (-5 1 1\-) rOSt`ripic-) 'TV ixeV--rit.5 i\)(37Ecs crs miaLc---ss 1=‘) (is m /DK) ( k)00Q Art 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee 16' tS0 PG- 0( K.)C. fru) N-fg- ZC S Pt1QD CD/Lk-OF-IQ • 1 Ce_ OF VV01 injel at{ g pizs. 91-ROEr. 19. What do you see as the objectives and goals of the body to which you seek appointment? kkoP6 -tv ol 2-&riAls.b (46 L)frTt 2)/Q kt-11) riNR:ck.c terfre- tU tw3C- 0 tA-U-1 "St0,)6e) Al., SO L-011 270-3 Co w ccrq 1cpio tT's ttz) iktELJ S' t ønrc. 20. How would you recommend the objectives and goals of the body be changed or augmented? I pak viDoEu u-Y f (2_4,01)s . 21. How would you help achieve the body's established objectives and goals? wbo (4) u n‹ rales (k) ',KIN I ED UN HECYCLED PAPEn Cb Ak331.4-ri v.< A-11Pc 5 AIRS 16.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? cotalow g i DJ REMINDER: All information on this application will become a public record and be available for public inspection or duplication as authorized by law. I hereby certify that the foregoing information is correct to the best or my knowledge You are invited to attach additional paps, enclose a copy of your resume, or submit supplemental in rorrnaliOn which you feel may assist the City Council in its evaluation of your application. Submit appii e a 1 ion(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (3 I CI) 253-5851 OPTIONAL in order to assist the City Council hi seeking to balance appointments in term of geographic location of residence and/or business: ethnicity, gender and age, the following information is desirable but not required for application submission Or appointment. If a City resident, for how long? i2d- 5 If a City business owner/operator, for how lone Year of Birth Male . , Female, V Ethnicity CA0.---• 5/98:jhe PRINT 014 RECYCLED PAPER 17.PF.0 Ei VED 2006 AUG 24 PH 3:50 CITY CITY OF CULVER CITY OF CULVER CITY 9770 CULVER BOULEVARD R.O. BOX 507, CULVER CITY. CA. 90232-0507 APPLICATION AND BIOGRAPHICAL DATA FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please type or print) The information contained on this form is for the use of the City Council in order to fill vacancies on City Commissions, Boards, Advisory Committees or Task Forces. However, all information on this form will become a public record and he available for public inspection or duplication as authorized by law. Separate applications mast he submitted for each body to which application is being made. General Information 1. IdentAche Commission, Advisory Committee . or Task Force to which appointment is desired: - I tie, 0 ,Lip H oe- cervt If applying for a position on the Landlord/Tenant Mediation Board, indicate whether you are applying as a tenant representative ( ), landlord representative ) or member at-large representative Call the Housing Division at (310) 253-5780 if you have any questions regarding eligibility for LantilordiTenuat Mediation Hoard positions, 3. Name: i•- /. -/ /12e 6.-' 7-g., o ii- L- Telephone 1,- ) Address. Business: p t7-7 i ) c b Telephone ( ) Address: Zip .........„___ -.....__, E-mail adclrei7C Answer the plitewittg: (11se sheets ifiteeessaty) 4. Conummity Service (List hoards, commissions, committees and organizations on which you have served or currently serve: offices ljeki and in what city.) NT7 I Li 41 rE-ie 7 )/v 10 Pe c-P /)1 7-14-t- LV 612 edy i9 b L salt ete y kir / /e19-,/1/,b,s-e rv5 5 t/-- ;)/ C( i) Li) Cuivar City tmployaos (aka pride in effectively providing die higtre$1 of servic# to emich (he q ' Imlay a life for the cancnonity by building on our C 173/ Iradllion of more Man seventy-Live years of public sen/lco, by our present commitment, and by our drollcalkm In 11k101 Mu challenges al the fultitv 18. V 0-- (10,17 ov37 muS-E141A6. 6. Education (Include professional or vocational licenses and certificates.) 4. L 057 i-77„e Eotle DiV Cd Arc Eiv rir YES NO 1/ Page 2 of Application 5. Employment e c_ Gticyee (Title and duties, current and past.) A -112-Ellniq e"" NJ //7 7 - "I'S' 7 61 ”,s- I ,A) @AI/ gG)5 1-/26-4- 464D viv-r- f- 6 ,p eezz,, 19' 74, Personal 7. Are you a U.S. citizen? YES NO 8. Are you registered to vote in Culver City? YES NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO____ probation for a felony or for a misdemeanor involving fraud? 10 Have you ever worked for the City of Culver City? (If yes, list dates and YES NO K-- mums of departments.) 