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HomeMy WebLinkAboutStaff Report 4159 CITY OF PALO ALTO OFFICE OF THE CITY CLERK October 8, 2013 The Honorable City Council Palo Alto, California Boards and Commssions Applications Revisions RECOMMENDED MOTION: Council Member XXXXX moved, seconded by Council Member XXXXXX to recommend the City Council approve the revised Boards and Commissions Applications. EXECUTIVE SUMMARY On April 9, 2013 Staff brought a revised Boards and Commissions Recruitment Program to the Policy and Services Committee. At that time a subcommittee consisting of Council Members Holman and Price was established to review the applications used in recruitment for Boards and Commissions and bring those revisions back to the Committee. DISCUSSION The revised applications are attached. We have also attached the current versions for comparison. Beginning in 2014 we plan to use fully electronic applications, so the format may need to change depending on the program or process we use to make them electronic. Significant changes include:  Information on the front of each application with pertinent information for applicants. o The Storm Drain Oversight Committee is incomplete. We did not have a place to pull the information from and relevant Staff is out of the office until mid- October. We will update this information prior to release  Links are provided in various places on the applications allowing applicants to opt-in for future recruitment notices, review commission relevant documents, and review applicable codes.  Applicants for the Architectural Review Board and the Historic Resources Board are asked to provide samples of work they find to be good examples.  All applications request the applicants indicate their level of familiarity with applicable documents. Our goal is to roll out the new applications, in a fully electronic format, at the beginning of the 2014 when we roll out the new Boards and Commissions Recruitment Program. Page 2 ATTACHMENTS:  ARB 2014 (DOCX)  HRB 2014 (DOCX)  HRC 2014 (DOCX)  LAC 2014 (DOCX)  PAC 2014 (DOCX)  PaRC 2014 (DOCX)  PTC 2014 (DOCX)  SDOC 2014 (DOCX)  UAC 2014 (DOCX)  ARB 2013 (DOC)  HRB 2013 (DOC)  HRC 2013 (DOC)  LAC 2013 (DOC)  PAC 2013 (DOC)  PaRC 2013 (DOC)  PTC 2013 (DOC)  SDOC 2013 (DOC)  UAC 2013 (DOC)  Minutes from 4-9-13 (PDF) Department Head: Donna Grider, City Clerk Application to Serve on the Architectural Review Board Authority of Board: The Architectural Review Board is charged with design review of some new construction, as well as changes and additions to commercial, industrial and multiple-family projects. The Board is responsible for:  Promoting orderly and harmonious development of the City,  Enhancing the desirability of residence or investment in the City,  Encouraging the attainment of the most desirable use of land and improvements,  Enhancing the desirability of living conditions upon the immediate site or in adjacent areas,  Promoting visual environments which are of high aesthetic quality and variety and which, at the same time, are considerate of each other. Please see Palo Alto Municipal Code Sections 2.16 and 2.21, as well as Titles 16 and 18 for more detailed information. The Architectural Review Board is composed of five members who are not Council Members, officers, or employees of the City, at least three of whom shall be architects, landscape architects, building designers or other design professionals. Palo Alto residency is not required. Terms of Members will be for three years. The Architectural Review Board typically meets on the first and third Thursdays of each month at 8:30 am. In addition to regular meetings, Members may be asked to participate on at least one sub-committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 Commissioners or Board Members? Are you available and committed to complete the term applied for? 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? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Architectural Review Board? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 3. List relevant education, training, experience, certificates of training, licenses, or professional registration: 4. Employment Present or Last Employer: Occupation: 5. Describe your involvement in community activities, volunteer and civic organizations: 6. Have you either attended or viewed an on-line a meeting, or read a report from the Architectural Review Board? Yes: Date(s): No: 7. Can you identify a recent topic that came before the Architectural Review Board and describe your view on the subject? 8. What is it about the Architectural Review Board that interests you, and why? 9. 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? 10. What qualities, experience and expertise would you bring to the Architectural Review Board? 11. What are the current issues facing the Architectural Review Board? 12. Are there issues, appropriate to the role of the Architectural Review Board in which you would you like to see the Board have a more active role? 13. What suggestions do you have about how the Architectural Review could explore issues and concepts related to architectural design and context that are educational and not specific application- based? 14. If appointed, what specific goals would you like to see the Architectural Review Board achieve, and why? 15. If applicable, please identify a project or projects that you find to be examples of good architecture, and explain why. You may attach samples, identify project addresses, or provide links. If you attach samples, Staff may request that you bring hard copy print outs to the interviews. 16. Architectural Review Board Members work with the documents listed below. If you have experience with any of these documents, please describe that experience. Experience with these documents is not required for selection. Palo Alto Comprehensive Plan LINK Zoning Code LINK El Camino Real Design Guidelines and Master Plan LINK Urban Design Guide/Plan LINK Area Plans such as the South of Forest Avenue (SOFA) I and II Plans LINK California Environmental Quality Act LINK Permit Streamline Act LINK Density Bonus Law LINK Secretary of the Interior’s Standards LINK 17. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Application to Serve on the Historic Resources Board The Historic Resources Board is responsible for  Reviewing and making recommendations to the Architectural Review Board on proposed exterior changes of commercial and multiple-family buildings on the Historic Building Inventory  Reviewing and making recommendations on exterior changes of significant (Categories 1 and 2) single-family residences on the Historic Building Inventory  Researching and making recommendations to the City Council on proposed additions and on reclassifications of existing buildings on the Inventory; and  Performing other functions as may be delegated from time to time to the Historic Resources Board by the City Council Please see Palo Alto Municipal Code Sections 2.16 and 16.49 for more detailed information. The Historic Resources Board is composed of seven members who are not Council Members, officers, or employees of the City. Members shall have demonstrated interest in and knowledge of history, architecture or historic preservation. One member shall be an owner/occupant of a category 1 or 2 historic structure, three members shall be architects, landscape architects, building designers or other design professionals and at least one member shall possess academic education or practical experience in history or a related field. Terms of Commissioners will be for three years. The Historic Resources Board typically meets on the first and third Wednesdays of each month at 8:00 am. In addition to regular meetings, members may be asked to participate on at least one sub-committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 or Commission Members? Are you available and committed to complete the term applied for? 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 you are applying for? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Historic Resources Board? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 3. List relevant education, training, experience, certificates of training, licenses, or professional registration: 4. Employment Present or Last Employer: Occupation: 5. Describe your involvement in community activities, volunteer and civic organizations: 6. Have you either attended or viewed an on-line a meeting, or read a report from the Historic Resources Board? Yes: Date(s): No: 7. Can you identify a recent topic that came before the Historic Resources Board and describe your view on the subject? 8. What is it about the Historic Resources Board that interests you, and why? 9. What qualities, experience and expertise would you bring to the Historic Resources Board? 10. What are the current issues facing the Historic Resources Board? 11. Are there issues, appropriate to the role of the Historic Resources Board in which you would you like to see the Board have a more active role? 12. If appointed, what specific goals would you like to see the Historic Resources Board achieve, and why? 13. If applicable, please identify a project or projects that you find to be examples of good historic preservation, and explain why. You may attach samples, identify project addresses, or provide links. If you attach samples, Staff may request that you bring hard copy print outs to the interviews. 14. Historic Resources Board Members work with the documents listed below. If you have experience with any of these documents, please describe that experience. Experience with these documents is not required for selection. Palo Alto Comprehensive Plan Land use Element LINK Palo Alto Municipal Code Chapter 16.49 LINK Secretary of the Interiors Standards for Preserving, Rehabilitating, Restoring, and Reconstructing Historic Buildings LINK California Environmental Quality Act, Section 15331 LINK 15. Can you identify recent projects that have come before the Board and describe your perspective and opinion? 16. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Application to Serve on the Human Resources Commission Authority of Commission: • To foster public awareness and understanding of human relations problems by any means of disseminating information including, but not limited to, educational programs and printed and electronic media, • To facilitate resolution of problems or improvement of conditions within the jurisdiction of the commission by encouragement, persuasion and mediation and by pointing out private or public agencies which might provide assistance, • To make such studies which, in the judgment of the commission, might aid in affecting matters within the jurisdiction of the commission, • To recommend local legislation or other action to the Council and to encourage the Council to support or oppose state or federal legislation or regulation relating to matters within the jurisdiction of the commission, • To coordinate programs of the commission with similar programs by private and public agencies and organizations, and • To recommend or oppose legislation other than that of the City, provided that the City Council has not taken an official position with respect to such legislation, and provided further that any communication, whether oral or written, from the commission concerning such legislation clearly indicates that such recommendation or opposition is that of the commission and is not necessarily that of the City Council. Please see Palo Alto Municipal Code Sections 2.16 and 2.22 for more detailed information. The Human Relations Commission is composed of seven members who are not Council Members, officers, or employees of the City, and who are residents of the City of Palo Alto. Terms of Commissioners will be for three years. The Human Relations Commission typically meets on the second Thursday of each month at 7:00 pm. In addition to regular meetings, Commissioners may be asked to participate on at least one sub-committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 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? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Human Relations Commission? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 3. List relevant education, training, experience, certificates of training, licenses, or professional registration: 4. Employment Present or Last Employer: Occupation: 5. Describe your involvement in community activities, volunteer and civic organizations: 6. Have you either attended or viewed an on-line a meeting, or read a report from the Human Relations Commission? Yes: Date(s): No: 7. Can you identify a recent topic that came before the Human Relations Commission and describe your view on the subject? 8. What is it about the Human Relations Commission that interests you? 9. What qualities, experience and expertise would you bring to the Human Relations Commission? 10. Are there issues, appropriate to the role of the Human Relations Commission in which you would you like to see the Commission have a more active role? 11. If appointed, what specific goals would you like to see the Human Relations Commission achieve, and why? 12. Human Relations Commission Members work with the documents listed below. If you have experience with any of these documents, please describe that experience. Experience with these documents is not required for selection. Human Services Needs Assessment LINK Muni Code 9.72 – Mandatory Response Program LINK Community Services Element of the Comprehensive Plan LINK 13. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Application to Serve on the Library Advisory Commission Authority of Library Advisory Commission: To advise the city council on matters relating to the Palo Alto City Library, excluding daily administrative operations. The Library Advisory Commission is responsible for:  Advising the city council on planning and policy matters pertaining to:  The goals of and the services provided by the Palo Alto City Library,  The future delivery of services by the Palo Alto City Library,  The City Manager's recommendations pertaining to the disposition of major gifts of money, personal property and real property to the city to be used for library purposes,  The construction and renovation of capital facilities of the Palo Alto City Library,  Joint action projects with other public or private information entities, including libraries.  