HomeMy WebLinkAboutID-2748CITY OF PALO ALTO OFFICE OF THE CITY CLERK
April 16, 2012
The Honorable City Council
Palo Alto, California
Appointments for Three Positions on the Human Relations
Commission for Three Year Terms Ending March 31, 2015
On Monday, April 16, 2012 the City Council should vote to appoint three terms
ending on March 31, 2015 to the Human Relations Commission. Three
Candidates interviewed on March 22, 2012.
The Candidates are as follows:
Ray Bacchetti
Theresa Chen
Diane Morin
Voting will be by paper ballot. Five votes are required to be appointed. The first
three candidates that receive at least five votes will be appointed.
REPORT PREPARED BY:Ronna Jojola Gonsalves, Deputy City Clerk
ATTACHMENTS:
·Bacchetti Application (PDF)
·Chen Application (PDF)
·Morin Application (PDF)
Department Head:Donna Grider, City Clerk
Updated: 4/11/2012 8:58 AM by Ronna Gonsalves Page 2
... ,~
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rfa1\hlli~')~~ LH1 .e.A Board or Commission applying for: HUMAN RELATIONS '--YIl"r~5'O Ff{Ct
CITY OF PALO ALTO
BOARD AND COMMISSION APPLICATION
12 JAN 21 AM \I: 50
SUBMIT TO: Office of the City Clerk
250 Hamilton Avenue, Palo Alto, CA 94301
(650) 329-2571
Please print or type answers to all questions and place N/A in those areas that do not apply. Be sure
that you fill out the attached supplement and return it with your signed application.
NAME Bacchetti, Ray HOME PHONE 324-7423
WORKPHONE N/A E-MAIL ADDRESSraybac@earthlink.net
RESIDENCE ADDRESS 850 Webster St., #700 Street City Palo Alto State CA
EDUCATION Rutgers University, B.A. in Business Administration, 1956
Rutgers University, Ed.M. in Philosophy of Education, 1959
Zip Code 94301
Stanford University, Ph.D. in Philosophy of Education and Higher Education, 1968
Stanford University, Stanford Executive Program, Graduate School of Business, 1978
List relevant training and experience, certifIcates of training, licenses,. or professional registration
Relevant experience includes service as a board and commission member (palo Alto Unified School District;
Foothill-De Aoza Community College District; Western Association of Schools and Colleges, Senior College
Accrediting Commission) where duties involved frequent controversial public issues and the need for
listening, negotiation, and decision-making. Other relevant experience involved numerous conflict
mediation activities while in the Stanford administration. I have no professional training or certification in
fields relevant to the ORC. (A short resume is attached.)
Are you a Palo Alto resident? Yes
Do you have any relatives or members of your household who are employed by-the City of Palo Alto, who are
currently serving on the City Council, or who are board members or commissioners? No
Are you available and committed to complete the term applied for? Yes
california state law requires appointed board and commission members to fIle a detailed disclosure of their fInancial
interests. Do you have an investment in, or do you serve as an officer or director of, a company doing business in
Palo Alto which you believe is likely 1) to engage in business with the City,2) to provide products or services for
City projects, or 3) be aflilcted by decisions of the board or commission you are applying for? No
Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? No
EMPLOYMENT --1
Present or last employer: Carnegie Foundation for the Advancement of Teaching (2001-20~
Occupation: Scholar in Residence (Now retired) ,
Signature of Applicant: _________ ~ __
,
)
CITY OF PALO ALTO
Human Relations Commission
Supplemental Questionnaire
Please return to:
Office of the City Clerk
250 Hamilton Avenue
Palo Alto, CA 94301
(650) 329-2571
NAME: Ray Bacchetti
DATE: December 28, 2007
Please print or type your answers to the following questions and submit with your completed
application. You may submit additional sheets, if necessary, to complete your answers.