11. Are you related to any current City employees or appointees of the City YES NO of Culver City? (T1 ,:zes, indicate name and relationship.) gRO — 14--(4i1J)) R l' Es - - A C&' A ife_44- Al /14 ( / YES NO 12. Are you aware that financial disclosure may be required annually? (e.g. sources of income, loans and gifts. investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14. Have there been, or are there now, any business circumstances which YES NO PIM C/N f4tcYCLE1) PA,-'Eft 19.Page 3 of Application might reflect adversely on the propriety of your serving as a member of any body to which you might be appointed? 15. How many meetings of the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 16. How much time, on a monthly basis, do you anlicipate spending on preparation for and attendance at meetings of the body to which you desire appointment? S 7-779 e /4-/14 17. Why are you interested in ppointment to a City Commission, Board, committee or Task Force? /q Mc /S, /11,-- hT 18. What is there specifically in your background, training, education or interests which qualifies you as an appointee? r4L e ff A-fr 19. What do you see as the objectives and goals of the body to which you seek appointment? e frit / 2-1-Erut- 20. How would you recommend the objectives and goals of the body be changed or augmented? /--77— .4-C /74m el\ii 21. How would you help achieve the body's established objectives and goals? ,47 774 ow MIN I ED Uhl MECYGLED PAPER 20.Date: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? 4- II 4-0' /31 REMINDER: All information on this application will become a public record and he available for public inspection or duplication as authorived by law. I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit application(s) and attachments to: City of Culver City Attention; City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council In seeking to balance appointments in terms of geographic location of residence and/or business, ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If City resident, for how long? . raj If a City business owner/operator, for how long? / Ethnicity CA-0 0 AS- 7 64) 5/9&jhe Year of Birth Male Female FANTFOOlAECYCLED PAPER 21.August 24, 2006 Elaine Struhl Attachment to Application (The Homelessness Ad Hoc Committee) 16. All the necessary time required completing the task. 17. My career has been in social services. I have concern and empathy for people struggling with issues of mental health, poverty, and homelessness. 18. My education and experience in counseling troubled families would be useful in dealing with the challenges to Culver City of its homeless population. 19. To look at the challenging issues of homelessness in our city, and to try to seek solutions. 20. A thorough assessment of the problem in Culver City, and a review of how this challenge is being met in other cities. 21. I would bring my experience to the exploration of possible solutions to this very challenging problem. 22. My empathy for people dealing with issues of poverty, mental health, and homelessness, as well as my long term concerns for our community. 22.CITY OF CULVER CITY RE CE VED 9770 CULVER BOULEVARD P.O. BOX 507, CULVER CITY. CA. 90232-0507 2006 AUG 28 PM 4 : 29 CITY CLERK APPLICATION AND BIOGRAPHICAL DATA ITY OF CULVER CFR FOR COMMISSION, BOARD OR ADVISORY COMMITTEE MEMBERSHIP (please typo or prbd) The information contained on this form is for the use of the City Council in order to nil vacancies on City Commissions, Boards,. Advisory Committees or Task Forces. However, all information on this form will become i Judaic record and he available to uthhc ins ection or du &anon as authorized by law Separate applications must be submitted for each body to which application is being made. General Information I. Identify the Commission, Advisory Commit "c or Task Force to which appointment is delired: A-6 l-14=•c-- yvVIO 40--yNamdS: La6,/ IA, If applying for a position on the LandlonifTenunt Mediation Board, indicate whether you are applying as a tenant representative ( landlord representative ( ) or member at-large representative ( ). Call the Housing Division at (310) 253-5780 if you have any queslionA reprding eligibility for Laittliordirenunt Mediation Board positions, 4,A C_c, -0- Telephone. ) 3. Name; Zip Telephone r„ ) Zip Answer the figialving: (Use addition I sheets if neeessary) 4. Community Service (List