Reviewing state legislative proposals that may affect the operation of the Palo Alto City Library.  Reviewing the city manager's proposed budget for capital improvements and operations relating to the Palo Alto City Library, and thereafter forward any comments to one or more of the applicable committees of the city council.  Providing advice upon such other matters as the city council may from time to time assign.  Receive community input concerning the Palo Alto City Library.  Review and comment on fund-raising efforts on behalf of the Palo Alto City Library. The Library Advisory Commission typically meets on the fourth Thursday of each month at 7:00 pm. In addition to regular meetings, Commissioners may be asked to participate on at least one sub-committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 or Commission Members? Are you available and committed to complete the term applied for? 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 you are applying for? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Library Advisory Commission? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 3. List relevant education, training, experience, certificates of training, licenses, or professional registration: 4. Employment Present or Last Employer: Occupation: 5. Describe your involvement in community activities, volunteer and civic organizations: 6. Have you either attended or viewed an on-line a meeting, or read a report from the Library Advisory Commission? Yes: Date(s): No: 7. Can you identify a recent topic that came before the Library Advisory Commission and describe your view on the subject? 8. What is it about the Library Advisory Commission that interests you, and why? 9. What qualities, experience and expertise would you bring to the Library Advisory Commission? 10. How would you see your role as commissioner when recommending policy and working with the Council? 11. What do you see as some of the key challenges in implementing the recommendations of the Commissions 2006 Library Services Model Analysis and Recommendations: LINK 12. Are you aware of programs or approaches to library services that have been used in other communities which you think Palo Alto should explore? 13. Are there issues, appropriate to the role of the Library Advisory Commission in which you would you like to see the Commission have a more active role? 14. If appointed, what specific goals would you like to see the Library Advisory Commission achieve, and why? 15. Library Advisory Commission Members work with the documents listed below. If you have experience with any of these documents, please describe that experience. Experience with these documents is not required for selection. Library Service Model Analysis and Recommendations LINK Library Technology Plan LINK 16. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Application to Serve on the Public Art Commission The duties of the Commission are:  To advise the city in matters pertaining to the quality, quantity, scope, and style of art in public places,  To periodically review, at least once a year, the capital improvement program with the director of arts and culture and such other members of the city staff as may be appropriate for inclusion of works of art in various projects,  To devise methods of selecting and commissioning artists with respect to the design, execution, and placement of art in public places and, pursuant to such methods, to advise the director of arts and culture on the selection and commissioning of artists for such purposes,  To advise the city regarding the amounts to be expended on art in public places,  To advise and assist the director of arts and culture in obtaining financial assistance for art in public places from private, corporate, and governmental sources,  To review plans for the installation of art in public places,  To review the inventory of art in public places and to advise the city in matters pertaining to the maintenance, placement, alteration, sale, transfer, ownership, and acceptance or refusal of donations of, and other mailers pertaining to, art in public places,  To recommend the retention of consultants, consistent with the city's consultant selection procedures, to assist the city in making decisions concerning the art in public places program,  To advise the city on such other matters pertaining to the art in public places program as may be appropriate,  To advise and assist private property owners who desire such advice and assistance regarding the selection and installation of works of art to be located on their property in the public view,  To act as a liaison between local artists and private property owners desiring to install works of art on their private property in public view,  To give recognition to, and to maintain, an inventory of meritorious works of art in the public view, and  To endeavor to preserve works of art in the public view deemed to be meritorious by the public art commission through agreements with the property owner and/or the artist. Please see Palo Alto Municipal Code Sections 2.16, 2.18, and 2.26 for more detailed information. The Public Art Commission is composed of seven members who are not Council Members, officers, or employees of the City and shall be members of the architectural review board or shall be professional visual artists, professional visual arts educators, professional visual arts scholars, or visual arts collectors whose authorities and skills are known and respected in the community and, whenever feasible, who have demonstrated an interest in, and have participated in, the arts program of the city. Palo Alto residency is not required. Terms of Commissioners will be for three years. The Public Art Commission typically meets on the third Thursday of each month at 7:00 pm. In addition to regular meetings, Commissioners may be asked to participate on at least one sub-committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 or Commission Members? Are you available and committed to complete the term applied for? 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 you are applying for? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Public Art Commission? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 3. List relevant education, training, experience, certificates of training, licenses, or professional registration: 4. Employment Present or Last Employer: Occupation: 5. Describe your involvement in community activities, volunteer and civic organizations: 6. Have you either attended or viewed an on-line a meeting, or read a report from the Public Art Commission? Yes: Date(s): No: 7. Can you identify a recent topic that came before the Public Art Commission and describe your view on the subject? 8. What is it about the Public Art Commission that interests you, and why? 9. What qualities, experience and expertise would you bring to the Public Art Commission? 10. 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? 11. What are the current issues facing both the Public Art Commission in Palo Alto and the broader issue of public art programs and installations via local government? 12. Are you aware of Palo Alto’s current inventory/collection of Art in Public Places? Do you have suggestions about how this information could be more broadly distributed? 13. Are there issues, appropriate to the role of the Public Art Commission in which you would you like to see the Commission have a more active role? 14. If appointed, what specific goals would you like to see the Public Art Commission achieve, and why? 15. Can you identify a recent topic that came before the Public Art Commission and describe your view on the subject? 16. Public Art Commission Members work with the document listed below. If you have experience with this document, please describe that experience. Experience with this document is not required for selection. Municipal Arts Plan LINK 17. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Application to Serve on the Parks and Recreation Commission Authority of Commission: The purpose of the Parks and Recreation Commission shall be to advise the City Council on matters relating to the activities of the Parks and Golf Division and the Recreation, Open Space and Sciences Division of the Community Services Department, excluding daily administrative operations. The Commission is responsible for:  Reviewing plans for park and community center renovations and expansions,  Reviewing information from stakeholder and community meetings and working to resolve competing needs from different constituents,  Developing Rules and Regulations that govern the congenial use of park facilities and community centers, and  Creating broad policies on trail connections, field use priorities and conservation of our natural resources, the Parks and Recreation Commission provides advice to the City Council on how the goals and objectives of the City’s Comprehensive Plan can best be implemented and achieved. Please see Palo Alto Municipal Code Sections 2.16 and 2.25 for more detailed information. The Parks and Recreation Commission is composed of seven members who are not Council Members, officers, or employees of the City, and who are residents of the City of Palo Alto. Each member of the Commission shall have a demonstrated interest in parks, open space and recreation matters. Terms of Commissioners will be for three years. The Parks and Recreation Commission typically meets on the fourth Tuesday of each month at 7:00 pm. In addition to regular meetings, Commissioners may be asked to participate on at least one sub-committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 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? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Parks and Recreation Commission? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 3. List relevant education, training, experience, certificates of training, licenses, or professional registration: 4. Employment Present or Last Employer: Occupation: 5. Describe your involvement in community activities, volunteer and civic organizations: 6. Have you either attended or viewed an on-line a meeting, or read a report from the Parks and Recreation Commission? Yes: Date(s): No: 7. Can you identify a recent topic that came before the Parks and Recreation Commission and describe your view on the subject? 8. What is it about the Parks and Recreation Commission that interests you, and why? 9. What qualities, experience and expertise would you bring to the Parks and Recreation Commission? 10. What are the current issues facing the Parks and Recreation Commission? 11. Are there issues, appropriate to the role of the Commission, that you would you like to see the Parks and Recreation Commission have a more active role? 12. If appointed, what specific goals would you like to see the Parks and Recreation Commission achieve, and why? 13. Can you identify a recent topic that came before the Commission and describe your view on the subject? 14. Parks and Recreation Commission Members work with the documents listed below. If you have experience with any of these documents, please describe that experience. Experience with these documents is not required for selection. Palo Alto Comprehensive Plan: Community Services and Facilities Element LINK Natural Resources Element LINK Baylands Master Plan LINK Park Dedication Ordinance (City Charter) LINK Bicycle - Pedestrian Master Plan LINK Youth Master Plan LINK Foothill Park Fire Management Plan LINK Cubberley Community Advisory Committee Report LINK 15. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Application to Serve on the Planning and Transportation Commission The Planning and Transportation Commission is responsible for:  Preparing and making recommendations to the City Council on the City's Comprehensive Plan regarding development, public facilities and transportation in Palo Alto,  Considering and making recommendations to the City Council on zoning map and zoning ordinance changes,  Reviewing and making recommendations to the City Council on subdivisions, on appeals on variances and use permits,  Considering other policies and programs affecting development and land use in Palo Alto for final City Council action,  Reviewing and making recommendations on individual projects such as Planned Community Zones, Open Space development, and those other projects as are directed by the zoning code, staff and City Council. Please see Palo Alto Municipal Code Sections 2.16 and 2.20, and 19.04.10 for more detailed information. The Planning and Transportation Commission is composed of seven Members who are not Council Members, officers, or employees of the City, and who are residents of the City of Palo Alto. Terms of Commissioners will be for four years. The Planning and Transportation Commission typically meets on the second and last Wednesdays of each month at 6:00 pm. In addition to regular meetings, Commissioners may be asked to participate on at least one sub-committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 or Commission Members? Are you available and committed to complete the term applied for? 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 you are applying for? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Planning and Transportation Commission? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 4. List relevant education, training, experience, certificates of training, licenses, or professional registration: 5. Employment Present or Last Employer: Occupation: 6. Describe your involvement in community activities, volunteer and civic organizations: 7. Have you either attended or viewed an on-line a meeting, or read a report from the Planning and Transportation Commission? Yes: Date(s): No: 8. Can you identify a recent topic that came before the Planning and Transportation Commission and describe your view on the subject? 