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HomeMy WebLinkAboutCOUNCIL - AGENDA ITEM - 02/01/2000 - RESOLUTION 2000-28 MAKING APPOINTMENTS TO VARIOUS AGENDA ITEM SUMMARY ITEM NUMBER: 21 DATE: February 1, 2000 FORT COLLINS CITY COUNCIL STAFF: Wanda Krajicek SUBJECT : Resolution 2000-28 Making Appointments to Various Boards and Commissions. RECOMMENDATION: Staff recommends adoption of the Resolution. i if 1 EXECUTIVE SUMMARY: A vacancy currently exists on the Air Quality Advisory Board due to the resignation of Dave Gallup. Applications were solicited and interviews were conducted by Councilmembers Mason and Weitkunat. The Council interview team is asking for a vote of the entire Council to decide between two candidates to fill the vacancy. The two applicants being recommended are Linda Stanley and Ken Moore. Applications are attached for Council to review and the name will be filled in the Resolution after the Council vote. The tern will begin immediately and is set to expire on June 30, 2004. A vacancy also currently exists on the Transportation Board due to the resignation of Mark Egeland. Councilmembers Kastein and Byrne reviewed the applications on file and are recommending Tom Kramer to fill the vacancy with a term to being immediately and set to expire on June 30, 2002. Two vacancies currently exist on the Youth Advisory Board due to the removal of members Ashlan Warsteane and Bill Leary for lack of attendance. Councilmembers Martinez and Kastein reviewed the applications on file and are recommending Harry McCrystal and Ana Rocca to fill the vacancies with terms to begin immediately and set to expire respectively on June 30,2001 and June 30,2002. • RESOLUTION 2000-28 OF THE COUNCIL OF THE CITY OF FORT COLLINS MAKING APPOINTMENTS TO VARIOUS BOARDS AND COMMISSIONS OF THE CITY OF FORT COLLINS WHEREAS,vacancies currently exist on various boards and commissions of the City due to resignations from board members; and WHEREAS,the City Council desires to make appointments to fill the vacancies which exist on the various boards and commissions. NOW, THEREFORE, BE IT RESOLVED BY THE COUNCIL OF THE CITY OF FORT COLLINS as follows: Section 1. That the following named person(name to be inserted after vote of the Council) be, and hereby is,appointed as a member of the Air Quality Advisory Board hereinafter indicated, with a term to begin immediately and to expire as set forth after the name: NAME OF BOARD: Air Quality Advisory Board Name Expiration of Term June 30, 2004 Section 2. That the following named persons be,and hereby are,appointed at members of the boards and commissions hereinafter indicated,with term to begin immediately and to expire as set forth after each name: NAME OF BOARD: Transportation Board Name Expiration of Term Tom Kramer June 30, 2002 NAME OF BOARD: Youth Advisory Board Name Expiration of Term Harry McCrystal June 30, 2001 Ana Rocca June 30, 2002 • Passed and adopted at a regular meeting of the City Council held this 1 st day of February,A.D. 2000. Mayor ATTEST: City Clerk NOV-03-99 WED 02: 11 PM FAX NO. P. 02 g�r� APPLICATION FOR BOARD OR COMMISSION MEMBERSHIP CiIV of Furl Collins NOTE: Application deadlines vary. Please check"Current Vacancy"listings for deadlines. Late applications will be filed ffuture vacancies. Return completed application to: City Clerk's Office • please type or use black ink City Hall West • please complete one application for each board or commission membership 300 LaPorte Avenue • please limit attachments to two pages P.O. Box 580 Fort Collins,CO 80522 . For questions or additional Information call the City Clerk's Office, 416-2525 FAX: (970)221-6295 Name of Board }� / or Commission: i Q (22 5( -.r u 1 Z�)Q l^nl Name: Rssidence: zO e to Zip: 2 P.O BoxfNupiimbie): Zip/ ^ Day Phone: (� /,�� [ 4� � Night Phone: C�7 O� Y �J� Wars of residence /� Do you live within the Urban Growth Area? in Fort Collins:_ 00 fees ❑No (see attached map) Which Council District dp�you live in?