HomeMy WebLinkAboutCOUNCIL - AGENDA ITEM - 02/16/1999 - RESOLUTION 99-20 MAKING APPOINTMENTS TO THE CITIZE AGENDA ITEM SUMMARY ITEM NUMBER: 23
DATE: February 16, 1999
FORT COLLINS CITY COUNCIL STAFF: Wanda Krajicek
SUBJECT:
Resolution 99-20 Making Appointments to the Citizen Review Board.
RECOMMENDATION:
Staff recommends adoption of the Resolution.
EXECUTIVE SUMMARY:
At its August 4, 1998 meeting,Council adopted on Second Reading Ordinance No.76, 1998 creating
the Citizen Review Board. The Board was created to: (1)upon the request of the City Manager or
the Chief of Police, make recommendations concerning the interpretation of police policies and
procedures; (2) review police internal investigations in those circumstances where police officers
and community service officers have used deadly force;(3)review police internal investigations in
those circumstances where persons have complained about the conduct of police officers and
community service officers;(4)offer review fornon-City law enforcement agencies operating within
the City;and(5)make annual reports to the City Council and City Manager concerning the activities
and recommendations of the Board.
Following creation of the Board,applications were solicited and interviews were conducted by City
Manager John Fischbach and Councilmembers Chuck Warmer and Bill Bertschy. At its November
17. 1998 meeting Council heard input from members of the community concerning the need to have
a more diverse membership on the Board. At its December 15, 1998 meeting, Council adopted on
Second Reading Ordinance No. 225, 1998 amending Section 2-138 of the Code to increase the
membership on the Citizen Review Board to seven members. Additional applications were solicited
in December and interviews were conducted by City Manager John Fischbach and Councilmembers
Chuck Wanner and Bill Bertschy.
um
DATE: ITEM NUMBER:
The interview team is recommending that the following individuals be appointed to the Board with
terms to expire as indicated below:
Name Expiration of Term
Carole 5tansfield June 30, 2000
Becky Richardson June 30, 2001
Eric Olson June 30, 2001
Rick Aulino June 30, 2001
Rudy Maes June 30,2002
Monica Garcia June 30, 2002
Brian Carroll June 30, 2002
RESOLUTION 99-20
OF THE COUNCIL OF THE CITY OF FORT COLLINS
MAKING APPOINTMENTS TO THE CITIZEN REVIEW BOARD
WHEREAS,on August 4, 1998,Council adopted on second reading Ordinance No. 76, 1998
creating the Citizen Review Board; and
WHEREAS,on December 15,Council adopted on second reading Ordinance No. 225, 1998
amending the Code of the City of Fort Collins to increase the membership on the Citizen Review
Board to seven (7)members; and
WHEREAS,the board was created to:(1)upon the request of the City Manager or the Chief
of Police, make recommendations concerning the interpretation of police policies and procedures;
(2)review police internal investigations in those circumstances where police officers and community
service officers have used deadly force; (3) review police internal investigations in those
circumstances where persons have complained about the conduct of police officers and community
service officers; (4) offer review for non-City law enforcement agencies operating within the City;
and (5) make annual reports to the City Council and City Manager concerning the activities and
recommendations of the Board; and
WHEREAS,applications for the Board have been solicited and interviews conducted by City
Manager John Fischbach and Councilmembers Chuck Wanner and Bill Bertschy; and
WHEREAS, Council wishes to appoint the charter member of the Board.
NOW. THEREFORE, BE IT RESOLVED BY THE COUNCIL OF THE CITY OF FORT
COLLINS that the following named persons be and they hereby are, appointed as members of the
Citizen Review Board with terms to expires as set forth below:
Name Expiration of Term
Carole Stansfield June 30, 2000
Becky Richardson June 30, 2001
Eric Olson June 30, 2001
Rick Aulino June 30, 2001
Rudy Maes June 30, 2002
Monica Garcia June 30, 2002
Brian Carroll June 30, 2002
Passed and adopted at a regular meeting of the City Council held this 16th day of February,
A. D. 1999.
Mayor
ATTEST:
City Clerk
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APPLICATION • BOARD OR
COMMISSION ME - -
City of Fort Collins
Applications received after December 15, 1998 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,416-2525
FAX: (970)221-6295
Name of Board Q
or Commissio —n: �r4 t I,_ Q
Name: ? d 4 lj/ - ' ,{�U es
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Mailing Address: —/—�C�((F--�//���/' 6�- ' I Zip:
Residence: Z4c pL 60 t1 PLO_ •/e !11 3a Zip:
Day Phone: _ 22Z? �_ Night Phone.