1. Have you attended any of the following meetings?
• Board/Commission Orientation Session No
• Human Relations Commission Yes
Date October 14, 2007
2. How did you learn about the vacancy on the Human Relations Commission?
Community Group X Newspaper Ad Place of Employment __ _
Utility Bill Stuffer City Clerk's Office __
Other (Specify) ___________________ _
3. Describe your involvement in community activities, volunteer and civic organizations.
Having lived in Palo Alto and Stanford for more than 48 years, I have been active in a
variety of ways. Most recently: I am a member of the board of PAGE (palo Altans for
Government Effectiveness), a group advocating increased civic engagement for the
common good; served on the Blue Ribbon Task Force on the Public Safety Building (2006);
served in the Restorative Justice Program of Santa Clara County for several years before it
ended in 2004, and, beginning in 2007, volunteer in the Palo Alto Police Department.
Before that I was elected to the Palo Alto School Board (1978-1983) and the Foothill-De
Anza Board of Trustees (1983-1991). In a long career at Stanford (1960-1993), I was
involved in many ways in the bringing of diversity to the campus, working through
problems of various sorts, and building a sense of community among my administrative
colleagues. In foundation work (1993-2001), one of my goals was to make grant-seekers,
whether successful or not, feel treated with understanding and respect.
4. What is itaboutthe Human Relations Commission that interests you? What
qualities, experience and expertise would you bring to the Human Relations
Commission?
The HRC has one of the more difficult roles in our community. Good human relations and
what flows from them-trust, respect, the ability to disagree without jeopardizing the
possibilities of agreement on other issues at other times-in many ways determines our
potential for making good decisions in other areas and for keeping the community's well
being topmost in our priorities. That sort of challenge interests me very much. I would
bring more experience than expertise from meeting similar challenges in other contexts.
Among the values energizing this application are a civic affection for the common good and
a desire to have individual voices heard toward that end. Argument, disagreement, debate,
and advocacy are important tools when those using them mean to persuade, to teach, to
listen, and to reason with the topic in the foreground and the common good as context. The
right to be rude and disagreeable is inalienable and most likely to be ineffective. In the
short run, the point may be lost; in the long run, our continuing relationships with one
another get battered and our willingness to work together shrivels. I am interested in
working through the HRC to keep problems from festering, make disagreements
productive, and build the sorts of relationships from which good things flow for our
community.
5. How would you see your role as a commissioner when recommending policy and
working with the Council?
The Council-as nine individuals elected to keep Palo Alto civically, socially, and
economically healthy-has several contributing commissions and other bodies to enable it
to carry out its responsibilities with the best information, perspective, and insight possible.
The HRC provides one channel for that advice. I would see my role as a commissioner in
contributing that kind of information, perspective, and insight so that Council decisions
would, whatever the topic, enhance the community's potential for bringing our best selves
to those civic issues we feel strongly about.
6. What are the current issues that the Human Relations Commission will face?
Combining issues I think it will face with those I hope it might face, here is my list:
o Enhancing the contributions of our multiple diversities, i.e., race, religion, economic,
age, gender, sexual orientation, long-timers and new residents, and the like; o Building community and elevating the common good in our civic conversations;
o Assisting in the productivity of consequential debates on topics such as housing,
economic development, preserving valued community qualities, community
cohesion, individual prerogatives, and reconciling needs and aspirations with
resources; o Increasing mutual respect and collaboration between City staff and citizens, with
particular emphasis on public safety;
o Increasing the level of skill and the height of our aspirations for conflict
management and resolution, keeping the long term as well as the short term in our
2
sights;
D Assessing tendencies toward civic dis-engagement and devising countermeasures;
and
D Contributing to the resolution of conflicts that come to the HRC's attention.
7. If appointed, what specific goals would you like to see the Human Relations
Commission achieve?
All of the topics in item #6 are part of my answer to this question. Among them these lie
nearest to my citizen's heart: matters that enhance our understanding of the common good
and our attachment to it, making the City a professionally satisfying place to work, and
engaging more of our citizens in civic and nonprofit efforts to enhance Palo Alto and make
civic imagination a hallmark of our community.