hoards, commissions, committees and organizations on which you have served or currently serve; °Ian held and in what city.) r Nr- J-4.1 og. (Pek,4- C .0 . ',nevi-yr, V) -1-11 I—, Irk . . C441 r-&-,r 4.4 ( .0 -Lis 6 le‘ (A) ak4-c11_, Address: Business: Address: E-mail address: Cigar City Employees take pride in effectively providing The highest ievelS Of service to winch ftio quality of fife for the community by butroYng on our tradition of more Than seventy-live years of public $011.4CO. by our present commitment, and by rvir detliceitoti to meet We chatte.nges of the kite* 113,17M C111 Prc ru 17.111 23.6. Education (Include professional or vocational licenses and certificates a-yoj|1010|.1 14.--,r Page 2 of Application 5. Employment (Title and duties, current and past.) CD R-1 wt4a-1-,-n4 C:{1y,c,,e ID, 1- Td.t„,t: ) sA r im 1' S ce-;kc-e_ A W:t- ttvi,v-e-4J7 I NO /41en V Personal 7. Are you a U.S. citizen? YES X NO 8. Are you registered to vote in Culver City? YES )( NO 9. Have you ever been convicted, fined, imprisoned, or placed on YES NO probation for a felony or for a misdemeanor involving fraud? 10. Have you ever worked for the City of Culver City? (If yes, list dates and YES NO '‹ names of departments.) 11. Are yon related to any current City employees or appointees of the City YES NO °C. of Cu Ivtr City? (If yes, indicate name and relationship.) 12. Are you aware that financial disclosure may be required annually? YES °c (e.g. sources of income, loans and gifts, investments, interests in real property.) 13.Rules or law and ethics prohibit members from participating in and Y voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation or :financial holdings in relation to your responsibilities as a member of the body to which you seek appointment? (If yes, please indicate any potential conflicts.) 14_ Have there been, or are there now, any business circumstances which - YES NO . PRINTED ON RECYCLED I-'AFER 24.Page 3 of Application might reflect adversely on the propriety of your serving as a mernber or any body to which you might be appointed? 15. How many meetings or the Commission, Board or Committee to which you are interested in being appointed have you attended in the last year? 1,1 4-4-4--,- Ctic, 16. How much time, on a monthly basis, do you anticipate spending on preparation for and attendance at meetings of the body to which you desire appointment? I D ^ g.A7 17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force?' 1/4 :3 I"( -1)0 4 t41 / 4-Z-r.s I o'c„e 18. What What is there specifically in your background, training, education or interests which qualifies you as an appointee? cal t-A4 VA+) t 1/4.1-4.41 +1, 44-5 1e,L 4j J L, gryz, ‘ Te-to 19. What do you see as the objectives and goals of the body to which you seek appointment? r•-44 '--c-& o c... 44AL r-1-2.4-1A."-c_e.a.- 4-0|1010|-- 4--t-e. t)17. s' A-ryv.t.144s , ri--2e4--t;L. i l AI S' ;1"`s... 4":1 ir1 1.4 •••••n 4A(----, CO-r -4 -"y - V -4 rrl' r-o--w.--S) LI e4"-- 20. How would you recommend the objectives and goals of the body be changed or augmented? vv 0 1-* a c73-1 v-e_ &A pal) vt ot, — I 0c,L4 21. Now would you help achieve the body's established objectives and goals? 'REStL cJL ‘s ci,s_g s-u-42.. PRINT ED ON RECYCLED PAPC-11 . kj_i_k_ 114 e4o./6-t--)--S 6-1->Q1 °3 GAR csre—T-;:,ttr, 25.Signature: Page 4 of Application 22. What special qualities can you bring to the body to which you seek appointment? AA-0-t--- I 4A--tit_e Iftsg—c vv.\ ,s‘ REMINDER: All nformation on this application will become a public record and be available for public inspection or duplication as authorized by I hereby certify that the foregoing information is correct to the best of my knowledge You are invited to attach additional pages, enclose a copy of your =SWIM, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Submit upplication(s) and attachments to: City of Culver City Attention: City Clerk 9770 Culver Boulevard Culver City, CA 90232-0507 (310) 253-5851 OPTIONAL In order to assist the City Council in socking to balance appointments in terms of geographic location of residence and/or business. ethnicity, gender and age, the following information is desirable but not required for application submission or appointment. If a City resident, for how long ? 14 If a City business owner/operator, for how long? Y ear of Birth Male - Female Ethnicity 519S:jhe PAIN1F(3 Oi AEC:WILED PAPER 26.