(see attached map) . Current Occupatil 1+6 k_ ,td1^ Employer: Prior work experience: (please include dates) Zb J_�J VVollunttalar WOP'rrk: (please include dates)r.t r. (� nl su55%tiro _ ns�i.U'r'f.nn� lam._ a�9b�c�en ,p,sene`b��� Have you ever been convicted of a crime (except for minor traffic offenses that resulted only in a fine)?0 Yes A2 No If yes, please explain in complete detail. State the nature and approximate date of the conviction,the sentence imposed, whether the sentence has been completed,and any other information you consider to be relevant. Are you presently serving on a city board or commission? ❑ Yes OK No If so, which one?_.. • Why do you want ecome a member of this particular board or commission? pllacts e S-- e , ` NOV-02-99 TUE 05:08 PN FAX NO, F. 02 Air quality will continue to be an issue facing Fort Collins for years to come. Good air quality is ofparaniount importance to our quality of life. Not only does poor air quality not look good,more importantly,it has major impacts on our citizens' health, especially our children's health,and on property. I believe that I can bring an integrated understanding of air quality issues from economic, planning, and transportation perspectives. I have served on the Larimer County Planning Commission, the Fort Collins City Manager's Transportation Funding Committee, and the Fort Collins Non-testing Maintenance and Inspection Air Quality Task Force. Air quality is complicated in so far as it results from planning decisions,transportation . decisions, individual, family and business economic decisions, etc. We must bring an integrated approach to air quality issues if we are to be truly successful at improving the air quality of Fort Collins. In addition,I have a Ph.D.in economics with emphasis in environmental economics and public finance. This means that I have an in-depth knowledge of incentives,regulation, and other measures that can be taken to change behavior and improve air quality. I understand the advantages and disadvantages of the various measures, and I can assess what is feasible and infeasible from a cost-bencliit perspective. Finally,I teach marketing,pricing, and consumer behavior courses at CSU and I have done significant work in these areas. Part of improving air quality in Fort Collins involves understanding why consumers of transportation and housing do what they do and how we can affect these consumer decisions through marketing,pricing, and other efforts. NOV-02-99 TUE 05:08 PM FAX NO. P. 03 Briefly explain what you believe are the three most important Issues facing this board or commission, and how do you believe this board or commission should address each issue? • ,l Otrr arr JPded c.�� n n -Z'UT—� Jac n.se_;n VA4TS ire go fie, mail to- e7 r.-i r,J17A /L-, V i a -6 p eyru�ncj_ Can serf_n f _._ ac Q : .1n ,ov /ire tu,o be 1� e,S . It o� e ,cerroru � �- e� m��f List any abilities, skills, licenses, certificates, specialized training, or interests you have which are applicable to this bcd cr cA�ml slon: • __11,�L1._eConomc�S 4! /Y-�., E?�z� ICc �11t�rt/Yl enanorn (C_S d ]yJ� C�� kPJ Please specify any activities wh h might create a serious conflict of interest if you should be appointed to this oar o commission: Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the board? Comments: All applicants are strongly encouraged to attend a regulady scheduled meeting of the board or commission for which tneyare applying. Frequent non-attendance may result in termination of the appointment. l • signet, Date. Z AAPPLICATION FOR BOARD OR OfFOrt'OKCOMMISSION MEMBERSHIP { OTE: Application deadlines vary. Please check"Current Vacancy"listings for deadlines. Late applications will be filed for fu:a-e vacancies. Return completed application to: City Clerk's Office •Please type or use black ink City Hall West "Please complete one application for each board or commission membership 300 LaPorte Avenue "Please limit attachments to two pages P.O.Box 580 "For questions or additional Information call the City Clerk's Office,416-2625 Fort Collins,CO 80522 � FAX: (970)221-6295 Name of Board A IT u&A� or Commission: Name: KFAJNf7W R. {�yl(x9,PE