End
3
Ray Bacchetti
850 Webster Street, #700; Palo Alto, CA 94301
Phone: 650-324-7423 Email: raybac@earthlink.net
Prior to retiring in late 2007, Ray served as scholar in residence at the Carnegie Foundation
for the Advancement of Teaching, where he co-directed, with Senior Scholar Tom Ehrlich,
the Foundation's Centennial project. A book based on this project that they co-edited was
published in October 2006: Reconnecting Foundations and Education: Turning Good
Intentions into Educational Capital. His most recent prior position was program officer for
K-12 and higher education at the William and Flora Hewlett Foundation (1993-2001). Prior
to that he was vice president for planning and management at Stanford University, which had
been his primary employer from 1960. He received his bachelor's and master's degrees from
Rutgers University and a Ph.D. in philosophy of education and higher education from
Stanford University in 1968. Other professional experience has included administrative posts
at the City University of New York and Rutgers University and elementary school teaching.
Professional assignments have included membership on the Senior College Commission of
the Western Association of Schools and Colleges (the accrediting association for California
and Hawaii, 1985-92), including a three-year term as chair. He was elected a member of the
board of education of the Palo Alto Unified School District (1978-83) and the board of
trustees of the Foothill-De Anza Community College District (1983-91), serving from time to
time as chair of both boards. He has taught workshops on management in higher education in
Australia, England, New Zealand, Singapore, and the U.S. He has consulted in the Every
Child a Reader and Writer program for the Noyce Foundation from 2001-03 and the Early
College High School program for the Woodrow Wilson National Fellowship Foundation from
2002-2005. He has also consulted for K-12, collegiate institutions, and philanthropic
foundations in the U.S on a variety of topics.
Past and current service on boards of directors includes the Bay Area School Reform
Collaborative, 1998 to 2004, now called Springboard Schools; Grantmakers for Education,
1995-2000; EdSource, 2000 to the 2007; Developmental Studies Center, 2002 to 2010; the
Student Loan Marketing Association (1978-1995); Channing House, 2007 to present, and the
Oregon Shakespeare Festival, 2001 to 2011. He has also served on the national advisory
board of the Stanford Center for the Comparative Study of Race and Ethnicity and the
Alameda County Office of Education Task Force on Charter School Policy. He has
volunteered for the Palo Alto Police Department since 2007. In 2007 he was appointed by the
City Council to the Palo Alto Human Relations Commission and reappointed in 2009 for a
three-year term. In 2008 he was appointed by the Palo Alto Board of Education to the
Citizens' Oversight Committee for the school district's $378 million facilities bond issue and
elected chair of the Committee for 2009. He was named by A venidas and the Palo Alto
Weekly as a 2009 Lifetimes of Achievement honoree. In 2010, he was appointed to the
Infrastructure Blue Ribbon Commission by the City Council and served as its co-chair until it
completed its work in January 2012.
He is married to Carol Bacchetti and they have three children and three grandchildren.
January 2012
C\ TY Of PALO ,t\Ll·O. CA
CIT Y CU:.Rr\'S ®fFICE
\2 JAN 3 \ ~M to! 08
City of Palo Alto
250 Hamilton Avenue
Palo Alto, CA 94301
CONSENT FORM
California Government Code Section 6254.21 states, in part, "No state or local
agency shall post the home address or telephone number of any elected or
apPointed official onthe Internet without first obtaining the written permission of
that individual." The full code is attached. This consent form will not be redacted
and will be attached to the Application and posted to the City's website.
Read the code, and check only ONE option below:
/' I ~ ~"-~,,h~/'!. give permission for the City of Palo Alto to post to the
City's website the attached Board and Commission Application Intact. I have
read and understand my rights under Government Code Section 6254.21. I
may revoke this permission at any time by providing written notice to the
Palo Alto City Clerk.
OR
I request that the City of Palo Alto redact my home
address, phone numbers, and email address from the attached Board and
Commission Application prior to posting to the City's website. I am providing
the following alternate information and request that they use the following
contact information instead.
Address
"ro-3J-'1' 7'(";-73
Phone
rct-'1 bAL @ e..Q r-J/,./.,.)c. J?e-t.