Years of residence Do you live within the Urban Growth Area?
in Fort Collins: F 4 w 5 XYes ❑No (see attached map)
Which Council District do you live in? (see attached map) -& / n
Current Occupation:TA r?,v/ Employer: 5-c f/./�
Prior work experience: (please include dates) !',#tf, — L
Volunteer Work: (please include dates)
Have you ever been convicted of a crime (except for minor traffic offenses that resulted only in a fine)? ❑Yes CrNo
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? D(Yes ❑ No
iIf so,which one?
Why do you want to become a member of this particular board or commission?
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?
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List any abilities,skills, licenses, certificates,specialized training, or interests you have which are applicable to this board
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)
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Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the
board? 0 Yes X 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: —Q a 714� Date: 1200Cn,
APPLICATION F • BOARD OR
COMMISSION MEMBERSHIP
• City of=�
Applications received after December 15, 1998will 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,416-2525
FAX: (970)221-6295
Name of Board
or Commission:
Name: l !/lr)ni'(n iq 1 y�� I •Mailing Address: �y `�'tq e n onw )Q�x g z-1/)V Zip:
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Residence: nmE r�� 0� �/ Zip:
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Years of residence /11(��� Do you live within the Urban Growth Area?
in Fort Collins: �LJ 1� (as 0 No (see attached map)
Which Council District do you live in? (see atta f hed map) J ISA-L C
Current Occupation. (�c NSF � e V mployer:
Prior work experience: (please include dates) � t f 0
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olunteer Work: (please include dates) l t - It
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Have you ever been convicted of a crime(except for minor traffic offenses that resulted only in a fine)? ❑Yes 1�d 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? 0 Yes 0/N0
. If so, which one?
Why do you want to become a member of this particular board or commission? ,� h a f )e_ " L)L-c( i 4'
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Briefly explain what you believe are the three most important issues facing this board or commission, and how do you
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Please specify,any activities which might create a serious conflict of interest 9 you should be appointed to this board or
commission: (if unsure call the City Attorney's Office at 221-6520)
Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the
board? ❑YesYNo
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. n
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APPLICATION F • R BOARD OR
COMMISSION MEMBERSHIP
city of Fort c-otlins
Applications received after September 4, 1998 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,416-2525
FAX: (970)221-6295
Name of Board
or Commission: / �/ z en S �� t//�nW / } O a rcY
Name: Gt. r-o le E-7.
Mailing Address: r yQ_,� ( _o ns� e�// d ,din , �r,� /=�, c7eU rzip: ,POSa.S-
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Day Phone: 9 76 - '/ 9/- D O Li y Night Phone: 9 76 -_1 e2 e�—S"/ 34
Years of residence Do you live within the Urban Growth Area?
in Fort Collins: a O JO Yes, ❑No (see attached map)
Which Council District do you live in? (see attached map) _1 1 S�r/ ,t '- .3
Current Occupation: "/Oror1 ro.+� 748 Employer: <:2o%radc) .Sfa�r Un,�ers,�N
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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 V No
• If so,which one?