9. What is it about the Planning and Transportation Commission that interests you, and why? 10. What qualities, experience and expertise would you bring to the Planning and Transportation Commission? 11. What are the current issues facing the Planning and Transportation Commission? 12. Are there issues, appropriate to the role of the Planning and Transportation Commission in which you would you like to see the Commission have a more active role? 13. If appointed, what specific goals would you like to see the Planning and Transportation Commission achieve, and why? 13. Can you identify recent projects that have come before the Commission and describe your perspective and opinion? 14. Planning and Transportation Commission Members work with the documents listed below. If you have experience with any of these documents, please describe that experience. Experience with these documents is not required for selection. Palo Alto Comprehensive Plan LINK Zoning Code LINK City Charter LINK California Environmental Quality Act LINK El Camino Real Design Guidelines and Master Plan LINK Downtown Urban Design Guide/Plan LINK South of Forest Avenue Plans I and II LINK Baylands Master Plan LINK 15. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Application to Serve on the Storm Drain Oversight Committee Authority of Storm Drain Oversight Committee: XYZ The Storm Drain Oversight Committee is responsible for  XYZ,  XYZ,  XYZ,  XYZ. Please see Palo Alto Municipal Code Sections 2.XX and 2.XX for more detailed information. The Storm Drain Oversight Committee is composed of five Members who are not Council Members, officers, or employees of the City, and who are residents of, own property in, or employed within the City of Palo Alto. Terms of Members will be for three years. The Storm Drain Oversight Committee meets on an as needed basis. In addition to regular meetings, Members may be asked to participate on at least one sub- committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 or Commission Members? Are you available and committed to complete the term applied for? 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 you are applying for? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Storm Drain Oversight Committee? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 3. List relevant education, training, experience, certificates of training, licenses, or professional registration: 4. Employment Present or Last Employer: Occupation: 5. Describe your involvement in community activities, volunteer and civic organizations: 6. Have you either attended or viewed on-line a meeting, or read a report from the Storm Drain Oversight Committee? Yes: Date(s): No: 7. Can you identify a recent topic that came before the Storm Drain Oversight Committee and describe your view on the subject? 8. What is it about the Storm Drain Oversight Committee that interests you, and why? 9. 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? 10. What are the current issues facing the Storm Drain Oversight Committee? Are there ways the meeting process could be improved? 11. Describe your specific education, training, or experience in the fields of accounting, engineering, municipal infrastructure planning, or water resources, if any. 12. Describe other personal traits that make you well-qualified to serve on this committee. 13. What qualities, experience and expertise would you bring to the Storm Drain Oversight Committee? 14. Are there issues, appropriate to the role of the Storm Drain Oversight Committee in which you would you like to see the Committee have a more active role? 15. If appointed, what specific goals would you like to see the Storm Drain Oversight Committee achieve, and why? 16. Storm Drain Oversight Committee Members work with the documents listed below. If you have experience with any of these documents, please describe that experience. Experience with these documents is not required for selection. City of Palo Alto Annual Budget LINK 2005 Ballot Measure Authorizing Storm Drainage Fees LINK 17. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Application to Serve on the Utilities Advisory Commission Authority of Utilities Advisory Commission: To advise the city council on present and prospective long-range planning and policy and major program and project matters relating to the electric utility, gas utility, water utility, wastewater collection utility, fiber optics utility and recycled water matters, excluding daily operations. The Utilities Advisory Commission is responsible for advising the Council on:  Development of the City utilities and the recycled water resources;  Joint action projects with other public or private entities;  Environmental aspects and attributes City utilities and the recycled water resources;  Water and energy conservation, energy efficiency, and demand side management;  The consistency with adopted and approved plans, policies, and programs of any major utility;  Legislative proposals regarding City utilities and the recycled water resources, to which the city is a party, in which the city has an interest, or by which the city may be affected;  Utility capital improvement programs, operating budgets and related reserves, and rates, and the recycled water program, budget, and rate. Please see Palo Alto Municipal Code Sections 2.16 and 2.23 for more detailed information. The Utilities Advisory Commission is composed of seven members who are not Council Members, officers, or employees of the City, and who are Palo Alto utility customers or the authorized representative of a utility customer. Terms of Commissioners will be for three years. The Utilities Advisory Commission typically meets on the first Wednesday of each month at 7:00 pm. In addition to regular meetings, Commissioners may be asked to participate on at least one sub-committee which could hold additional meetings. Click here to receive email notifications of vacancies CLICK HERE. You are also welcome to contact the City Clerk's Office at 329-2571 or ronna.gonsalves@cityofpaloatlo.org. Completion of the application is a requirement for consideration. 1. Personal Information Name: Address: Phone 1: Phone 2: E-mail: 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 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 you are applying for? Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 2. How did you Learn about the vacancy on the Utilities Advisory Commission? Community Group Email from City Clerk Palo Alto Weekly Daily Post (Will Customize this section based on current advertising strategy) 3. List relevant education, training, experience, certificates of training, licenses, or professional registration: 4. Employment Present or Last Employer: Occupation: 5. Describe your involvement in community activities, volunteer and civic organizations: 6. Have you either attended or viewed on-line a meeting, or read a report from the Utilities Advisory Commission? Yes: Date(s): No: 7. Can you identify a recent topic that came before the Utilities Advisory Commission and describe your view on the subject? 