Email
gi?,4"-6 t c> Ck"""'7 ~¢I;Z
Signature* Date I
*The applicant must have a digital signature or print the application, sign in ink,
and deliver to the City Clerks Office. A typed signature or unsigned application
will not be accepted.
Bds/Commissions -702-23 1130/2012
CITY OF PALO ALTO
~lY Of PAb9l"~0'7A Q3fTY CLERh v '" F\&'£
12 fEB -I PH 21 55
BOARD AND COMMISSION INCUMBENT APPLICATION
SUBMIT TO:
Office of the City Clerk
250 Hamilton Avenue, Palo Alto, CA 94301
(650) 329-2571
Incumbents may use this form to declare their intent to apply for another term in office.
BOARD CURRENTLY SERVING ON: --L..H~L{<-!.!m..r..=;fll~n..~R-:.-....='..t1..:..r: .. ~~~' ~ _______ _
NMlli: ___ C~h~e_.~_. ______ -,r.~/ __ te~Y~~~k~ __ _
RESIDENCE
ADDRESS:·
Last First
HOME
WORK
CEll
I am reapplying for the board listed above; please resubmit the most recent application I have on file.
I am reapplying for the board listed above; I will update my application and submit it prior to the deadline.·
I Will NOT reapply for another term at this time.
*Blank applications may be found at www.cityofpaloalto.org
Signature of Applicant d-// I d-tJ/..l-Dme: ________ ~ ________ _
Bds/Commissions -702-23 1/28/2012
City of Palo Alto
250 Hamilton Avenue
Palo Alto, CA 94301
CONSENT FORM
California Government Code Section 6254.21 states, in part, "No state or local
agency shall post the home address or telephone number of any elected or
appointed official on the Internet without first obtaining the written permission of
that individual." The full code is attached. This consent form will not be redacted
and will be attached to the Application and posted to the City's website.
Read the code, and check only ONE option below:
I give pennission for the City of Palo Alto to post to the
City's website the attached Board and Commission Application intact. I have
read and understand my rights under Government Code Section 6254.21. I
may revoke this permission at any time by providing written notice to the Palo
Alto City Clerk.
OR r-
~ I --;her-est!. Ue.ne request that the City of Palo Alto redact my home
address, phone numbers, and email address from the attached Board and
Commission Application prior to posting to the City's website. I am providing
the following alternate information and request that they use the following
contact information instead.
Address
, (6n) 22-1-sY-s-i
Phone
Email
Signature* Date
*The applicant must have a digital Signature or print the application, sign in ink, and
deliver to the City Clerks Office. A typed signature or unsigned application will not
be accepted.
Bds/Commissions -702-23 1/28/2012
CITY OF PALO ALTO
BOARD AND COMMISSION APPLICATION
SUBMIT TO:
Office of the City Clerk
250 Hamilton Avenue, Palo Alto, CA 94301
(650) 329-2571
.-:J
Please print or type answers to all questions and place Nt A in those areas that do not apply. Be sure that you fill out the attached
supplement and return it with your signed application.
NAME: Chen Theresa ~~----------~--~~~---------------HOME PHONE:
Last First
WORK PHONE:
,ffiSIDENCE
ADDRESS: CELL PHONE: .
EMAIL:
Education: Ph.D., University of Rochester, Rochester, New York
M.A., University of Missouri, Columbia, Missouri
B.S., National Taiwan University, Taipei, Taiwan
List relevant training and experience, certificates of training, licenses, or professional registration:
Research Scientist, Stanford Uni versi ty, Palo Alto VA Health Care System (volunteer)
Adjunct faculty, Notre Dame de Namur University, Belmont, CA
Group Leader, Abbott Laboratories, Abbott Park, IL
cientist, Genentech Inc., South San Francisco, CA
• Are you a Palo Alto Resident?
• Do you have any relatives or members of your household who are employed by the City of
Palo Alto, who are currently serving on the City Council, or who are board members or
commissioners?
• Are you available and committed to complete the term appliedfor?