Residence: oi��O�G4s.F�Fer�ES bezvE. �Ra' e �15 co zip: g3©5ilz y P.O Box ra wkawl Zip: Day Phone: (970) y8q- 083el Night Phone: C9;;V) 4193— 697/ Years of residence Do you live within the Urban Growth Area? in Fort Collins: ISYes ❑No(see attached map) Which Council District do you live in? (see attached map) dur-5,'Of DF 0,17-r Current Occupation: aus a'ESS OwNE 2 Employer: N i s€l1 S Au fo reck eF,o7'ra Prior work experience: (please include dates) A Rxl- !977 7LO 226,W--- Aa�o i- 6'ye MECf/— A,V iC % 7Z6#,0rCIAi4J AYVL> AS OF CIIA1,197 OcvA-)gx ®F .UElsev s AuCA �741/ L° 4.rL 1969 Q A7c - U, . N A --D r e A v,e DL Ern- OF6.ce e- A as 7' OLASS GE-6 X bfVy4f,40� 1967 ra Allez 1969- 0��(oaufivr- *-ez-lrn,✓-a� —I 72+rry8f /4-5�7iVL V7- A -fie Elm r, Volunteer Work: (please include dates) Z t7� i z A L nT f,L t/LC.�✓ C� G � I i 4 Have you ever been convicted of a crime (except for minor traffic offenses that resulted only in a fine)? ❑Yes X No If.yes,please explain in complete detail. State the nature and approximate date of the conviction,the sentence imposed, whether the sentence has been completed, and any other information you consider to be relevant. tWA re you presently serving on a city board or commission? ❑ Yes I$ No r so,which one? hy do you want to become a member of this particular board or commission?�ff ti5 f see rF7iAn��D i*2 A Nf47F-1- CO22v 6/^- T7�fis b�>`isys�,vT, Briefly explain what you believe are the three most important issues facing this board or commission, and how do you believe this board or commission should address each issue? (� A A4 4-rij- d[AASQ S4!�X A t) U E err!I f, !11�Cfs TR a Uf L D (Vlrr-) ,ra.vi� �,•�,•��cE3,�f E/Ns NSF t�S j ICE 60A,"D 0044D EW4Qe-r. Mtw4 r 12ic r rR.nflFL T-m/led Zor Zoo ('o/l��ftr.yz7 s� �L,gvtilsyG 2) _ A..zk l/ZsiR,TL.z. ry / 'e-ea o CLouD �fW Z Gbra` Y.�o T r�!$ C1-TY I ,C CS Ti � �� S�i�✓�dEO `�� NE -&A-eQ aaka Z'CeX-�V &bua&AJ A.—i �61ic25 8,�7_ rioA) PCAA.) lai> 6 61 .rW,,OX AyrNG A� AAexx-5s- 19W P> C�4 xkA YT 0"7 . g, Tyc F"u rdrX v Aze Evy/ rs1 ovs s'�o�✓ri o,e�.y�. i! P.� CauG-J SMhL, ,44Z;WAJ,ar`o& rnav3fid ei c16 s I`Es i9'A c� -;a saz� -171A r rs me ez r-F771E Cz F��T C°oLLs�JS' Tit_'c<E f'!lVS C L)S (rugL; 77k- .&,;o,ee CO"LD RIf/_'aAIAYf-Ny 2��EA 5u erF6 P�d K atc F•�ru oG -rlm /f L st any obi sties,s ills,licenses,certificates,specialized training,or interests you have which are applicable to this board or commission:7-NG2e LI e. Ik a.t�)PI Y 7- 45- CEF-G SAI IG. A69-5 £ 5er- A ftlkcJ Please specify any activities which might create a serious conflict of interest if you should be appointed to this board or co(n�fission: �2saIeA-At5 .4.!?isS 6-42s Y"-"Sy7$ _X 'Vo Fz��- 7' r/,,a Sl/ruID sale- Al le14(57« Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the board? (BYes ❑ No Comments: �uC=N �� S�n, 7/! AN'7 J—LlyiJ SCEfi4c��C Alt applicants are strongly encouraged to attend a regularly scheduted meeting of the board or commission for which they are applying. Frequent non-attendance mayresult in termination of the appointment. Signature-, ��!- " - Date: /Dl�/>9 . Kenneth R Moore 2901 Pleasant Acres Drive Fort Collins, CO 80524 (970) 493-6970 Work Experience: April 1977 to Present: Automotive Mechanic/Technician and as of January 1997 Owner of Nelsen's Auto Tech Center. April 1969 to April 1977: Electronics Technician,U. S. Navy, attained rank of Petty Officer First Class (E6) December 1967 to April 1969: Automotive Mechanic Tminee/Assistant at Nelsen's Auto Electric, (later to become Nelsen's Auto Tech Center). Volunteer Work: 1998 to Present: Member of the Regional Inspection&Maintenance Committee. • 1997 to Present: Member of the Front Range Community College Advisory Board for the Automotive Technologies Program 1997: Member of the City of Fort Collins, Early Action Non-Testing Inspection and Maintenance Committee. 1988 to 1989: Chairman of the Elks Lodge#804's Drug &Alcohol Abuse Awareness Committee. 