8. What is it about the Utilities Advisory Commission that interests you, and why? 9. What qualities, experience and expertise would you bring to the Utilities Advisory Commission? 10. Are there issues, appropriate to the role of the Utilities Advisory Commission in which you would you like to see the Commission have a more active role? 11. What do you identify as noteworthy accomplishments through the Utilities Advisory Committee Land and the Utilities Department? 12. If appointed, what specific goals would you like to see the Utilities Advisory Commission achieve, and why? 13. Utilities Advisory Commission Members work with the documents listed below. If you have experience with any of these documents, please describe that experience. Experience with these documents is not required for selection. The Utilities Strategic Plan LINK The Long Term Electric Acquisition Plan LINK The Gas Utility Long-term Plan LINK Urban Water Management Plan LINK Ten-Year Electric Energy Efficiency Plan and Ten-Year Natural Gas Energy Efficiency Plan LINK Utilities Quarterly Update for the most recently reported quarter LINK 14. Consent to Publish Personal Information on the City of Palo Alto Website 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. The full code can be read here: LINK Read the code, and check only ONE option below: 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 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: Phone 1: Phone 2: E-mail: Signature: ________________________________________________________ Date: _____________ Bds/Commissions – 702-23 10/2/2013 ARCHITECTURAL REVIEW BOARD 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 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: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant Date: Bds/Commissions – 702-23 10/2/2013 CITY OF PALO ALTO ARCHITECTURAL REVIEW BOARD SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Architectural Review Board (Date: ) 2. How did you Learn about the vacancy on the Architectural Review Board? Rotary Club: Palo Alto Weekly: The Daily Post: Email from City Clerk: AIA: Flyer/Bookmark: Other, Please Specify: 3. Describe your involvement in community activities, volunteer and civic organizations: 4. What is it about the Architectural Review Board that interests you? What qualities, experience and expertise would you bring to the Architectural Review Board? Bds/Commissions – 702-23 10/2/2013 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? 6. What are the current issues facing the Architectural Review Board? 7. If appointed, what specific goals would you like to see the Architectural Review Board achieve? Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law. Bds/Commissions – 702-23 10/2/2013 HISTORIC RESOURCES BOARD 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 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: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? 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. EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant Date: Bds/Commissions – 702-23 10/2/2013 CITY OF PALO ALTO Historic Resources Board SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Historic Resources Board (Date: ) 2. How did you Learn about the vacancy on the Historic Resources Board? Community Group: Palo Alto Weekly: The Daily Post: Email from City Clerk: Library Bulletin Board: Flyer/Bookmark: Other, Please Specify: 3. Check Any That Apply: I own or occupy a category 1 or 2 historic structure, or a structure in a historic neighborhood I am an architect, a landscape architect, a building designer, or other design professional I have an academic education or practical experience in history or a related field 4. Describe your involvement in community activities, volunteer and civic organizations. Bds/Commissions – 702-23 10/2/2013 5. What is it about the Historic Resources Board that interests you? What qualities, experience and expertise would you bring to the Historic Resources Board? 6. 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? 7. What are the current issues facing the Historic Resources Board? 8. If appointed, what specific goals would you like to see the Historic Resources Board achieve? Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law. Bds/Commissions – 702-23 10/2/2013 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 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: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant Date: Bds/Commissions – 702-23 10/2/2013 CITY OF PALO ALTO HUMAN RELATIONS COMMISSION SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Human Relations Commission (Date: ) 2. How did you Learn about the vacancy on the Human Relations Commission? Community Group: Palo Alto Weekly: The Daily Post: Email from City Clerk: Library Bulletin Board: Flyer/Bookmark: Other, Please Specify: 3. Describe your involvement in community activities, volunteer and civic organizations: 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 10/2/2013 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? 6. What are the current issues facing the Human Relations Commission? 7. If appointed, what specific goals would you like to see the Human Relations Commission achieve? Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law. Bds/Commissions – 702-23 10/2/2013 LIBRARY ADVISORY 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 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: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant Date: Bds/Commissions – 702-23 10/2/2013 CITY OF PALO ALTO LIBRARY ADVISORY COMMISSION SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Library Advisory Commission (Date: ) 2. How did you Learn about the vacancy on the Library Advisory Commission? Community Group: Palo Alto Weekly: The Daily Post: Website: _____ (if yes, please identify website) ___________________________________ Email from City Clerk: Library Bulletin Board: Flyer/Bookmark: Other, Please Specify: 3. Describe your involvement in community activities, volunteer and civic organizations: 4. What is it about the Library Advisory Commission that interests you? What qualities, experience and expertise would you bring to the Library Advisory Commission? Bds/Commissions – 702-23 10/2/2013 5. How would you see your role as commissioner when recommending policy and working with the Council? 6. What do you see as some of the key challenges in implementing the recommendations of the Commission’s December 2006 report to Council “Library Services Model Analysis and Recommendations: http://www.cityofpaloalto.org/knowzone/agendas/library.asp 7. If appointed, what specific goals would you like to see the Library Advisory Commission achieve? Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law. Bds/Commissions – 702-23 10/2/2013 PUBLIC ART 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 N/A in those areas that do not apply. All forms must have a digital signature or the applicant must print the application, sign in ink, and deliver to the City Clerks Office. A typed signature or unsigned application will not be accepted. NAME: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant* 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 10/2/2013 CITY OF PALO ALTO PUBLIC ART COMMISSION SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Public Art Commission (Date: ) 2. How did you Learn about the vacancy on the Public Art Commission? Community Group: Palo Alto Weekly: The Daily Post: Website: _____ If Yes, Please Identify: ___________________________________________ Email from City Clerk: Library Bulletin Board: Flyer/Bookmark: Other, Please Specify: 3. Describe your involvement in community activities, volunteer and civic organizations: 4. What is it about the Public Art Commission that interests you? What qualities, experience and expertise would you bring to the Public Art Commission? Bds/Commissions – 702-23 10/2/2013 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? 6. What are the current issues facing the Public Art Commission? 7. What are your feelings about Palo Alto’s current inventory/collection of Art in Public Places? What suggestions would you have for increasing the availability of more Art in Public Places? 8. If appointed, what specific goals would you like to see the Public Art Commission achieve? Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law. Bds/Commissions – 702-23 10/2/2013 PARK AND RECREATION 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 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: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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 at 650-329-2171.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant Date: Bds/Commissions – 702-23 10/2/2013 CITY OF PALO ALTO PARK AND RECREATION COMMISSION SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Park and Recreation Commission (Date: ) 2. How did you Learn about the vacancy on the Park and Recreation Commission? Community Group: Palo Alto Weekly: The Daily Post: Website: _____ If yes, please identify website: _____________________________________ Email from City Clerk: Library Bulletin Board: Flyer/Bookmark: Other, Please Specify: 3. Describe your involvement in community activities, volunteer and civic organizations: 4. What is it about the Park and Recreation Commission that interests you? What qualities, experience and expertise would you bring to the Park and Recreation Commission? Bds/Commissions – 702-23 10/2/2013 5. How would you see your role as commissioner when recommending policy and working with the Council? If it were necessary to change current roles, how would you approach making such changes? 6. What are the current issues facing the Park and Recreation Commission? 7. If appointed, what specific goals would you like to see the Parks and Recreations Commission achieve? Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law. Bds/Commissions – 702-23 10/2/2013 Planning and Transportation 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 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: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant Date: Bds/Commissions – 702-23 10/2/2013 CITY OF PALO ALTO PLANNING AND TRANSPORTATION COMMISSION SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Planning & Transportation Commission (Date: ) 2. How did you Learn about the vacancy on the Planning and Transportation Commission? Rotary Club: Palo Alto Weekly: The Daily Post: Email from City Clerk: AIA: Flyer/Bookmark: Other, Please Specify: 3. Describe your involvement in community activities, volunteer and civic organizations: 4. What is it about the Planning & Transportation Commission that interests you? What qualities, experience and expertise would you bring to the Planning & Transportation Commission? Bds/Commissions – 702-23 10/2/2013 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? 6. What are the current issues facing the Planning & Transportation Commission? 7. If appointed, what specific goals would you like to see the Planning & Transportation Commission achieve? Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law. Bds/Commissions – 702-23 10/2/2013 STORM DRAIN OVERSIGHT COMMITTEE 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 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: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant Date: Bds/Commissions – 702-23 10/2/2013 CITY OF PALO ALTO STORM DRAIN OVERSIGHT COMMITTEE SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Storm Drain Oversight Committee (Date: ) 2. How did you Learn about the vacancy on the Storm Drain Oversight Committee? Community Group: Palo Alto Weekly: The Daily Post: Website: _____ If yes, please identify Website: ____________________________________ Email from City Clerk: Library Bulletin Board: Flyer/Bookmark: Other, Please Specify: 3. Describe your involvement in community activities, volunteer and civic organizations: 4. What is it about the Storm Drain Oversight Committee that interests you? What qualities, experience and expertise would you bring to the Storm Drain Oversight Committee? Bds/Commissions – 702-23 10/2/2013 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? 6. What are the current issues facing the Storm Drain Oversight Committee? 7. Describe your specific education, training or experience in the fields of accounting, engineering, municipal infrastructure planning or water resources, if any. 8. Describe other personal traits that make you well-qualified to serve on this committee. Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law. Bds/Commissions – 702-23 10/2/2013 UTILITIES ADVISORY 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 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. This application is public record and may be posted to the internet in its entirety. NAME: HOME PHONE: Last First WORK PHONE: RESIDENCE ADDRESS: CELL PHONE: Street EMAIL: City State Zip Education: List relevant training and experience, certificates of training, licenses, or professional registration: Bds/Commissions – 702-23 10/2/2013 Yes No  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 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.  Excluding your principal residence, do you own real property in Palo Alto or within two miles of Palo Alto? EMPLOYMENT Present or last employer Name of Company: Occupation: (If retired, indicate former occupation) Signature of Applicant Date: Bds/Commissions – 702-23 10/2/2013 CITY OF PALO ALTO UTILITIES ADVISORY COMMISSION SUPPLEMENTAL QUESTIONNAIRE Please Return to: Office of the City Clerk Name: 250 Hamilton Avenue Palo Alto, CA 94301 Date: 650-329-2571 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? Yes No  Utilities Advisory Commission (Date: ) 2. How did you Learn about the vacancy on the Utilities Advisory Commission? Community Group: Palo Alto Weekly: The Daily Post: Email from City Clerk: Library Bulletin Board: Flyer/Bookmark: Other, Please Specify: 3. Describe your involvement in community activities, volunteer and civic organizations: 4. What is it about the Utilities Advisory Commission that interests you? What qualities, experience and expertise would you bring to the Utilities Advisory Commission? Bds/Commissions – 702-23 10/2/2013 5. How would you see your role as board member when recommending policy and working with the Council? 6. What are the current issues facing the Utilities Advisory Commission? 7. If appointed, what specific goals would you like to see the Utilities Advisory Commission achieve? Bds/Commissions – 702-23 10/2/2013 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 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 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 10/2/2013 CALIFORNIA CODES GOVERNMENT CODE SECTION 6250-6270: http://www.leginfo.ca.gov 6254.21. (a) 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. (b) No person shall knowingly post the home address or telephone number of any elected or appointed official, or of the official's residing spouse or child, on the Internet knowing that person is an elected or appointed official and intending to cause imminent great bodily harm that is likely to occur or threatening to cause imminent great bodily harm to that individual. A violation of this subdivision is a misdemeanor. A violation of this subdivision that leads to the bodily injury of the official, or his or her residing spouse or child, is a misdemeanor or a felony. (c) (1) (A) No person, business, or association shall publicly post or publicly display on the Internet the home address or telephone number of any elected or appointed official if that official has made a written demand of that person, business, or association to not disclose his or her home address or telephone number. (B) A written demand made under this paragraph by a state constitutional officer, a mayor, or a Member of the Legislature, a city council, or a board of supervisors shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (C) A written demand made under this paragraph by an elected official shall be effective for four years, regardless of whether or not the official's term has expired prior to the end of the four-year period. (D) (i) A person, business, or association that receives the written demand of an elected or appointed official pursuant to this paragraph shall remove the official's home address or telephone number from public display on the Internet, including information provided to cellular telephone applications, within 48 hours of delivery of the written demand, and shall continue to ensure that this information is not reposted on the same Internet Web site, subsidiary site, or any other Internet Web site maintained by the recipient of the written demand. (ii) After receiving the elected or appointed official's written demand, the person, business, or association shall not transfer the appointed or elected official's home address or telephone number to any other person, business, or association through any other medium. (iii) Clause (ii) shall not be deemed to prohibit a telephone corporation, as defined in Section 234 of the Public Utilities Code, or its affiliate, from transferring the elected or appointed official's home address or telephone number to any person, business, or association, if the transfer is authorized by federal or state law, regulation, order, or tariff, or necessary in the event of an emergency, or to collect a debt owed by the elected or appointed official to the telephone corporation or its affiliate. (E) For purposes of this paragraph, "publicly post" or "publicly display" means to intentionally communicate or otherwise make available to the general public. (2) An official whose home address or telephone number is made public as a result of a violation of paragraph (1) may bring an action seeking injunctive or declarative relief in any court of competent jurisdiction. If a court finds that a violation has occurred, it may grant injunctive or declarative relief and shall award the official court costs and reasonable attorney's fees. A fine not exceeding one thousand dollars ($1,000) may be imposed for a violation of the court's order for an injunction or declarative relief obtained pursuant to this paragraph. (3) An elected or appointed official may designate in writing the official's employer, a related governmental entity, or any voluntary professional association of similar officials to act, on behalf of that official, as that official's agent with regard to making a written demand pursuant to this section. A written demand made by an agent pursuant to this paragraph shall include a statement describing a threat or fear for the safety of that official or of any person residing at the official's home address. (d) (1) No person, business, or association shall solicit, sell, or trade on the Internet the home address or telephone number of an elected or appointed official with the intent to cause imminent great bodily harm to the official or to any person residing at the official's home address. (2) Notwithstanding any other law, an official whose home address or telephone number is solicited, sold, or traded in violation of paragraph (1) may bring an action in any court of competent jurisdiction. If a jury or court finds that a violation has occurred, it shall award damages to that official in an amount up to a maximum of three times the actual damages but in no case less than four thousand dollars ($4,000). (e) An interactive computer service or access software provider, as defined in Section 230(f) of Title 47 of the United States Code, shall not be liable under this section unless the service or provider intends to abet or cause imminent great bodily harm that is likely to occur or threatens to cause imminent great bodily harm to an elected or appointed official. (f) For purposes of this section, "elected or appointed official" includes, but is not limited to, all of the following: (1) State constitutional officers, 2) Members of the Legislature, (3) Judges and court commissioners, (4) District attorneys, (5) Public defenders, (6) Members of a city council, (7) Members of a board of supervisors, (8) Appointees of the Governor, (9) Appointees of the Legislature, (10) Mayors, (11) City attorneys, (12) Police chiefs and sheriffs, (13) A public safety official, as defined in Section 6254.24, (14) State administrative law judges, (15) Federal judges and federal defenders, (16) Members of the United States Congress and appointees of the President. (g) Nothing in this section is intended to preclude punishment instead under Sections 69, 76, or 422 of the Penal Code, or any other provision of law.