• California state law requires appointed board and commission members to file a detailed
disclosure of their financial interests, Fair Political Practices Commission, Conflict of Interest,
Form 700. Do you have an investment in, or do you serve as an officer or director of, a
company doing business in Palo Alto which you believe is likely to; 1) engage in business
with the City, 2) provide products or services for City projects, or 3) be affected by decisions
of the board or commission you are applying for?
If you answered yes, you may wish to consult with the City Attorney before filing this
appliCatiOn. Please contact the City Attorney's Office at 650-329-2171 to arrange an
appointment.
• Excludingyour principal residence, do you own real property in Palo Alto or within two miles
x
x
of Palo Alto? X
If you answered yes, you may wish to consult with the City Attorney before filing this
application. Please contact the City Attorney's Office at 650-329-2171 to arrange an
appointment.
~MPLOYMENT
Present or last employer
x
x
Biomedical Research Scientist
N arne of Company: Stanford University Occupation: University Faculty
(If retired, indicate former occupation)
Signature of Applicant Date: 0/ tJ-/..J.'V l u
Please Return to:
Office of the City Clerk
250 Hamilton Avenue
Palo Alto, CA 94301
650-329-2571
CITY OF PALO ALTO
HUMAN RELATIONS COMMISSION
.SUPPLEMENTAL QUESTIONNAIRE
Name: Theresa L. Chen
Date: 212110
Please print or type yom answers to the following questions and submit with yom completed application. You may submit
additional sheets, ifnecessary, to complete yom answers.
1. Have you attended the following meeting? Yes
• Human Relations Commission ~are: __________ -J)
2. How did you Learn about the vacancy on the Human Relations Commission?
No
X
Community Group: __ Palo Alto Weekly: Palo Alto Weekly Online: __
Email from City Clerk:.L Library Bulletin Board: Fogster.com: __
Other, Please Specify:
3. Describe your involvement in community activities, volunteer and civic organizations:
I have been actively involving in the Chinese-American community, to serve new immigrants and visiting
scholars. I have done the following:
1. Give numerous health-related seminars at Home of the Christ at Cupertino, A Chinese independent
Evangelical Church for the past 10 years in various fellowship groups.
2. Work as a volunteer researcher at the Palo Alto VA hospital since 1997 to help visiting scholars,
which includes newly arrived students and post-doctoral fellows to accommodate life in the US.
4. What is it about the Human Relations Commission that interests you? What qualitieS, experience and expertise
would you bring to the Human Relations Commission?
As an immigrant myself, I can relate with a broadly diversified population to understand their needs and ways of
living. Not only with Chinese population, I am experienced to handle issues generated from many other ethnic
origins. This experience is derived from my job as a faculty member at the Notre Dame de Namm University
where student population is quire diversified. I believe with my experience, expertise and enthusiasm, I am able
to acComplish my duties at the Human Relations Commission.
--------------------------------~-------------------------------------
-1-
,.
5. How would you see your role as board member when recommending policy and working with the Council? If it were
necessary to change current roles, how would you approach making such changes?
I will do a thorough investigation of each situation and recommend a fair and effective policy. This will be
fccomPliShed after total understandiJig and careful consideration..
I am VeIY flexible and willingto change when situation requires.
6. What are the current issues facing the Human Relations Commission?
I do not know the answer.
7. If appointed, what specific goals would you like to see the Human Relations Commission achieve?
To serve Palo Alto residents effectively with fair and responsible decisions.
-2-
HUMAN RELATIONS COMMISSION
CITY OF PALO ALTO
BOARD AND COMMISSION APPLICATION
SUBMIT TO:
Office of the City Clerk
250 Hamilton Avenue, Palo Alto, CA 94301
(650) 329-2571
Please print or type answers to all questions and place NI A in those areas that do not apply. Be sure that you fill out the
attached supplement and return it with your signed application.
NAME: Morin Diane
RESIDENCE
ADDRESS:
Education:
~L~M~'t-----------------F~~-t------------
HOME PHONE:
PHONE:
PHONE:
EMAIL:
1972: B.A. Pomona College, Claremont California. English & International Relations.·
1975: M.A. Univ. of California, Berkeley. Comparative Literature.
1982: J.D. University of San Francisco
List relevant training and experience, certificates of training, licenses, or professional registration:
1988-1991: District Attorney, Santa Clara County; 2000 to 2009 Training in Mediation (Family &
Community), and Collaborative Law. 2002: Certified as Family Law SpeCialist by State Bar/Calif ..
Born and raised in Italy, French & US citizen. Have empathy and experience in multi-cultural
interactions and am skilled in the use of methods for alternative dispute resolution.
Bds/Commissions -702-23 9/1/2011
• Are you a Palo Alto Resident?
• Do you have any relatives or members of your household who are employed by the City of
Palo Alto, who are currently serving on the City Council, or who are board members or
commissioners?
• Are you available and committed to complete the term applied for?
• California state law requires appointed board and commission members to me a detailed
disclosure of theirfmancial interests, Fair Political Practices Commission, Conflict of
Interest, Form 700. Do you have an investment in, or do you serve as an officer or director
of, a company doing business in Palo Alto which you believe is likely to; 1) engage in
business with the City, 2) provide products or services for City projects, or 3) be affected
by decisions of the board or commission you are applying for?
If you answered yes, you may wish to consult with the City Attorney before filing this
application. Please contact the City Attorney's Office at 650-329-2171.
• Excluding your principal residence, do you own real property in Palo Alto or within two
miles of Palo Alto?
EMPLOYMENT
D
D
D
Presentorlast employer Law Offices of Diane J.N. Morin
Name of Company: Attorney/Mediator Occupation:
(If retired, indicate former occupation)
Signature of Applicant Date: 2/9/2012
Bds/Commissions -702-23 9/1/2011
,
Please Return to:
Office of the City Clerk
250 Hamilton Avenue
Palo Alto, CA 94301
650-329-2571
CITY OF PALO ALTO
HUMAN RELATIONS COMMISSION
SUPPLEMENTAL QUESTIONNAIRE
Name: Diane J.N. Morin
Date: 219/2012
Please Print or type your answers to the following questions and submit with your completed application. You may submit
additional sheets, if necessary, to complete your answers.
1. Have you attended the following meeting?
• Human Relations Commission
No
D
Yes I t/ I (Date: 11/12/09 & twic)
2. How did you Learn about the vacancy on the Human Relations Commission?
Community Group: D Palo Alto Weekly: D The Daily Post: D
Email from City Clerk: 0 Library Bulletin Board: D FlyerlBookmark: 0
Other, Please Specify: I have applied before.
3. Describe your involvement in community activities, volunteer and civic organizations:
~rvU~~~
4. What is it about the Human Relations Commission that interests you? What qualities, experience and expertise
would you bring to the Human Relations Commission?
Bds/Commissions -702-23 9/1/2011
S. How would you see your role as board member when recommending policy and working with the Council? If it
were ne'jSSary to· change current roles, how would you approach making such changes?
~~.
)
6. What are the current issues facing the Human Relations Commission7 k /lM . . ~
7. If appointed, what specific goals would you like to see the Human Relations Commission achieve?
Bds/Commissions -702-23 9/1/2011
Supplemental Sheet to
Appl~cation of Diane J.N. Morin for:
Human Relations Commis~ion of City of Palo Alto
February 9. 2012
3. Describer your involvement in community activities, volunteer and civic
organizations:
I am a member of several court committees relating to my field oflaw Family Law
(including Minor's Counsel; Family Law Executive Committee, ADRpanels in both
San Mateo and Santa Clara Superior Courts and Collaborative Practice panels in San
Mateo and Santa Clara County) These do not impinge directly on Palo Alto, but they
,have helped me networks with some of the people in our community.
I have ~een involved in volunteer activities relating to Leadership Palo Alto in the
past, and have been very involved in activities related to my child's schools. I am a
single par~nt of a 19-* year old daughter, now in college.
