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
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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.)
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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?
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What is there specifically in your background, training, education or
interests which qualifies you as
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19, What do you see as the objectives and goals of the body to which you seek appointment?
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20. How would you recommend the objectives and goals of the body be changed or augmented?
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MINI EU UN HECYCLED PAPERPage 4 of Application
22. What special qualities can you bring to the body to which you seek appointment?
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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.)
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6. Education
(Include professional or vocational licenses and certificates.)
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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
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18. What is there specifically in your background, training, education or interests which qualifies you as
an appoi nice?
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19. What do you see as the objectives and goals of the body to which you seek appointment?
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20. How would yOU recommend the objectives and goals of the body be changed or augmented?|10 10|21. How would you help achieve the body's established objectives and goals?
.,b6feeril-i- 0 VI iP1surk
PAIN I El.) HECYCLED PAPER
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8.Signature:
Page 4 of Application
22. What special qualities can you bring to the body to which you seek appointment?
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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.)
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(Include professional or vocational licenses and certificates.)
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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?
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17. Why are you interested in appointment to a City Commission, Board, Committee or Task Force?
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18. What is there specifically in your background, training, education or interests which qualifies you as
an appointee?
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19. What do you see as the objectives and goals of the body to which you seek appointment?
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21. How would you help achieve the body's established objectives and goals?Date: es7(7,5-/04
Page 4 of Application
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22. What special qualities can you bring to the body to which you seek appointment?
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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__
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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-
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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
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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
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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;
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c
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21. How would you help achieve the body's established objectives and goals? j
A
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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?
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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
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p 101-e VA.
20. How would yOU recommend the objectives and goals of the body be changed or augmented?|10 10|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—
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6. Education
(Include professional or vocational licenses and certificates.)
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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?
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18. What is there specifically in your background, training, education or interests which qualifies you as
an appointee?
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19. What do you see as the objectives and goals of the body to which you seek appointment?
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20. How would you recommend the objectives and goals of the body be changed or augmented?
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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?
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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
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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.)
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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) .
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18. What is there specifically in your background, training, education or interests which qualifies you as
an appointee
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19. What do you see as the objectives and goals of the body to which you seek appointment?
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20. How would you recommend the objectives and goals of the body be changed or augmented?
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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.)
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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.
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20. How would you recommend the objectives and goals of the body be changed or augmented?
vv 0 1-* a c73-1 v-e_
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vt
ot, — I
0c,L4
21. Now would you help achieve the body's established objectives and goals?
'REStL
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‘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/ (
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Cr
„
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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
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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
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474
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// 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?|10 10|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
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,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
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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
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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
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19. What do you see as the objectives and goals of the body to which you seek appointment?
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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.)
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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
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t
1/4.1-4.41
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4j
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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
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CO-r -4 -"y - V -4 rrl' r-o--w.--S)
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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.