Why do you want to become a member of this particular board or commission? /,`4 e 40 A e 4,9 rc.Jel"e
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List any abilities,skills,licenses,certificates,specialized training, or interests you have which are applicable to this board
or commission: = c�rr-/I-e c 'I r a te 4- to r-o f o w l s a n d /e a s e s a t
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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)
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Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the
board? ❑Yes 5t No
Comments: 7-Ais or-d is 4trs �oerrrsr
All applicants are strongly encouraged to attend a regularly scheduled meeting of the board or commission for which
they are applying. Frequent nonattendance may result in termination of the appointment.
t- 30 / 99f
Signature: � Date:
AUG-23-96 SUN 21 :13 CITY CLERK FAX NO, 9702216295 P, 02/07
APPLICATION FOR • OR
COMMISSION MEMBERSHIP
clrroF+���
Applicat ons received after September 4, 1998 will not be considered for current vacancies.Late applications wilt 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
For Collins,CO 805Y2
Box 5�
Fort •For questions or additional information call the City Clerk's Office,41&2525
FAX: (970)221-MS
Name of Bawd �O i '�s v I-P,c �U G.f U
or Commission:
Name: _ . �CYJCG cc�
Mailing Address:lJ a y U ( W a fL"<1 U l 1Z� !J Q U�2� C Zip: rQIUSZ.'
Residence: �`1 U i w )Lw�C�U c Q t.� L <� Zip: t))�Z(o
Day Phone: y C4 S - ca 14 C7 Night Phone•. �94.4 U 3-�
Years of residence 1 Do,,yyOuu live within the Urban Growth Area?
in Fart Collins: 2- S Cr%es O No(see attached map)
Which Council District do you live in? (see attached map) S
Current Occupation: JI��iFe_f Zt /" 1 U- Employer:Tay-j. Val
Prior work experience: (please include dates)
'SP e eA ��rl
Volunteer Work: (please include dates) `� t)cprL �
V 6( t [(
Have you ever been convicted of a crime(except for minor traffic offenses that resulted only in a fine)? ❑Yes GlNo
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 Yos TNo
if so,which one? T )
• Why d u want to become a member of this particular board or commission?
AUG-24-1998 09:29 9?02216295 96% P.02
AUG-23-88 SUN 21:14 CITY CLERK FAX NO. 9702218295 P. 03/07
Briefly explain what you believe are the three most important issues facing this board or commission,and how do you
believe bh
,-k board or commission should address ach'issue.
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List any abilities,skills,licensee,certificates,specialized training,or interests you have which are applicable to this board
e
Gam+ e
vw
Please specify any activities which might create a serious conflict of interest 9 you should be appointed to this board or
commission: (rf unsure call the CityAttorney's Office at221-6520)
Have you attended eetinq of the board or commission you are applying to or talked to anyone currently on the
board? D Yes VNo
Comme
rt'Cy\ YI.O TLe ,2.�-J i otwrJ
All applicants sre TFfectnonattendance
ouraged to attend a regularly scheduled meeting of the board or commission for welch
they are apptying. may result in termination of the appointment.
U U
Signature: Date:
RUG-24-199e 09:28 9702216295 96% P.03
Becky W. Richardson
• 2401 Wyandotte Drive
Fort Collins, CO 80526
(970) 484-4839
QUALIFICATIONS
Organizational Skills
♦ Implemented a means of written communication among staff
♦ Researched and composed agency wide policies
♦ Recorded and transcribed minutes for weekly and monthly meetings
♦ Performed bookkeeping duties including payroll, accounts receivable,
accountspayable and inventory
♦ Organized and scheduled daily activities of employees working at numerous
sites
Interpersonal Skills
♦ Hired, trained and supervised office staff
♦ Consulted over the phone and face-to-face with clients in crisis situations
♦ Supervised volunteers assisting with office projects
♦ Assisted developmentally and physically disabled students with daily school
activities and personal needs
Technical Skills
♦ Mastered several word processing, database and desktop publishing programs
♦ Composed monthly newsletter
♦ Copy-edited departmental newsletters and policy and procedure manuals
♦ Developed training manual for specialized database
♦ Maintained database and performed computerized scheduling of rooms,
supplies, equipment and personnel
WORK EXPERIENCE
SECRETARYII