1984 to 1985: Committee Chairman and a Cub Master of Cub Scout Pack 84, at the Laurel and Harris schools. Why do I want to become a member of the Air Quality Advisory Board? Having lived in Fort Collins since birth, excepting eight years in the navy, I have seen many changes in the area take place. Some of the changes have been positive, and some of them negative. I have always felt that one needs to contribute to their community. I would like the opportunity to serve on this advisory board as a service to • the general public in the area, as well as contributing to the quality of life of my many friends and family members. As far as experience and knowledge, my credentials as a licensed Emissions Mechanic/Inspector in the state of Colorado and general knowledge of the Automotive Emissions Industry over the last twenty years is a plus. Through my experience as a Radiological Technician and Control Point Monitor in the Nuclear Navy and with my knowledge of radioactive materials, I believe I could be an asset to this advisory board. However, my heart lies in protecting the quality of life in my birthplace and hometown for generations to come. An advisory board such as this needs someone with knowledge and community spirit. I can provide both. What do I believe are the three most important issues facing the Air Quality Advisory Board? 1.) Vehicle Miles Traveled (VMT)and Auto Emissions. The board could explore the area of multi-model travel improvement and community ping. 2.) Air visibility/brown cloud and the fact the city fails state standard 1/3 of the time. The board could look into VMT reduction and transportation planning by improving public awareness and cooperation. 3.) The future of air emissions monitoring The board could study alternative monitoring sites and possibly select a site that is more representative of the City of Fort Collins' true emissions level. The board could recommend continued support for some form of I/M emissions testing, even though there are those that wish to eliminate such programs since the air quality has met certain standards. List any abilities, skK licenses, certificates, specialized sldlls, or interests that are applicable. 1.) State of Colorado Air Program Mechanic/Inspector license#131-1. 2.) ASE Certified Auto Technician with the Advanced Engine performance L-1. 3.) Formerly State of Colorado Diesel Inspector#6303. 4.) Mobile Air Conditioning Society-Certified CFC-12 Mobile Air Conditioning Technician. 5.) Formerly certified Radiation Worker. Certified to handle radioactive material. 6.) Formerly certified Radiation Control Point Monitor. Certified to act as a Monitor at a containmen*control point. 7.) Formerly a Radiation Instrumentation Technician. Performed repair and calibration on radiation detection instrumentation. 8.) Formerly carried Top Secret security clearance with Crypto and S. I. Endorsements, needed for my work with automatic secure voice communications.. 9.) Member of the Better Business Bureau. 10.)Member of the Automotive Service Association. 11.)Member of the National Federation of Independent Business. RPR-13-99 TUE 11 :40 KRAMER g. HOUSTON TOWING 903 493 6740 P. 02 c p - ; APPLICATION A • • A 130ARD R • COMMISSION MEM13ERSHIP CItyof Folt Coltims Applications received after April 14, 1999 will not be considered for current vacancies.Late applications will be filed for future vacancies. Return completed application to: City Clerk's Office •please type or use black Ink City Hall West •Please complete one application for each board or commission membership 300 LaPorte Avenue •Please limit attachments to two pages P.O.Box 580 Fort Collins,CO 80522 •For questions or additional information call the City Clerk's Office,416-2625 FAX: (970)221-6295 Name of Board �— orCommission: Y"0.ri4DDIr'iy'l'Ovr x6c%-Y'j Name: e--Y MaiiingAddress: f?D, ffox 970/ z�f 6//-W5 . a,__ _ zip: 1S05a� Residence: 36/30 artfk6yen -:* CONT319 a. Zip: !FD5"3 _ Day Phone: a 70) Night Phone: a-9 3 Years of residence L/ Doyou live within the Urban Growth Area? in Port Collins: CK 7 `� .0`fes O No(see attached map) Which Council District do you five in? (see attached map) 'J Current Occupation: Oerr `�.�Yn� Employer. el,� /7UU�N l�Wlh� y� Prior work experience: (please include dates) —7 D — f��s Gr <huAf/r -k*�- ���J.4rQo.5. �— Volunteer Work: (please include dates) C��?of Y>j NY /r0.»Sari,ja4gavr 0.) Y�r Q� �n Drt�S�nfi Have you ever been convicted of a crime (except for minor traffic offenses that resulted only in a fine)? ElYes , No If yes,please explain in complete detail. State the nature and approximate date of the conviction,the sentence imposed, whether the sentence has been completed,and any other information you consider to be relevant. Are you presently serving on a city board or commission? O Yes No If so,which one? Why do you want to become a member of this particular board or commission? ,1.141CM4 :I a ^$ q{ µ O +f - H APR-13-99 TUE 11 :41 KRAMER & HOUSTON TOWING 303 493 6740 P. 03 Briefly explain what you believe are the three most important issues facing this board or commission,and how do you believe this board or commission should address each issue? t) rotAh'�1 4:5t'hC� /f r t4 .&M c(F.1 o, r7rn ve:ffi osv) a c-t-14 ")f.J14 , W/t fAXN5 Pia e t, Lr f���1 r /vs�/v w,`f/ 4.�# i C C'dcef,14V z> ��{'/.¢•Ss 7"ro�hsi c�rvr- /o®'.� �-t`' yiafi/r c4/�t'rnQ/r'v�r /o+tl6iaafiov, o� C�-f Lr T6trz`fco�rx�deon 3) !v %�C1A aX6 ��li�Gl/,'1 % o/ /i?r �prY i�(�as awcl nM�rTf?Os� t � �l�ss t 7 fr rt' _ __is•1Ct r��—T6�- 7�'a`i s no,^/a77 on , List any abilities,skills,licenses,certificates,specialized training,or interests you have which are applicable to this board or commission: AV S3FfJIeh GZGY ,�"/� l%lG/OYJN1xf�ir7�S. T/'eoun� Please specify any activities which might create a serious conflict of interest if you should be appointed to this board or commission: (if unsure call the City Attorneys Office at 221-6620) Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the Ward? 0 Yes.,H`k)o Comments; All applicants are strongly encouraged to attend a regularly scheduled meeting of the board or commission for which they are applying. Frequent non-attendance may result in termination of the appointment. !f Signature: �� -� , H�� Date: l3r ` YOUTHADVISORY BOARD APPLICATION aE Fort Collins Applications received after April 14, 1999 will not be considered for current vacancies. Late applications will be filed for future vacancies. Return completed application to: Ll1 City Clerk's Office • Please type or use black ink !!f' City Hall West • Please limit attachments to two pages 1 300 LaPorte Avenue . For questions or additional information P.O.Box 580 Fort Collins,CO 60522 call the City Clerk's Office,416-2525 + ` + FAX: (970)221-6295 Name: a'wx i M CwV!;4 Mailing Address: )I I y �G Y ro%� Cal i x Zip Code: 0 S"�I Phone: q-7 U' b Are you under 21 years of age: ❑Yes R No Years of residence in Fort Collins: 3 Which Council District do you live in? S (see attached map) If you are currently in school, which school do you attend? Q / A If you have a!job, where do you work and what do you do? I LAVA I C ro PC l rt� CQ >^,��� ro✓ yDA dNTA �V ; I;+�s L✓1C._ VL Qm 114JYUjy� r'v-oay If you do any volunteer work,what kind of work do you do and where? U .( A Are you presently serving on a city board or commission? O Yes A No If so,which one? U 1 la Can you commit to meeting one day a month for at least 1 year? Yes ❑No Will you be able to provide your own transportation to meetings? AYes O No If you are under the age of 21 and still in school, have you discussed your participation on this board with your parent(s) or guardian(s): ❑Yes U No U r Have you ever been convicted of a crime (except for minor traffic offenses that resulted only in a fine)?)lYes O No If yes, please explain in complete detail. State the nature and approximate date of the conviction,the sentence imposed, whether the sentence has been completed, and any other information you consider to be relevant. �onvic�7� �Wh1 I NoV-&w6✓ �� t )9914 6ou1�QR'/ � C.G - 4,) P WaS r2iNS4u F-eLuevu Ib� 144 �, _ F i Briefly explain what you believe are the three most important issues facing this board or commission, and how do you believe this board or commission should address each issue? 1) --)�o LQ fob P ci. r- iVg e r01e- OAC) h - 4, t. c�.bSlm�> r?� �a tV c�- Jl o �V� M Z I 4 -s� 1 u DTI ar ;' :V S S 1 o Vj n V, Vr\Q v ^Q E )NS I IJ\P N � raubl� _ r �r S liltp 1 A��rP4 ' l� Cvl �1 � Lrl ��l �77 1 ' , tt - n 2) T ;•/�,N"wh7, i- ?1 . Ll n l ) S !CO�`�.�1C 1 i i r, ,4 ] C X \ r 4 d v ``t 11�1 E t r0 A/ 41 o/ o�i ih 6 -Y)j S' ✓ Y� a fo ;$ 9. ) Sew 10 �a(. 0 C _4"/— k-) Q S 440 0 tt-\ pn Z (wri) q u, 1 i 1 ( r L V l0 L S I s - rr ✓`P '1 Y,, :� f/`'IT .S , List any abilities, sk' s, licenses, certificates,specialized training, or interests you l4ave hich are applicable to this board or commission: k , Sa3L CJ,v.,�'C4- S06,,a-4 1046,16✓ (Lt5WL i U_.v,ll \J Allot, S n, l D./ CL _Z4 I/S fRlC 0V1 UJaVk_IA- c Odo Please specify any activities which might create a serious conflict of interest if you should be appointed to this board or commission: (if unsure call the City Attorney's Office at 221-6520) tJ � Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the board? O Yes A No Comments: All applicants are strongly encouraged to attend a regularly scheduled meeting of the board or commission for which they are applying. Frequent non-attendance may result in termination of the appointment. Signature: Date: 13�jr I . Harry McCrystal LCSW CAC II 1114 Argento Drive Fort Collins,CO 80521 (970)484-3709 Education Master of Social Work(MSW) Colorado State University,Fort Collins,CO May 1996 Bachelor of Arts(Cum Laude),History and Secondary Education Hofstra University,Hempstead,New York August 1988 Experience Therapist,Male Residential and Adolescent Day Resource Programs Turning Point Center for Youth and Family Development,Inc.,Fort Collins,CO May 1996-Present Therapist in residential and day treatment programs for adolescents ages 12-18 experiencing legal an nvolvement, substance abuse problems,familial dysfunction, educational deficits and various psychiatric sues. Primary responsibilities include the provision of individual,group, and family therapy; intake d assessment;treatment planning, and the supervision of interns and line staff. Participated in the formulation ofa new intake process and the revision ofclinical assessment instruments. Member of the Outdoor Experiential Program Committee and a regular participant in its programming components, including several backcounhy excursions with clients throughout Colorado. Full-time position. MSW Intern,Emergency Psychiatric Services Mental Health Center of Boulder County,Longmont,CO September 1995-May 1996 Crisis intervention and intakelassessment in person and by telephone. Responsible for conducting psychiatric evaluations and mental status exams and providing accompanying clinical documentation. Also maintained own client caseload(individuals and families)and co facilitated a weekly outpatient group for clients in crisis. Approximately 22 hours per week Graduate Research Assistant,Human Services Assessment Project Department of Social Work,Colorado State University,Fort Collins,CO September 1995-May 1996 Assisted in program evaluation and assessment ofvarious area non-profit agencies and organizations as part of a grant-funded project. Involved with data collection and entry, quantitative and qualitative data analysis, and report writing. Participated in the formal presentations offindings to involved agencies. Approximately 20 hours per week • Program Specialist(Relief),Community Support Program Larimer County Mental Health Center,Fort Collins,CO March 1995-September 1995 Supervised and assisted 8 chronically mentally ill adults in a half-way house setting. (Typical diagnoses included Schizophrenia and Bipolar Disorder.) Responsible for administering and monitoring medications, conducting groups, assisting clients with daily living skills(chores, etc.), maintaining the facility, and clinical documentation. Approximately 20 hours per week Program Specialist(Relief),Day Reporting Center Larimer County Community Corrections Department,Fort Collins,CO February 1995-October 1995 Administered urinalysis and blood alcohol tests, and dispensed medications, to adult felons in the community on probation or parole. Also monitored clients'employment status through contact with supervisors and occasional work site visits. Approximately 20 hours per month. Mental Health Worker II,Adolescent Inpatient Unit Cleo Wallace Center,Westminster,CO February 1991-August 1994 Front-line staff on an inpatient unit for 20 adolescents experiencing myriad psychiatric disturbances. Responsible for milieu management, conducting groups, and implementing various behavioral interventions within a solution focused, brieftherapy model. Considerable contact with psychiatrists, psychologists, social workers and teachers. Participated in weekly team meetings and client stafngs. Selected to assist in the orientation and training ofnew staffinembers. Full-time position. Certifications and Credentials Certified Addictions Counselor(CAC H) Licensed Clinical Social Worker(LCSW) CPR/First Aid Wilderness First Aid Memberships National Association of Social Workers(NASW) Re erences Personal and professional references furnished upon request YOUTH ADVISORY BOARD APPLICATION • Citvaf Fort.Catine Applications received after Apr//14, 1999will not be considered for current vacancies. Late applications will be filed for future vacancies. Return completed application to: City Clerk's Office • Please type or use black Ink City Hall West • please limit attachments to two pages 300 LaPorte Avenue • For questions or additional Information P.O.Box 580 Fort Collins,CO 80522 call the City Clerk's Office,416-2525 FAX: (970)221-6295 ` Name: - j an A -117 CC G� Mailing Address: ` 4 IX--i P+.'L2cnof Zip Coder Phone: (--� 5� J Are you under 21 years of age: AYes ❑ No Years of residence in Fort Collins: + Which Council District do you live in? �, ,1 (see attached map) ap) Cam, If you are currently in school,which school do you attend? T( A dyt- rl ' k If you have a job,where do you work and what do you do? T-�d If you do any volunteer work,what kind of work do you do and where? h au UO(U n+-e , Intl 0. ca ate, q f-acgw +- ,IZ Sb adA ool Are you presently serving on a city board or commission? ❑ Yes No If so,which one? Can you commit to meeting one day a month for at least 1 year? `X7 Yes ❑No Will you be able to provide your own transportation to meetings? 1w,Yes D No If you are under the age of 21 and still in school,have you discussed your participation on this board with your parent(s) or guardian(s): A Yes O No Have you ever been convicted of a crime(except for minor traffic offenses that resulted only in a fine)? ❑Yes P1fQo If yes,please explain in complete detail. State the nature and approximate date of the conviction,the sentence imposed, whether the sentence has been completed,and any other information you consider to be relevant. Briefly explain what you believe are the three most important issues facing this board or commission,and how do you believe this board or commission should address peach issue? 1) �evetoy Rn0ararn5 -4Or t-iMdb -E Iat W& help %elyr . a iiwe rne�ni a Gu rheols t i Mn �'otue o n edu ca har 2) 8y)y i(-o n rnenf Zssu loo SFC'i jn mrarns b e#La'gqe LAPLL h in c.l-an cinx C,o nse rya.�ion> zsswes� a) TN kooA 4- U voice., e,!' fir`' ou rnore �o AGIe Cc h —Fo t +he to o +ct 2PM h aLkc� itv- .r (Akan o u� i r\-1 o be-n ovvlcl d-a.la.� ackw;�s w c H� 11.0•S List any abilities,skills,licenses,certificates,specialized training,or interests you have which are applicable to this board or commission: T'Oucdre so k in ut- 0'Y' Z o inions rn PoUCAre fnsclxcoo1 shu e�£S fl )en to Span,i9h .ieOm Hernber : Gass Ca.tniry, Please specify any activities which might create a serious conflict of interest if yoj�ro Id b—e ap i�nie to this board or commission: (if unsure call the City Attorneys Office at 221-6520) UohQ Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the board? ❑Yes i'No Comments: All applicants are strongly encouraged to attend a mgu/ady scheduled meeting of the board or commission for which they are applying Frequentnon-attendance may resu/tin termination of the appointment. Signature: •. `(� F—f i� Date: 4