I have my own business (a law office) in Palo Alto. I have attended some council
meetings in the past.
4. What is it about the Human Relations Commission that interests you? What
qualities, experience and expertise would you bring to the Human Relations
Commission?
I am interested in the peaceful resolution of conflict between individuals and
groups. I grew up in Rome, Italy, the daughter of a French and U.S. national, and
attended an American school in Rome. I came to the U.S. when I wa~ eighteen years
old for college. Hence I have great empathy for issues involving bi-cu)tural
communication and have always been passionate about multi-lingual and multi
cultural learning. My only daughter speaks Chinese since she began studying the
language in middle school (and she IS now concentrating in journalism & Chinese.)
5. How would you see your rale as board member when recommending policy
and working with the Council? If it were necessary to change current rales,
how would you approach making such changes?
I am a facilitator by training and personality. I would try to build consensus after
seriously examining the issues presented by the Commission so that we could give
the Council information and also present our recommendations persuasively. I am
not clear on the meaning of the second question. I act, however, similarly in most
situations: (1) gather facts; (2) analyze the facts as objectively as I can; (3) come to
a position and attempt to persuasively argue for it while keeping an open ear to the
information I receive from others.
I
6. What are the current issues facing the Human Relations Commission?
The issues I can count, but are not inclusive are: (1) Diversity and intercultUral
. communication; (2) public safety; (3) communication between the Council and city
staff regarding labor negotiations.
7. If appointed, what specific goals would you like to see the Human Relations
Commission achieve:
See above. I will attempt to add a supplemental document to this one, as I do
not have the time to complete it at this time.
City of Palo Alto
250 Hamilton Avenue
Palo Alto, CA 94301
CONSENT FORM
California Government Code Section 6254.21 states, in part, "No state or local
agency shall post the home address or telephone number of any elected or
appointed official on the Internet without first obtaining the written permission of
that individual." The full code is attached. This consent form will not be redacted
and will be attached to the Application and posted to the City's website.
Read the code,'and check only ONE option below:
D I give permission for the City of Palo Alto to post to the
. City's website the attached Board and Commission Application intact. I have
read and understand my rights under Government Code Section 6254.21. I may
revoke this permission at any time by providing written notice to the Palo Alto
City Clerk.
OR 01 Diane J.N. Morin request that the City of Palo Alto redact my home
address, phone numbers, and email address from the attached Board and
Commission Application prior to posting to the City's website. I am providing the
following alternate information and request that they use the following contact
information instead.
Law Offices of Diane J.N. Morin, 2211 Park Blvd., Palo Alto, CA 94306-1533
Address
(650) 473-0822
Phone
d.morin@sbcglobal.net
Email
~ i,lt. ~ 2_19_/20_12 ______ _
Signaturet' . Date
*The applicant must have a digital signature or print the application, sign in ink, and
. deliver to the City Clerks Office. A typed signature or unsigned application will not be
accepted.
Bds/Commissions -702-23 9/1/2011
2211 PARK BLVD., PALO ALTO, CA 94306
T (650) 4730822 F (650) 4730812
Ms. Ronna Gonzalves
Deputy City Clerk
Office of the City Clerk .
~ ~" CITY OF PALO ALTO. CA
DIANE J.N. MORIN CITY CLERK'S OFFICE
ATIORNEY AT L.AW 5.
'CERTlFlED FAMILY L.AW SPECIAUST 12 FEB lOAM 6: .
D.MORIN@SBCGLOBALNET
WWW.DIANEMORfNFAMILYI..AW.COM
February 8,2012
250 Hamilton Avenue, Palo Alto, CA 94301
Re: Application for Library Advisory Commission, City of Palo Alto
Dear Ms. Gonzalves:
I enclose my application for a position on the Human Relations Commission.
Thank you for your kind direction and attention.
Thank you and best regards.
Sincerely yours,
~J/l~
DIANE J.N. MORIN
• AS CERTIFIED BY THE STATE BAR OF CAUFORNIA BOARD OF LEGAL SPECIALIZATION