Poudre Valley Hospital, Fort Collins, CO (April, 1997 to present)
CUSTOMER SUPPORT REPRESENTATIVE
Lanier Worldwide via CNS, Denver, Colorado (January, 1997 to April, 1997)
SPECIAL EDUCATION PARA-PROFESSIONAL
Rocky Mountain High School, Fort Collins, Colorado (December, 1995 to January, 1997)
ADMINISTRATIVE ASSISTANT
Hospice of Larimer County, Fort Collins, Colorado (July, 1994 to December, 1995)
ER CRITICAL CARE TECH
Memorial Medical Center, Las Cruces, New Mexico (June, 1991 to February, 1994)
OFFICE MANAGER
Mesilla Valley Rehab, P.A., Las Cruces, New Mexico (August, 1990 to May 1991)
OPERATING ROOM SCHEDULING COORDINATOR
Memorial Medical Center, Las Cruces, New Mexico (February, 1990 to August 1990)
MEDICAL ASSISTANT
OB/GYN Consultants, Las Cruces, New Mexico (December, 1985 to January, 1990)
• EDUCATION
Attended Front Range Community College
Attended New Mexico State University
APPLICATION FOR • OR
COMMISSION MEMBERSHIP
Cityof�
Applications received after September 4, 1998 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,416-2525
FAX: (970)221-6295 I
Name of Board �'�L7J� -&a
or Commission: f
Name: �9zt� tom. OL
Mailing Address: S1� lza46)�Cp&-4. q_Gil4` , CO Zip:
Residence: (( Zip:
Day Phone: 4�3"'Night Phone:
Years of residence Do you live within the Urban Growth Area?
in Fort Collins: �`y 13 �I Z +� (-1- � YeS ❑No(see attached map)
Which Council District do you live in? (see attached map) *D' r
Current Occupation: snb a rpMc Teter Employer:
u Q
Prior work experience: (please include dates)
K4 '.,,12or- We k,ra. .q 1
VA
Volunteer Work: (please include dates) r' iCAL� vi r r
O -- Oror A/GaK:A— ,:v r,
Ce»•w% s�1
Have you ever been convicted of a crime (except for minor traffic offenses that resulted only in a fine)? ❑Yes No
If yes, please explain in complete detail. State the nature and approximate date of the conviction,the sentence imposed,
whether the sentepce has been completed,and any other information you consider to be relevant.
Are you presently serving on a city board or commission? 0 Yes )d No
If so,which one? �A
r^Why do you want to become a member of this particular board or commission? f'tZ;,yx. r� 4;D
f-aj � Ah
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
1) 5 IQ-vrti�,v. ✓G1nJQ.r �Y�T
2)
3)
List any abilities,skills,licenses,certificates,specialized training,or interests you have which are applicable to this board
or co mission
io ..
Please specify any activities which might create a serious conflict of interest if you should be appointed to this board or
commission: ('rf=11 the City Attorney's Office at 221-6520)
Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the
board? ❑Yes�d No
Comments:
All applicants are strongly encouraged to attend a regularly scheduled meeting of the board or commission for which
they are applying. Frequent nonattendance may result in termination of the appointment.
Signature: ���i w2 Date: - !y
• Citizen Review Board Application for
Eric B. Olsen, M.D.
Supplemental Answers
why do you want to become a member of this particular Board or Commission?
I grew up in Fort Collins from elementary school through several years at CSU. Since our family
moved here in 1972 I have seen many changes to our home community, yet I still believe that this is
an excellent city that few can equal. The pride that I have in this community which has "molded"
me, and now in turn will mold my children runs deep and my desire to foster improvement in our
home has existed for quite a while.
I believe that the Citizen Review Board is the ideal opportunity for my community volunteer service
and I believe that I make an excellent candidate for this board for several reasons. As a physician,
particularly as an Emergency Physician at Poudre Valley Hospital, I have been, and continue to be
privy to many of the situations which might trigger a review by this board. I am a daily witness to
the interactions between law enforcement personnel and the citizens in their custody. Many times I
have the opportunity to follow circumstances as they develop through radio and dispatch
communications, paramedic reports, as well as through their evaluation in the Emergency
Department. I believe that this has given me the advantage of being knowledgeable about what the
officers are often up against in their charge to uphold the law. I don't believe that this 'real time"
insight is not always easily discernible through a retrospective review of a report.
In addition, my medical training and more so my clinical practice through out the years has given me
cause to try to view each encounter as a different and unique situation without bias. A member of
this review board must be able to put aside any personal bias in order to preform fair and accurate
review. I also would be able to provide the board expertise in patterns of injury and injury
recognition.
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. In my opinion one of the most important issues will be decided through the application and selection
process. This 5 member board must be composed of citizens who have as their primary agenda to be
fair, considerate, honest and just in their call to serve. Each time that the Citizen Review Board is
convened, all preconceived issues, notions and any other bias laden conceptions must be discharged
prior to meeting so that fair and accurate consideration can be rendered.
Clearly, there exists potential for this board to be charged with significantly emotion-laden topics.
As with many items which may be brought forward for review, there may be public activism, media
attention or other opinion to which the members may be exposed. As members of the Citizen
Review Board, such exposure bias must be eliminate so that a fair and appropriate review may be
conducted.
Hopefully, through the scrutiny of Citizen Review Board applications, any persons who may intend
to achieve personal gain or promote biased issues might be screened out from the list of viable
candidates. Although many potentially agenda-bearing members, while they may believe that they
act and debate with the best intentions of the board, may in fact have their consideration and
responses tainted by their various bias. Also the board members may have to make unpopular
decisions as a result of their review process. Those people on the board must be strong enough to
overcome reaction to unpopular decisions so as to not be pressured by the "court of public opinion.'
2. I view this board as being charged with a protection type of role. First and foremost is the
protection of the citizens of Fort Collins against wrongdoing or perceived wrongdoing by any peace
officer. However, in the same respects,an equally important role of the Citizen Review Board is
that of protecting those members of our community who are charged with enforcing the law and the
protection of people and property. Members of the board must be able to accept that their decisions
regarding their work may elicit unpopular responses. Reactionary responses by people following an
incident are not always appropriate responses. In that light it may often be the peace officers who
need the protection that a Citizens Review Board review may provide after a complaint has been
deemed not sustained or unfounded.
3. The "Use of Force" ability is an important right which citizens entrust to their peace officers and is
certainly one of the central issues which has instigated the formation of the Citizen Review Board.
The appropriate use of force, whether this be to physically restrain an individual or subdue and
apprehend a person by non-lethal or lethal force is a capability that must be protected, yet not
abused. The proper use of force or even the ability to threaten force can maintain credibility and
respect that peace officers must have in order to maintain the law. Training in the appropriate use of
force is required by any individual who is entrusted with its use. However, even the perception of
improper use of force can be sufficient to tarnish the credibility of an officer or officers
In this light, the review of actions which require the use of force is likely the most important charge
of the Citizen Review Board. Credibility and integrity by peace officers must be maintained by the
proper and appropriate use of force, while the perception or actions of"bullying" and hassling must
be eliminated. The Citizen Review Board must consider each instance with thorough and thougbtful
fairness keeping in[Hind the best interests of the community.
2
APPLICATION F • BOARD OR
COMMISSION
�it3r of=ort
Applications received after September 4, 1998 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 -For questions or additional information call the City Clerk's Office,416-2525
Fort Collins,CO 80522
FAX: (970)221-6295
Name of Board
or Commission: 0 RE-n&w
Name: BR/FIAT 1'- CARROU.
Mailing Address: 7124 6144 O; M' rf-- COF L�uS� �- Zip:
Residence: 7-24 2A6R QKtE aP Zip: S't7J 1T
Day Phone: 974•q44 ei( Night Phone: g70•��6'64��
Years of residence Do you live within the Urban Growth Area?
in Fort Collins: kYes, ❑No(see attached map)
Which Council District do you live in? (see attached map) I
Current Occupation:XfP&0 YCO Employer:
Prior work experience: (please include dates) �f,(a�j 7 y ,Z ,�6 SLerl& 4dj!:yj FA i
Volunteer Work: (please include dates) 8-q7 w -P F5---L - Aflil LQ "C
Have you ever been convicted of a crime(except for minor traffic offenses that resulted only in a fine)? ❑Yes I)?,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? 1p'Yes ❑ No
If so,which one? k C
Why do you want to become a member of this particular board or commission?
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?
e4 A
2)
Alz
lal�'t/X;M iZeltu,C AIt
3) alp
List any abilities,skills, licenses, certificates,specialized training, or interests you have which are applicable to this board
or commission:
C'AhaMAV POPC'E p6yiew 5&9doxzlftfTTtF 0(- #Rd • AS ;f3/ Adgr iuv�sr/�it�.
SV47W4619 , 94A,0 AE7iD�eQ OCU695iYlbGy BF A7/e&VA44vtr DR VSe' dz- f)E�fW )QRdf
�Y r-�jl OER� � L{Ai� EkPt�16X.c'.E /AAA=sTIG�F� f�D So�iQG/t�lt� C/G%L R/E7h� /!!
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)
Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the
board? ❑Yes 9 No
Comments:
All applicants are strongly encouraged to attend a regularly scheduled meeting of the board or commission for which
they are applying. Frequent nonattendance may result in termination of the appointment.
Signature: {7(Y4Gh 0' Date:
► • • • OR
• • MEMBERSHIP
�Cityof�l
Applications received after September 4, 1998 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,416-2525
FAX: (970)221-6295
Name of Board C ft liP Reulew f c
or Commission: 1�
Name: �(L A'd i1 o
Mailing Address: 210 6. 4a0- .5t' Zip: 905'�?Y
Residence: 5t- Zip: �y51U
Day Phone: S Night Phone: 221-41675
Years of residence 1 Do you live within the Urban Growth Area?
in Fort Collins: 1 Yes Cl No(see attached map)
Which Council District do you live in? (see attached map)
Current Occupation: E-t!i0fer Employer:
Prior work experience: (please include dates)
(- flat-Packard 19-88-4�
Volunteer Work: (please include dates)
CMa sf firt C,(GNS Ir QKreatIDN 198t PE5-ew
Ct(araa t,
j/arcc,s actilirf�s /988rese,7f
Have you ever been convicted of a crime(except for minor traffic offenses that resulted only in a fine)? ❑Yes A 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 K No
If so,which one?• L /Why do you want to¢ PO/fecome a member of this particular board or commission?sion? e acovu'{Gt>�'/(If 15 ap
nor ti 1-r it larro,outy *A 6 u ,tv -T) 1E ,
SVCLPS G' r J F7 Y +1 �N�.
Briefly explain what you believe are the three most important issues facing this board or commission, and how do you
believe this board or a2mmi4slon should address each issue? r D
�l Loor<l� Cal ou6frL IfS �S -f� mo,H cat.Ynn l o f fltt Ctr�jGoN fC�ev,'PW Jund NB
Q6 1Agire o t,01 ad at,
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rU�rM,INinict-llcf �lr p 5 Irer,;f.
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a r. s lA) k CRP) C4ill be G le N ,e r
lvd -pent Ir1 ally 11- o f 20 (. ' Air� v 16,
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9) u411 iilt' CAB a-/16 aw f r(' 1� /5 f i os�
c�MD N w, etc! o ,`e t
U&NMV,0 uxue. `fly B RIuJ4 'If - . This w l
Nb1 it ir51 'fly d a g
List any abilities,skills,licenses,certificates,specialized training,or interests you have which are r�.� applicable
--to this board
or commission
rl>� : /� 1 � 4-k hylyav t'I Ud1L�'Q WTT� `f' � l.ala(' 0 b 1�� lrlrl
Uw-bt -f'ar�(4 rs,54 '? uecr5• We hat daali Wrtl, Indh i gk Pahct rt(&VA Qdllit� J-5 U S
IN -i lleri`!m-4 M¢..
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)
Have you attended a meeting of the board or commission you are applying to or talked to anyone currently on the
board? ❑Yes ar No G- n
Comments: 11Zx Is No Grfl?t4 We W f� 11 -
All applicants are strongly encouraged to attend a regularly scheduled meeting of the board or commission for which
they are applying. �Frequent nonattendence may result in termination of the appointment.
Signature., Date: