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HomeMy WebLinkAboutItem 8.4 Human Services Task Force Appoint . e STAFF REPORT CITY COUNCIL e CITY CLERK File #110-30 )( LbOO- 3D DATE: March 20, 2012 TO: Honorable Mayor and City Councilmembers FROM: Joni Pattillo, City Managerc.J~ ~ . SUBJECT: Human Services Task Force Appointments Prepared by: Gaylene Burkett, Administrative Analyst EXECUTIVE SUMMARY: The City Council will consider appointments to the Human Services Task Force to review the Eastern Alameda County 2011 Human Services Needs Assessment Findings Report to identify service gaps and produce a Task Force Report in the format of a Priority List for the City Council's consideration. In addition, the Mayor will appoint two Councilmembers to serve as liaisons to the Task Force. The City Council will also consider authorizing the City Manager to hire a facilitator to assist with the Task Force process and approve a budget change form in the amount of $15,000. e FINANCIAL IMPACT: . The funds for the administration/coordination of the Task Force were not included in the FY 2011-12 budget. Funding for the $15,000 Change Order will come from the General Fund Budgeted Contingent Reserve. RECOMMENDA TION: Staff recommends that the City Council: 1) Approve the Mayor's appointments to the Human Services Task force; 2) Appoint two Councilmembers to serve on the Task Force as liaisons; and 3) Approve the budget change to the Social Services budget in the amount of $15,000 and authorize the City Manager to enter into a contract with a consultant to assist with the process; or provide alternate direction. {!l~f- Reviewed By Assistant City Manager Submitted By Director of Community Development Page 1 of 3 ITEM NO. 8.4- w DESCRIPTION: One of the City Council's adopted 2011-2012 Key Initiatives is to create a Human Services Task Force. On February 7, 2012, the City Council received Staff's recommendation (Attachment 1) regarding: • Duration and Mission of Task Force -Four meetings over a four month period to provide a Task Force Report for City Council's consideration; • The size and makeup of the members of the Task Force - 10-15 members from various representations of the community; • Selection Process -Solicitation of applications through media outlets and direct mailings; and, • Proposed timelines -from February through July, 2012. The City Council directed Staff to solicit applications for the creation of a task force that would review the Eastern Alameda County 2011 Human Services Needs Assessment Findings Report and identify service gaps. The Task Force would produce a Report in the format of a Priority List for the City Council's consideration at a later date. The City received 21 applications (Attachment 2) from various segments of the community and the Mayor is recommending that all 21 of the applicants be appointed to the Task Force. The applicants are listed below: 1. Uma Bird 2. Marilyn Briones 3. Sue Compton 4. Albert Edge 5. Gloria Gregory 6. Lee Jouthas 7. Kimberly Kemp Brown 8. Ann King 9. Rameet Kohli 10. Terry Lacey 11. John Ledahl 12. Janet Lockhart 13. Claudia McCormick 14. Mary McHugh 15.Amy Miller 16. Bidi Millet 17. Don Mutch 18. Mildred Seibel 19. Melissa Sladden 20. Suzanne Wakamoto 21. Michele Wayland A task force of this size can be challenging to facilitate, which is the reason Staff suggested a smaller group, as noted above. For example, the most recent Green Initiatives Task Force consisted of 12 members and that Task Force successfully fulfilled their charge in a reasonable period of time. Therefore, due to the size and scope of the project, Staff recommends hiring a professional facilitator to assist with the process. Staff believes that the services of a professional facilitator would be beneficial as the facilitator would have experience in dealing with a large group dynamic and would be able to make sure that all opinions be heard and captured to accurately reflect the recommendations of the Task Force. A budget change in the Social Services budget in the amount of $15,000 is attached as part of this request (Attachment 3). After the facilitator has been selected, Staff will contact the new Task Force Members with the dates and times of the meetings. It is estimated that there will be four meetings with each meeting lasting approximately two hours. Page 2 of 3 NOTICING REQUIREMENTS/PUBLIC OUTREACH: Advertisements for the Task Force were placed on the City's website, in the Valley Times and through mailings to various faith based organizations, community based service clubs and service organizations and past Dublin 101/Leadership Academy participants. ATTACHMENTS: 1. February 7, 2012 Staff Report w/o attachments. 2. Human Services Task Force Applications (Redacted). 3. Budget Change Human Services Task Force. Page 3 of 3 ~~~~ Off' nU~~~ !ii ~ 111 L~~ - ~ ~~~ DATE TO: FROM February 7, 2012 STAFF REPORT CITY COUNCIL Honorable Mayor and City Councilmembers } w. Joni Pattillo, City Manager ~~..~~~ ~ ~ ~~ ~.,.~~~~ CITY CLERK File #585-40 SUBJECT: Summary of the Eastern Alameda County 2011 Human Services Needs Assessment Findings Report and Establishment of a Human Services Task Force Prepared by Gaylene Burkett, Administrative Analyst EXECUTIVE SUMMARY: The City Council will receive a report on the Eastern Alameda County 2011 Human Services Needs Assessment Findings Report completed by the consulting firm of Resource Development Associates (RDA) that was prepared for the Tri Valley region. Additionally, the City Council will consider creating a Human Services Task Force. FINANCIAL IMPACT: City Staff would facilitate the Task Force. Recommendations to the City Council from the Task Force may result in additional resources that would be brought back to the City Council at a future meeting for consideration. RECOMMENDATION: Staff recommends that the City Council: receive the Staff Report; approve the recommendations for establishing a Human Services Task Force; and direct Staff to solicit applications for the Human Services Task Force or offer alternative direction. ~,~, .~a~~ ~~~ ..e.~~... ~ .~ ~_ _. ~. ~.~. .... Submitted By Reviewed By Director of Community Development Assistant City Manager DESCRIPTION: Over the past year, Staff from the cities of Dublin, Livermore and Pleasanton worked with the consultant, Research Development Associates, on the preparation of the Eastern Alameda County 2011 Human Services Needs Assessment Findings Report (Report). Extensive outreach was done and data was collected from a variety of sources, including data from the 2010 U.S. Census and American Community Survey, which demonstrates demographic and economic trends. Initial Report findings were communicated in several community meetings and a draft of the Report was widely distributed in December 2011 for public comment. The final Report was released in January 2012 (Attachment 1). On pages 74 and 75 of the Report, eight common themes emerged from focus groups, informant interviews and surveys as key concerns related to human service provisions in the Tri-Valley. Those eight areas were: 1. The demand for human services is increasing at the same time that resources to provide services are diminishing; 2. Public transportation limitations present a significant barrier to residents seeking human services; 3. An increase in ethnic diversity and linguistic isolation creates a barrier to accessing services, and organizations are struggling to adjust; 4. There is not enough affordable housing to meet the growing demand; 5. Increased homelessness has amplified the demand for a variety of housing options and services; 6. There are not enough Mental Health and Alcohol and Other Drug Services located in the Tri-Valley; 7. There is insufficient affordable extended care, after school and summer programming in the Tri-Valley to support the social development of children and youth; and 8. There are insufficient workforce development opportunities in the Tri-Valley, particularly for women, seniors, youth and the disabled. The Report goes into much more detail in each of these areas. One of the City Council's adopted 2011-2012 Key Initiatives is to create a Human Services Task Force (Task Force) to evaluate service gaps identified in the Report. Human Services Task Force Formation Over the years, the City has established several task forces, including: a Housing Task Force; a Fallon Sports Park Task Force; aSmoke-free Multifamily Task Force; and a Green Initiatives Task Force. Typically, when the City Council directs Staff to form a Task Force, direction is given in several areas: 1. Identify the goal of the Task Force; 2. Identify the duration and mission of the Task Force; 3. Establish the size and make-up of members of the Task Force; and 4. Establish a timeline for completion of the Task Force. Staff's recommendation for the Human Services Task Force is as follows: Task Force Goal: The goal for the Task Force, as established in the City Council initiative, is to review the Report and identify service gaps. Staff recommends that the Task Force product would be a Task Force Report in the format of a Priority List for the City Council's consideration. Duration and Mission of the Task Force: Staff recommends that there be four meetings of the Task Force, one meeting per month until completion. More meetings may be held, if necessary, to ensure the project is not rushed. Each meeting would last approximately two hours. The dates and times of the meetings would be determined based on the availability of Task Force members. The following is the proposed schedule: Meeting One: Overview of Needs Assessment Report Meeting Two: Overview of City Grant Processes and Finances Meeting Three: Establish draft Priority List of recommendations Meeting Four: Finalize Priority List of recommendations Staff will provide the Task Force with an overview of the Report and of the City's policies, practices and programs currently in place relating to Social Services and City finances. This will establish a baseline from which discussions will continue. In addition, the Task Force will receive information on the City's Community Grant Program and Community Development Block Grant federal guidelines to ensure the Task Force is aware of constraints as well as opportunities in these areas. At the conclusion of the Task Force, a prioritized list of recommendations would be presented to the City Council in the form of a Task Force Report. Size and Make ua of Members of the Task Force: Staff recommends that the size of the Task Force be limited to 10-15 members to ensure sufficient input while allowing adequate management of the overall process. Staff recommends that the make-up of the Task Force include: • Members from the faith based community; • Members from community based service organizations; • Members from service clubs; and • Members that are Dublin residents, including residents that receive, or are familiar with, social services. The final makeup of the Task Force would be determined by the City Council based on an application pool. Selection Process for Task Force: In an effort to seek balanced representation from the community, it is proposed that the interested community members apply for the Task Force by using the attached application (Attachment 2). In order to reach the desired populations, it is recommended that Staff place an advertisement in the local newspaper, mail applications to service organizations and clubs and advertise on the City's website. In addition, Staff would use the list of all past Dublin 101 participants as a recruitment tool. Proposed timelines for the selection and duration of the Task Force: February 7, 2012 -City Council approval of Human Services Task Force structure February 10, 2012 -Newspaper Advertisement /Posting on City Website /mailing to organizations, clubs and past Dublin 101 participants March 2, 2012 -Application deadline March 20, 2012 -City Council appointments to Task Force April -July, 2012 -Task Force convenes NOTICING REQUIREMENTS/PUBLIC OUTREACH: None required. ATTACHMENTS: 1. Final Draft Needs Assessment Report January 2012 2. Task Force Application G~~J ~~~ HUMAN SER1~fCES BASK EQRCE ~IP~~fCATf~N ~ ~ FULL NAME: ~ (. ~~ C.~ l~ ~' \ ~LI~OR~' ~ J ADDRESS: _ , CETY 1N WHICH YOU LIVE TELEPHONE{Daytime, _ {Evening): ,~(~$'V~~ !=MAIL ADDRESS: EXP1AiN Wl-iY YOU WOULD LIKI; TO SERVE DN THIS TASK FORCE: ~S~ L1 ~{,~[,1C. ~~~~ ~n ~~~~t~ Sti}'1~!`[~ ' Cd ~iGJ ~ i 5 f S G(t . t ~ ~.t~v-~ _ V ~~ _jj hrg~ ~ s~ IS ~ ~trf~~`~f ~~r~~. ~j c~~ t~~~~ ~tnt~ is ~ c, +~G~rr`~ c~ ~fl~i~j ~nGi t1 ~~} ~C.~,/3 IY) L~ [U~ jf Q ~.t~ `'I"~Gl~ ~ ~~~.~ ~i(1! CE.~ ~~ ~1r~Y3G2, 1~ ~zl1 ~~ ~~ ~ jf~.~ ~~~c~ ~~n~ ~.~~s~ i( Irr but sCl~rJS ri~~+:~ . i l;~~u~t~ ~~1~z~~a~:r ~~~~~ ~~~~-r'~~~.~, ~ar~a-~~,~~~r~r~ ~~ ~a~~ula.~`r~s f~, ©u~ cc~ . PRIOR PUBLIC SERVICE OR CIVIC ACTIVITY: , ~' C~~z. ~ ~ Ve lf~ ~~~.- ~~r ~ vur` S~'~ ~~ ~'ctrs ~=~ C~~f~ ~~cul ~.~G~~ r ~sic~c~r~ ~ cs vcur ~' D~~l~ ~ ~ [Iv~i~~-~~,~~ L': e~r~ ~ ~~~. I 1 E r~~ t~~ I~1~1~' ~t~fc~ u~ .5~-/c' t~5 cr ~ e~ E~ ~? ~ ~~~~-.7 ~~f ~~~~ ~~~~ 7~-- ~lrlr~~ ~~t~ ~fa~z ~~ ARE YOU A L TO COMMITT TO FOUR OR MORE MONTHLY MEETINGS ~ I~`YES ^ IVO PREFERRED DAY{Sj OF THE WEEK: ~ ~ ~' ~ _ ~ ~ F S f~Lr~ tom. AREYOU ABLETO ATTEND MEET[NGS DUR[NG 6USINESS HOURS: C~YE ^ NO V41 l {£. F"~ PREFERRED TEMES: GI r :~f~ lam - c~,,~ DO YOU WISH TO SERVE ON THE TASK FORCE 1N THE CAPACITY AS A: (check one or more) ^ Faith Based Organization -Warne of church ^ Comr-nunity Based Organization orclu{~-name oforganization or ciub Dublin Resident, and are familiar with human services? Q YES ^ NO ~,~~7~~~vtJ~-~,,,~- ~,~ ;~;z~;,tJ :,~71~:~-~- ^ Non Dublin Resident, and are familiar with human services? ^ YE5 ^ NO What Cit ~~ ~{~' ~~ ~ e~JnJ' Y ~~ Ctil ~~t~ viz OTHER INFORMATION OR COMMENTS: `~ ~~Y} ~fl, [~-~-Z~~~ {~ t~j ~!t~ ~~z~~~ ~~ I in T~isb Jrn ; ~~ aG-~~~ u~-~-iu' n~ ~~ ~ )~ur~t~.~ ~ v~u clL ~~ ass f61~ re(c •~ ~+~ #~IC. ~~~~~~ 4ta~ u~~ L~r'~ LU ~-~-o lfe.~~ r~ur r~~sr`c~C~I~S ~ ~~ ~t. ~~5~ ii v~ i~ ~ SIGNATURE: ~.,~ DATE: ~ i~ ~ ~ ~I ~ f {~`~ ~ J~Gt/~'; ~t2GJ ~e~diine f®r appii~a~i®rr~s is Flrid~~, i1~~rch 2, 2012. ~e~u~~ appiica~i®nl~~~. r~ t~~.~1s~, . '~®: City of Dublin, City Clerk's Office 10D Civic Plaza, Dublin, CA 94-568, Attn: Patricia Parks , ~US~~ av~~ S~,Eu~.~~2.. HUMAN SERVIC~5 TASK F®RCE APP~.ICAT1~~~~_ ~ 2 P~~; ~ ~ ~cvo FULL NAME: ~ /~ C~~t f~~i~t.~ ADDRESS: _ _ „-CITY III WHICH YOU LIVE TELEPHDNE ]:Daytime EMAIL ADDRESS: (EVening}: w~~ r PUBLIC iE~V1Cl= OR C1VIC~ACTIVITY: ~- ARE YDU RBLE TO COMMITTTO FOUR OR MOR~ MONT Y MEETINGS ~YE5 ^ NO '~ ` f~l ~~Y PREFERRED DAY(S) OF TH1; WEEK: /~ ARE YOU ABLE TO ATTEND MEETII~IGS DURING BU51NES5 HOUR5: ~ YES ^ NO PREFERRED TIMES: ~~ " DO YOU WISH TO SERVE ON THE TASK FORCE IN THE CAPACITY AS A: (check one or more) ^ Faith Based Organization - name of church ^ Community Based Organization orclub - name of grganization or club Dublin Resident, and are familiar with human services? YES ^ NO ^ Non Dubiin Resident, and are familiar with human services? ^ YES ^ ND What City OTHER INFORMATION OR COMMENTS: ~. ~ ~ . ,.~~,zr~ ~~ _ =~i"{.~.~r ~ . 5117 NATO ~. ~~ 7 f+- Z` ~~ ~ . ®~~dla~~`~®rr ~p~~~~~~i®~s is ~r~da~, Mare ~, X012, ~e~~rlr~ ~~p6i~~~~®~ '~~. City of Dublin, City Cierk's Office 1{)© Civic Piaza, Dublin, CA 94568, Attn: Patricia Parks 1"XPLAIN WHY YOU WOULD I.1KE TO SERVE ON THIS TASK FORCE; "~~~ HuMa~ s~~v~eES ~-asi< ~o~c~ ~~~~~c~--~ia~ ~~~~ ~a2 1 ~~ 03-0?- 12 P04: Q5 RCVD ~ ~ ,/ ~~r1Tr~,~,~Z~' FULL NAME: ~~~ f 4/~- L`. r ~ ~ :~- ~- 4 ADDRESS: TELEPHONE ~Da~irne} EMAIL ADDRESS: CITY IN WHECf~ YOU LIVE _(Evening}: ~-~-• IN WHY YOU WOULD LiKETO SI~RVE gN THfSTASK FORCE: .~'~dt~r~t f,~ ~.- rr~ .-1~~. ~ /~f.~ ~.~-it-Cr~ 4%~-fry R PUBLICSERViCE OR CIVICA IViIY: Ecru,/ ~ .~ ~- ~-- ~~v ~-~ ARE YOU ABLE TO COMMITf TO FOUR Ofi MORE MONTHLY MEET11~fGS ~i YE5 ^ NO PREFERRED DAY{s} oF.THE WEEK: ~ ~. f ~~~~• ~~5 ARE YOU ABLE TO ATTEND MEETfNGS DURING BUSfNESS HOURS: ,L3s~YES ^ NO PREFEItIiEDTIMES: ~~ r ,S ~~ ~i--Y~~G,r~~ .~r>,~..,4,;~5. S Gi1~. ~ ~i~l~• DO YOU WISH TO SERVE ON THE TASK FORCE IN THE CAPACITY AS A: (check one or more) ^ Faith Based Organixatian ~- name of church ^ Cott~muni#y Based Organiza#ion or club -Warne of organization or club ~ ' ~~] DuEZlin Residenf, and are familiar with hun'ran services? ~ZYES ^ NO ^ Non Dublin Residen#, and are familiar with human serviees~ ^ YES ^ NO VVha# City OTNIwR INFORMATION OR COMMENTS: SIGNATURE: f6~~li-' Oy~n-~~-~J DATE: ~~~ ~~ ~~ ®~adlin~ fir applica~i~~s i~ F~id~~, i~l~rch 2~ ~®~2. ~e~urn app@ic~~i®n ~O: City of Dublin, Ci#y Clerk's Office 1001 Civic Plaza, Dublin, CA 94568, A##n: Patricia Par[cs D3-J?--~ 2Pp3:5~ RCVD TELEPHONE (Dayt[me~ EMAIL ADDRESS: _ Evening): EXPLAIN WHY YOU WOtiLD LIKE TO 5i;RVE DN THIS TASK a ,e.1~~ eb mc~l PRIOR PUBLIC S 15~~ ga.~n,~ HUMAN SERVICES TASK FORCE APPLICATION FULL NAM E: t t 1IL.112~1'~'}-t'~~ ~A~~~~~§ ADDRESS: QTY IN WHICH YOU L1Vt cheS~- r~ DR CHIC AC7hVITY: ~~ o ~ ~u_p-~U~~rs 1~~, ~~,pr.~s'~.u~'t-I-~~ ~.-(sc~t~~ lnC~ust~z.L1 u.~~ s w>~s wc~~.~s~c`~ [~n rh ARE YOU ASL£ TO CO MITT TO FOUR OR MORE MONT Y MEETINGS ~Y£5 ONO PREFERREDDAY(5)OFTI-IEWEEK;~V'~5 Or~1UCZ5 c~0.uS car' o~~~-u~an5 ARE YCiU ABLC TO ATTi;NC3 MEETINGS DURING BU51NE55 HOURS; YES ^ NO PREFERRED TIMES: ~17~.5 ~' ~'~C1U aY YYlV~1 ~ ~ ~IA~Y1 DO YOLI W15H T4 SERVE Dl~ TH£ TASK FORCE IN TH£ CAPACITY AS A: (check one or more) D Faith Based Organization - Warne of church ^ Community Barad Organization or club -name of organization or club Dublin Resident, and are familiar with human services? ©YE5 ^ NO ^ Nan Dublin Resident, and are familiar with human services? ^YE5 ©NO What City OTHER INFORMATION DR COMMI"NTS: SEGNATURE: 'r~~W.._.__aa~~~ DATE: ?~~ a( ~~ Deadline for applications is Friday, March 2, 20.2. Return application t0: City of Dublin, City Clerk's Office 101} Civic Plaza, Dublin, CA 94568, Attn: Patricia Parks E;~-~e.~e t- ~Z.Ytr~ m~ 15~- ~e3~s o~ ~u~k.1~ ~o5~.kt~~ i~S S~s~icst,Coc~c-c~l~~af ~e ~~ ~m ctarr~. ~~' k ~. ui~ ~ v Ott. S ~ ~~ ct~L. ~'--s4 d~.~s n~ ~u6iin _ 1 1 ~ r _. o ~~n k~l-£__. S~ ~~ ~ '~ is ~~~~~~~ J~~ ` ~~~ i~UMAN SERVICES TA5{C FORE APPLICATI~~ ~~A~ 4 ~ 20j2 ~ ~ ~~ ~~ ~~ I~l~E~I.~I~ ~ ~ ~ ~~~~ ~~I~A~I;~~~ ~~~~~~ `~, ~~~ FULL NAME ~L{jf~f}~' C~r2~ ~LLFQ~~ ADDRESS: `CITY IN WHICH YOU LIVE TELEPHONE (Daytime}:. - _ (Evening}: `S EMAIL RDDRESS: EXPLAIN WHY YDU WOULD LIKE TO SERVE ON THIS TASK FORCE: y~ ~~h` [~L ~~c~~1 f ~Cit,sl~;~- ~ ~ !-~u,~-€~r~ -~~E' UEC~c%3 ~~~735 !xr '(7-f-~ %f~~ - t~/dc.c_c t /J t/ ~, Gc:c,:l~c-~c:J~ Sri l~L~~;~ t~ I.~n r-~ -Y~fLG ~r i~ ~d /t ~ SCE'-r.'~ ~~o ~~ nlG~-ys ca t/cr 72. N' ~.t u ~~`F2_ O%~ ~l~~tY'-S ~~t-{r~~l~st ~~~~) ~~{ ~ r r '~ ft 1 ~ ` F` :rte ~%rt` f~~}~-.~ Gci~tl~~s~ C_t%UJ:~~sc~~ ~ .~rz~' `~~F~ ~~ [.. F`!~-C~ ~~. ~ WALL-C:`~H ! 1` -GG ~~k"'..F (.C1 ~ t„l 4 L~Z~ 1fa,1 ~ 1+~~~1 ~~p~e ~ f-{~vr~ .~l~cZS~ ~~ f C-r' s> :ai t-C.' 1~ G"~ l~ ~ •'/~~htV C%~ i~ rf ~ 1 ffC~~~vtJ'~T <._.~ ~~iJ~"~.'~ ~''f> ,cJ ~ ~G.~ L-i r..1 d" Cd f-E-cJlt`/vY~:~ ! :J a /11~ ~`-G'~ ARIOR PUBLIC SERVICE OR GVIC ACTIVITY: ~`~ ~-`~Z'= :~~ f~ ~- ~~'r~r~~ 3 :'-~1-'~ s:/-~vi'~C~' `~ :.~c• ~~'" Td~~~'= ..-, ~ ors=i'if ~ ~~"--t: ~' ~(~oGU~.~r~c~2 .~ I~ •t~s ~s .u .,.. t.~..r r i , ,Cl~~~J 5. f G ~~?~-fie 4sS ~12L~1~,7Z .-~s~- f . ~~l~-t-'L~ G fnr-s . i t-w ~~Z~ !:1 .' C f:,1 ~- -~c~-~~. ~'~• /r,C ~! ~~-~r C~ M;`Jc~,. f ~~.Y' v~ ~i~~f~'7u c^~ l(- G'Y~.'~•F' yr ~fY=-rss7%r..t ~jftrl-nth=:7Y I~;Cu.6~~v'G :a .I d~c•c.:,cr~:,! f-'I~i%:c~'~ ~f'c:Z-77-; r:.r i7;ti: .r ~ u/h'~ a ~ ~ %~C.c1f~SfrrJ z~ N E~tl,~.{tN ~-~Zt_r~7f~.~-c':~j ~~•~,u.t ~72=~ !Yd'dr lg~~ ARE YOU ABLE TO COMMITT TO FOUR OR MORE MONTHLY MEETINGS) ,1~7<YES~!^t_~N~,O _ ~ j.I3T (;`~V2. 1`` F,ciL ~ l f.uG~lJ L'S 4~ ~' t ^ ~ ~%~-r: o J •.1 ~ s ~ e~'iitr t l! E: PREFERRED DAY(S) OF THE WEEK: ~u. ~3 ~ L .~ ` ~ ., _- { .: ~ _. ' - . f G-~I-C-'~ U V ?~Pf ryy~~(„~~~ ef,'.v L~l`4~N C.v G--~ t~:iVJ~ .L~i~ii x`-~-i'C - AREYOU ABLE TO ATTEND MEETINGS DURING BUNESS {OURS: YI=S ^ NO AREFERREDTIMI:Sj[laZ~`I~ !_}z3a~•~ .~ lrJ~`~,+f~.A~~lrti ~'t~-~~'-- '~'~~t-t : ~L~`te,~s"e~/Ptj,t~f~~t=-- ~;`~'~r.{t}- I ~~'3 JF~ ~~/17f i4 (~tU'~f! ~V~Niri%~c-r ~r` fi~~•~ ~~.~`t _Gk'~- DOYOU WISH TO SirRVE ON THE TASK FORCE IN THE CAI~ACITY AS A: (check one or mare} !~ ds~ a t,~ Faith Based Organization -name of church ~~'~-~-c-~ ~nz-rs r7=F~ ~~ ~~ ^ Community Based Organization or club -name of organization or club ^ Dublin Resident, and are familiar with human services? ^ YES ^ NO Non Dublin Resident, and are familiar with human services? ~YE$ ^ NO What City ~~ %~'~M~ ~' OTHER INFORMATION OR COMMENTS: _-~~ ~~-~'`~ ~~'-'~~=l~s~~-f~~r ,~,~~ Yt~ ,g-~•~,`,~X~ ,,f f ~==".,C.S~Cr~~ S •~r/--~C=4:ti"5/:~;.+_!c .r~E-z~ ~~i~'Ltvt ~ ~-'~?'~ C r /~< 7 c v S Tl~t'~:.7-t~IF Y~-y 6'% t.*'c..~ ~z27=-c=--r-- ~~1-`'~ ~• 1?~~'~ f-tr~`~iJ! S ~~ !..! ~ct u L-c U't~'' ~-°l~: r'"" ~~ kf'~€"'~%I~7 ,J ~ iv~ ~~~<fu-3 7'9 r, { F' C~1-r~ v i ~ ~}~~ ,~ZL " :-~. ~/•. /L ti ~2 L~.~ ~2- ~Lrt.VC~4. tL r,Y o If ~ '1 - f~'zc.~fJ~' ~ v~ (a' ~ ~ f SIGNATURE: /' '~' ~-1! BATE: J ~' ~~ 4~r"u~ c,tr~ _ ~ ®e~diine fir a iica~i~~s is Frida March 2 20.2, ~~~urn air I~ca~i®~ ~~ pp Y, pp ~~ - ~~~? ~~~ ~o: City of Dublin, City Cierk's Office 100 Civic Plaza, Dublin, CA 94568, Attn: Patricia Parks ~~~~~~~ ~~ ~f~ HUMAN SERVICES TASK 1=4RCF APPLICATION MAR 4 ~ 2012 ~ ,te . q ~'~ s2 c~-~ ®~ ~u~~g~ ~ c~rv r~~>v~clr~~~ ®~rrrc~ /~y ( FULL NAME: Melissa 5fadden ~li11 r,-.r..,1.~`~~ ADDRE55 _ CITY IN WHfCH YOU LI TELEPHONE (Daytime): ~ (Evening): EMAIL ADDRESS: EXPLAIN WHY YOU WOULD LIKE TO SERVE ON THIS TASK FORCE; I am dedicated to volunteering and serving members of my community in many vrays. Qften my experience is hands on and involves one-on-one activities. 1 would like Ea work on a Task force to assess the services being offered, identify fhe current needs of the community and aid with devgfoping a plan to make sure the needs of our community are aligned with current programs and to improve efficiencies and synergies of Dublin programs where possible. PRIOR PUBLIC SERVICE OR CIVIC ACTIVITY: Please see the attached CV ARE YOU ABLE TO COMMITT TO FOUR OR MORE MONTHLY MEETINGS ®YES ^ NO PREFERRED DAY(S) OF THE WEEK; Tuesday and Saturday ARE YOU ABLE TO ATTEND MEETINGS DURING BUSINESS HOURS: ^YES ONO PREFERRED TIMES: 6:0[7 PM DO YOU WISH TO SERVE ON THE TASK FORCE 1N THE CAPACITY A5 A: (check one or mare) ^ Faith Based Organization - name of church ^ Community Based Organization or club -name of organization or club ® Dublin Resident, and are familiar with human services? ©YES ^ NO ^ Non Dublin Resident, and are familiarwith human services? ^YES ^ NO OTHER INFORMATfON OR COMMENTS: What City SIGNATURE: Melissa 5ladden DATE; March 2, 2012 Deadline for applications is Friday, (March Z, 2012. Return applicati®n . t®: City of Dublin, City Clerk's Offite 1DD Civic Piaza, Dublin, CA 9#568, Attn; Patricia Parks .. ~~~~~~~® MAR 0 Z 201? ~ or« au~~l~ HUMAN SERVICES TASK FORCE APPLiCAT[ON ~~n~~~~elda~so~F~c~ FULL NAME: ~~ ~.~~' ~I{~~~~~i t~~ I/1~:~ {`~ ADDRESS; TELEPHONE {paytirne):, CITY iN Wf-iiCH YOU LIVE {Evening}: ~t ~~~~_.1 _ EMAIL ADDRESS: WHY YpU WOULD L1KE3T0 SERVE ONi T1~115 TASK ARE YOU ABLE TO COMMiTT TO FOUR OR MORE MONTHLY MEETINGS `YES ©NO PREFERRED DAY{S) OF THE WEEK: ~~~ ARE YOU ABLE TO ATTEND MEETINGS DURING BUSINESS HOURS: ©YES NO PREFERRED TIMES: { ~~~ ~ ~'~` DO YOU WESH TO SERVE ON THE TASK FORCE iN THfE CAPAC[TYAS A: {check one o(r~more) .'Faith Based Organization -name of church ~.i.~ ~'~~ ~ ~-'t t~~ © Community Based Organization or clu}J -name 9f organiaation or clul, Dublin Resident, and are familiar with human services?~(ES ©NO ^ Non Dublln Resident, and are familiar with human services? ^ YE5 ©NO What City OTHER 1NFORMA7ION OR COMMENTS: t~ •K.-~1.~ ~ ~Y~-~- ~~fr i~~~~~ ~ ~~~i~ SIGNATURE: l.` ~ DATE: I ~ ~~ Deadline for applications is Friday, March 2, 2012. Return application ~O: City of Dublin, City Clerk's Office 100 Civic Plaza, Dublin, CA 94568, Attn: Patricia Parks PRIOR PUBLIC SERVICE OR CIV1C ACTNiTY: _ ~~~~~~ /~ "' "~h BAR ~ ~ 2012 ~~~ HUMAN SERVICES TASK FORCE APPLiCATlON ~~~ ~~ s cis cF ~~~>L~~~ t ~~ ~A~~~E~~s o>~~~c~ ~t '~ ~` ~~ FULL NAME: ~l L~M'~.r~-- Mt{~ ~-~c~-e ADDRESS: ~ CITY IN WHICH YOU LIVE TELEPHONE (baytime}: (Evening} EMAIL ADDRE55: EXPLAIN WHY YOU WOULD LIKE TO SERVE.ON THIS TASK FORCE: -~ ~~cvve. ~% I1a~~ a-. ~f" ,~ d~ ~t ,~ a ~,G~... '~rt.ft~ G-x f S~ a~.. r.-s ~~eou.~we. ~ vti-c-~,r ~-r~.c. Try - vw ~. b - ~.~.~ fly -~'~5:t~c, ~v A-Ss~S-i" ~~v,.cv,F~ C~.dt c.ow ~ ~t~u.~...-4 ~',,I,c.~ i,~.~-v~'~ lticru.~v~.~ E'~.~~5 awJ- PRIOR PUBLIC SERVICE OR CIVIC RCTIViTY: a ~` ~~ ~~ • ~- ~ ice, U~e-~v~~- ,~ 1 ~# ~ ~ r ?~ ~-~i La.~ t- ~v .,a.~h t~ i ~-~tc~c.~.~~.~" i/ ~~cc~~v~ ~ w~.t.~ur TV lfi~ ~ SPMI vu~ (.ass -- ~a `•r..~, ~,uM,-c•, ~,,~r.€s ARE YOU ABLE TO COMMITT TO FOUR OR MORE MONTHLY MEETINGS ~ YES d NO PREFERRED DAY{S} OF THE WEEK: ~(R~ s 5 ARE YOU ABLE TO ATTEND MEETINGS DURING BUSINESS HOURS; ®YE5 ^ NO U~~ -~'~~~~~ ~`D ~"`~' PREFI=BRED T[MES: cv„~ -- Lt a.~„~ ~ - ~ DO YOU WISH TO SERVE ON THE TASK FORCE IN THE CAPACITY AS A; {check one or more} ^ Faith Based Organization--name of church ® Community Based Organization orclub--name of organization or club ~~t • ~~~ ~S ~u-q ~(~.~'~' ^ Dublin Resident, and are familiar with human services? ^YE5 ^ NO ~ ~~~ ~- Non Dublin Resident, and are familiar with human services? i~YES ©NO What City ~-Iy-~srnla~re-- OTHER 1NFORMATlON OR COMMENTS: _ ~ ~,ua ~- ,~~~^t~ru..rth -Iz~ ft,Ss ~ S '~-u,~G..K. i~~ tR-t-~ rti., ~.vo~,~ ~. r~-ecdGs R~ss-essr~..-~. SIGNATURE: DATE:. -_ ~'~'u'~ ~) ~~ ~ ®eadline for applications is Friday, march 2, 2®~.2. Rettarn application t0: City of Dublin, City Clerk's Office 100 Civic Piaza, Dublin, CA 9~I568, Attn: Patricia Parks ~ HUMAN SERVICES TASK FORCE APPLICATION ~~~~~ ~$~ FED ~ 9 ~~?~~ o -~ ®®~ ~ c~F D~~BP.~C~ ~~~~o~~~" ~~~ ~A~a~~~~~ ~ia~~~~ FULL NAME: Lee louthas ADDRESS: CITY IN WHICH YOU LIVE TELEPHONE (Daytime): (Evening): EMAIL ADDRESS: EXPLA[N WHY YOU WOULD LIKE TO SERVE ON THIS TASK FORCE; [ am the Manager of the Dublin Library. In this most current economic recession, the Dublin Library has seen an increase in the numbers of the homeless, the unemployed, and people with mental health challenges using the Library. Library staff rely on the 211 Referral Service, but many times the type of help needed is not local, and the person has na way to provide for transportation to the other side of the hills or to Livermore. On the other side of the coin, the Library offers services that can be of help to people, and it would be beneficial if other human service organizations in the TriVa[ley were aware of those services. These include programs like the Library's Literacy Project, the Lawyer in the Library free legal advice, free tax assistance, help forjob seekers, and #ree early literacy programs for young children. The Library is often a place of last resort for people struggling with homelessness or other economic deprivation ; as a result, we have a unique perspective that not only helps define the scope of the problem, but can help envision solutions that are strategic and effective. PRIOR PUBLIC SERV]CE OR CIVIC ACTlV[TY: My public service experience is entirely within the realm of public library services. As a Branch Manager and Librarian I have been serving the public interest for over 20 years. My experience as a librarian necessitates understanding how to match people's needs with information that is viable and effective so they can move forward. This includes referral services to legal help, health care information, housing, jobs, education and training. ARE YDU ABLE TO COMMlTTTO FOUR OR MORE MONTHLY MEETINGS X YES ^ NO PREFERRED DAY(S) DF THE WEEK: -Monday or Wednesday ARE YOU ABLE TO ATTEND MEETINGS DURING BUSINESS HOURS: XYES ^ ND PREFERRED TIMES: Mornings DO YDU WISH TO SERVE ON THE TASK FORCE IN THE CAPACITY AS A: (check one or more) ^ Faith Based Organization -name of church ; X Community Based Organization orclub -name of organization or club _Dublin Library ^ Dublin Resident, and are familiar with human services? ^ YES ^ NO ^ Non Dublin Resident, and are familiar with human services? ^ YES ^ NO What City OTHER I~IFDRMATIOIV OR COMMEl~TS: _l would be happy fo serve on this Task Force and bring whaf expertise i can to help structure some solutions that are really workable, in a climate where there is little or no money for addressing our community's human Service needs. SfGRfATURE: ~ ~ DATE: ~- ~ ~l ~~~~~~ ®~~~9il~e ~®~° ~p~l~~a~~®~s ~s ~~~da~, ~ar~~h ~, ~®1~. ~~~~~n ~p~~QC~~6®~ ~®: City of Dublin, City Clerk's Office 100 Civic Plaza, Dublin, CA 94568, Attn: Patricia Parks ~ ur ~U €~~~~~© ~~~ ~~il ~IUllif(A1~ SERVICES IAS(C P~RCE APPL(C,4T'(O~i ~~t~{\ ~~~~~ s~ - ~ F~~B ~ ~ 2QlZ (~LIFpR~~. FULL NAME: ~~ I~I~ ~ %~~~~fU O~TY F*~l~t~tAGE~'~ ~Ff°~'CE ADDRESS: QTY !N WI-lICF[ YOU LfVE TELEPHONE {Daytime}= _{Evening}: _ ~ - EMAIL ADDRESS: - - - - EXPLAIN W Y YOU 1NO~U~LQ~-lKE T©SERIIf; ON TH[S TASK FORCE: '~ ~, ~ ~ .._ ~ ~=-; ~ _ Thy ~~-~- -~~~ . _~-~ ~~L~~.~ ~c.~ . ~.c? ~ .~ PRIOR PUBLIC SERVICE OR C[V!C ACT[VlTY: ARE YOU ABLE; TO COMMlTTTO FOUR OR [MORE MONTHLY MEEffNGS YES ^ NO PREFERRED DAY{S} OFi'[-!E WEEK: ~~ ---~ ARE YOU ABLE TO ATTEND MEET[N6S DUR[NG BUSINESS [OURS: YES ^ NO PREFERRED TIMES: DO YOU WISH TO SER1/E ON THE TASK FORCE 1[V THE CAPACITY AS A: {checfc one or more} ~i~F'aith Based Organization -Warne of church ~ l • ~,~ ft2~i~~~ ^ Community Based Organization or club -name of organization ar club ^ Dublin Resident, and are farr~iliar with human services? ©YES ^ NO ^ Non i~u6[in Resident, and are farni[iar with human services? ^ YES ^ NO Whaf City OTHER INFORMATION OR COMMENTS: / ~ SfGNATURE /.~/ Ui'1~2 ~^ DATE: ~ . ~' ~ ®ead~a[~e ~®~ ~ plications ~s Friday, ~darch 2, 2®12, Return app[ieati®n ~®: City of Dublin, City C[er[c's Office 100 Civic Plaza, Dublin, CA 94565, Attn: Patricia Parks ~~o~ nU~lf ~'~~ ~ `~ ZQ1Z ~, ~ F9UMAi~ S~RV[C~5 TASK FORCE /~PPLiCATIaN ~~d~ ~ ~~ ~~~~ ®~ ~~ a~ ~ I~~~~~rwl~~~ ~~~~~>e ® ~ ~~ FULL NAME: ~A-l~l ~ j ~0 l~~z ~~LIFC~R~~~ ADDRESS CITE 1N WHICH YOU LIVE TELEPHONE {baytimeJ• {Evening~: EMAIL ADDRESS: EXPLAIN WHY YOU WOULD LIKE 70 SERVE ON THIS TASK FORCE: PRIOR PUBLIC SERVICE OR CIVIC ACTIVITY; U-o`vtr ~,. ~1~1•S• ~}ov5.~ 3]~ ~r}t~.e~,-~N~-~~s•} U. S. G, r r nG +,n~-.~I, yDek~.~ Mltl~-~• ~O Z5A1 ~r55i?~.~[VA+ W~a.-~5 ~ 1.-LZ~!!'V__...3~CL.$~ ~ f~~~~~....~ 5,,,,:ln~' IdCJJ,7['4~ ~O[.rR~ i"~d ~nC Sfl~ CC,}fuNh~i . r ARE YOU ABLE 70 COMMlTT70 FOUR OR MORE MONTHLY MEETINGS DYES ^ NO r-• PREFERRED DAY(S) OF 7HE WEEK: rt? 0. ARE YOU ABLE 70 A7TEN/~D MEETINGS DURING BU5INESS HQURS: l~S ^ NO PREFERREb7iME5: >~~~' DO YOU WISH TO SERVE ON 7HE TASK FORCE IN 7HE CAPACITY AS A: {check one ar more) ^ Faith Based Organization --name of eleurch ^ Community Based Organization or club--name of organization or club ^ Dublin Resident, and are familiar with human services? l~ES ©NO ^ Non bublin Resident, anal are familiar with human services? ^ YES ^ NO What City A7HER INFORMATION OR COMMENTS: SIGNATURE: i DATE: ~~2~! f ®eadline for appE~ca~ions is Friday, MareF~ 2, 2~i2. Return applica$~on $®: City of Dublin, City Clerk's Office 1I)D Civic Plaza, Dublin, CA 9~I568, Attn: Patricia Parks -2.x 4r-i 2, c.e ~'a ~, u~-- I`7~n ~ 1r ,, 4' ~ ~u LL. 1 ivt. ~ ~ , ~% ~ ~ff~~ 1~U11~A~ S~RV(CES T.=~S1< ~~F~C~ APP~.1C~~ IaN ~~11 +~ ~ ~=~ `\ ~` ~ ~t~t~.I~ing .f,~'.ti~ FULL NAM1=: - ADDRESS: TELEPHONE (Daytimes - f=MAli_ ADIIRESS: CfTY fN WHICH YOU Vii, Evening}: EXPLAif~i 1tVHY YOU Ir~OULQ LIKE TO SERVE Oi11 THIS TASK FORCE: 1..s the exec~t~tive dia•ecic~t• ~f,a,_"~ri-~r~alleE- crisis set~ccs ter ra~iiz~tit~n I F~oulci l~rin~ bath ser~-ice experie~~ee and local tre.tids to the Task Force. I'd enjo}= tl~e oppoa'tc~i~i~ to lear~7 t7'on~ others as ~~~ell. PRIOR PUBLIC SERVICE C3R CIVIC ACTiZlITY; ~_1~a~fel~~Een i€~ the snciai Ser~ricPS ti~lr3 fi}r ;t7 ~ln~G ~_~,~€•S (~i-c:r?1 nf`tbnsP i~ ~€~,_r Hare ~~vnrkc r3 in llonieless sere°ices, anci I l~a~fe ~'ac~sed o~ ciamestic ~;iolence, sexual assault, and. hoir~elessness ~~iti~ Tri-Valle}~ Hav-en for the fast I5 years. ARE YOU A6LE TO COMMiTT TO FOUR OR MORE MDNTHk.Y MEET1lt1GS DYES ^ NCJ PREFERRED DAYS) OF THE 4'VEEK: T1~1at~t[ag~s, Tt~esda~~s, or ~~i~etinesda~ s ARf= YOLt ABLE TO ATTEf1€D Ml~ETli~65 Dl}RING BUSif~ESS HOURS: DYES ^ NO f'€~EFERRED TIMES: End o~ cfa}~, car the be<~i~~nit~g ~~ft]~L il;~y QO YOU t~tISH TO SERVE ON THE TASIf FORCE IN THE CAPACITY AS A; (chec[c or€e nr mare) ^ Faith Based Organization -name of church l~ Community Based Organization or e3ub ~- name of argan'szation or club Tri-Valle}' Hai=en ^ Dublin Resident, and are familiar t~vitl~ human services? ^ YES ^ NQ ^ Non Dublin Resident, anr~ are familiar vlifih hu€rian services? DYES ^ [~fO 4Nhat City OT}-fER ff~{FORMATION DR t~OMMENTS; ~~f SIGtV~tTURE: Gft.~~g~. ~ DATE: ? ? 31l 3 FEB 2 ~ 2D~~ ~ f~~ ~~l~~r~ ~i~i+ €~~1~l~~~l~'~ ~~~~li ~eac~~i~~ far ~pp~~ca~iar~s is ~~~d~y, ~(at~~~ ~, X012, R~~~~n ;~pp~ic~~i€~~ ~~1: City of Dublin, City Clerk's Office 1D0 Civie Plaza, DubH€~, CA 9568, Attn: Patricia Parks HUMAN S~R1IIC~S TASK FaR~E APP~[CATfa~~~~~~ FULL NAME: _ _ . TY of ~~~~~ ADDRESS: CITY IN I+VHICH YOU LIVE TELEPHONE ~Dayt~meJ: _ iEven€ng~: - EMAfL ADRRESS: 1=XPLAiN WHYYOU WOULD [.fKE TO SERVE ON THIS TASK FORCE: ~c r CQ v by ,L' ~ ~~ ~ ~r ~ ~.c~ ~c.b~ ~? -~ v ~ ~.~` ~ ~J r G `~ ~ ~~ or, PRIOR PU$LiC SERVECE OR CIV[C ACTIVITY: ~~~ ~~t,e C~SS'~ o~u S ~~~ ~~~~~v ~~. ~ 5~c1 ti ___. _.. _._._. v~v Cr ~~ ~ U ?~ ARE YOU A$LE TO COMMfTT TO FOUR OR MORE MONT"HO~LY MEETINGS YES ^ NO ,- PREFERRED DAY(S~ OF THE WEEK: f~/a'i. C,'~ / d -~.~l, ~a o ~ ~~ ARE YOU ABLETO ATTEND MEET[NGS DURING BUS€NE5S HOURS: -YES ^ NO PREFERRED T[MES: - / C76 ~ ~o , 3 ° ~ T~l~[ DO YOU WISH TO SERVE ON THE :TASK FORCE IN THE CAPACITY AS A: check one or morel © Faith Based Organization -name of church ^ Community Based Organization arclub--name oforgattization orcfub Dublin Resident, and are familiar with human services~~YES ^ NO -'_ _~ ^ Nan Dublin Resident, and are familiar with human services? ^ YES ^ NO What City OTHER €NFORMRTfON OR COMMENT5: ~ ~~' 25'~1S ~w ~Q c r a.~~ ~-~ vr~-~-S CUt~ ~-~L~rat..~~- ~ ~ u ~ ~ pia ~~ c~.~o ~ ~J ~~ c ct ~ S ~ ~-~c / V S'.~ i ~ o SfGNATURE: ~`~~ ~ t~`{ ~1~ .DATE: ~ r~ 7 f l ~~ ~~~ ®~adiinrv for appii~a~ior~s is Friday, N'larch 2, 2012. R~~urr~ appii~ati®n '~®: City of Dublin, City Clerk's Office 100 Civic Plaza, Dublin, CA 64568, Attu; Patricia Parks H~M~N S~RI~[~ES ~~IS~ FQR~~ APP~[~A~`IQ{~ ~~~~~'~~~ ~~~ ~ ~ 2012 FULL NAME: ~ ~.._ C~ E.~ ~ ~~, ADDRESS: ~~~~~lal~~~ ®~~~~~ ~~ E ~ rr~ WHICH You LIVE TELEPHONE (Daytime): ~ (Evening}: EMA[LADDRESS; EXPLAIN WHYYDU WOULD LIKE TO SERVE Oly THIS TASK FOf{CE: ..~G ARE YD A8L TO COMMITTTD FOUROR MORE MONTHLY~iNGSYi~YES ^ NO PREFERRED DAY(S) OFTHE MEEK: f~~~~ • ,~,, t1.;~~ ARE YOU ABLETO ATTEND MEETINGS DURING BUSfl1fESS.HOURS: YES ^ t~D PREFERRID TIMES: ~ - ~ DO YDU WISH TO SERVE ON TH>; TASK FORCE IN THE CAPACITY AS A: (cheei< one or more) ^ Faith Based Organization -name of church }~, Community based Organfzatian or cfub--name of organization or erUb ~ ~ ~ ~,-;t~~ ~,,~~~ [ ~~i<~.;.~ © Dublin Ecesident, and are familiar with human services? ^ YES D ItfO ^ Non Dublin Resident, and are familiar with human services? ©YES ^ NO 1+Vhat City OTHER fNFORMATION OR COMMEi~tTS: SIGNATURE: tt__ C~c~ DATE: ~ ~~ ~ ®~adl~~e ~'®~ ~pp~a~a~~®>l~s ~s ~r~da~, f~ar~h Z, ~022p R~~urn appl~c~~i~n ~®: Cify of Dublin, City Clerk's Office 1©0 Civic Plaza, Dublin, CA 9~i,568, Attn: Patricia Parks =~`~~~ ~~~~~ ~fiUM~N SERII[CES ~r~SK ~'~R~E ,~PPL[CA~[~[VFEB ~ ~ 2~~2 ~1i ~~ ~ ~~~~ c ~ U~~, r~ "~-fj ~} ~'~LII`o~~ FULL i~tAME: ~ ~,._~~~~1\. ~6 Y~~ __ ADDRi=SS: - -CITY II\I WHICH YOti LIVE TELEPHONES©aytimei ~ (Eveningy:- EMAiL ADDRESS: EXPLAIN WHYYOU WOULia LIKE TO SERVE ON THIS TASK FORCE; R PU BLIC SI~RVICE OR CI IC A TIViTY: J ARE YOU ABLE TO COMMiTT TO FOUR OR MORE MONTHLY MEETINGS ~ YES ^ NO PREFERRED DAYS} OF THE WEEK: ARE YOU ABLE TO ATTEND MEETINGS DL1RiNG BUSINESS HOURS: ~ YES ^ NO PREFERRED TIMES: DO YOU WISH TO SERVE Oi~! THE TASK FORCE IN THE CAPACiTYAS A: (check one or more) ^ Faith Based Organization -name of church ~ Community Based Organization or club - name of organization or ciub ~~ ~,~~ ^ Dublin Resident, and are familiar with human services? Q YES ^ NO ^ Non Dublin Resident, and are familiar with human services? ^ YE5 ^ NO What City OTHER INFORMATION OR COMMENTS: SIGNATURE. ~~ ~,~/!-•'l PATE: ~ c~•l ~ ~/ ~. ®~adl~i~ ~F~r app~ica~~oriEs ~~ Friday, ~arc~i ~, 2012. ~e~ulrm app~ac~t8an ~®: City of I]ublin, City Cieri:`s Office lOQ Civic Plaza, Dublin, CA 94568, Attn: Patricia Parks ~.~~~~~ .~ o~ ~r,~ ~`~ _~~~ HUMAN SERVICES `BASK FORCE APPLICATION ~~g ~ 3.2412 ~ ®~~ t8 ~~ ~~ f~tx~ ~~~~~~ ~ ~ ~ FULL NAME: ~ 1 t`1`•1 ~ ~•#r~ lr~ f'`r~°-•~ ~ j~2?~t~ i~ _ O ~~~'~°~~~ ~ ADDRESS: CITY IN WI--fICH YOU LIVE TELEPHONE (Daytime}: _ _ (Evening): W EMA[L ADDRE55: EXPLAIN WFfYYOU WOULD LIKE TO SERVE ON THIS TASK FORCE: _ s C~ ~~5~~c~-.__s! ~~J~1tin s~y~ce ~?~? ~ ,_•._Ia~,n__~-~~ ~-~5 ~i-f~~ - -k~----------___.__ _---~-----.~ ~4~ F`~~%{~ ~CI~SE~`~I ~=6:'~`~~wf{_ ~ t~~l~~t~ ~-P'~/`~/!Ct?.~ `-~i?`~i- ~~C~'~~t"~'T'G~.~( PRIOR PUBLIC SERVICE OR CIVIC ACTEVITY: <~€ -fit C,~.~~}.~e~t ~' f. ~ ~C~~~~ I~~~~ ARE YOU ABLE TO COMM[TT TO P=OUR OR MORE MONTHLY MEETINGS ~Y(ES ^ NO PREFERRED DAY(Sj OFTHE WEEK: ~1~~-S~j ~ ~tJ-~G?r~ 1}{'.Z~~" ~~'l'~E~i.t~ C~,~~ Gfv~SC~f. ,"CJ (}~ ARE YOU ABLE TO ATTEND MEETINGS DURING BUSINESS HOURS; ^ YES ,~~ NO PREFERRED TIMES: DO YOU WISH TO SERVE ON THE TASK FORCE [N THE CAP s ~~~- I~ AS A. (check one or more} ^ Faith Based Organization -name of church ^ Community Based Organization or club -name of organization or club ~, Dublin Resident,~and are familiar with human services7] Yr5 ^ VO ^ Non Dublin Resident, and are familiar with human services? ^ YI_S ^ NO What City OTHER INFDRMAT[ON OR COMMENTS: ~~-~~ Gt1 t/1 G'~.1~U~•`~'LLj ~~ F SIGNATURES ~~ , -' r -~ ATE: ~ I _~~'` p ~ ~ ~. F ~ ®ead~~ne for appli~ati~~~ is Friday, Rflarc~ 2, ~0~.~. Rl~t~rn applicat~o~ $~: City of Dtablin, City Clerk's Office 100 Civic Plaza, [)uhlin, CA 94568, Attn: Patricia Parks ~~~~~~~~ NuM~n~ s~~ufe~~ ~~~K ~~~c~ APP~~c,~~~a~ ~Ea ~ ~ X012 FULL NAME: U M A [ ~ ~~~ {oi~ F31.~DLEi~ ~ ~ ~~~~~~ ADDRESS: "ITY iN WHICH YOU LIVE TELf~PHONE (Daytime}. EMAIL ADDRESS: (Evening}: 1=XPLAIN WHYYOi3 WOULD LIKE TO SERVE ON THIS TASK FORCE: r .~ ~. ( m i n~ri ~" -~` ~` ~ t i vrn ~ an t€ u ~ ~a r. ~. ~ ~.arzd® ~ ~.# ' nv®lv~ f ~~, A ~ ~w ~ a eo~~oure~~r . -.. -- - PRIOR PUBLIC SERVICE OfrR~. CIVIC ACTS fVITY; ! r~ T 1 ~r~4.ld(G,!'] ~- j1P~C~P~"~f'~ t~ f~ r L~IITY7 ,,, ~. 1 ~ ~ S~(ki7lit? . ILlf1 C7 t'~9 d/~f f zi'l ~ I R ~ ~f rn QYYt Q1~af _~.f" t Q$ GI TiA ~t ° ~1„t~?G~ E~'~~C~'t~f .,..,. _ ARE YOU ABLE TO COMMIT7" TO FOUR OR MORE MONTHLY ME~i'1NG5 ,~Yi=S ^ Na PREFERRED DAYtS) OFTHE WEF=K; Wl~l~i~S7A ~{(,(~~~ ARE YOE! ABLE TO ATTEND MEETINGS DURING BE~SINE5S HOURS: ^ YES ~' NO PREFERRED TIMES: ~: OD -, ~(: pp m DO YOU WISH TO SERVE ON THE TASK FORCE 1N THE CAPACITY AS A: (check one or more) ^ Faith Based Organization ~- Warne of church © Community Based.Organizatian or club-name of organization or club ^ Dublin Resident, and are familiar with human services? i~YE$ ^ NC3 ^ Non Dublin Resident, and are familiar with human services? ^ YES ^ NO What City OTHER INFORMATION OR COMMENTS: SIGNATURE:~~„~ _~DATE: ~. "~1"021'~laZ ®~adl'sn~ fir app[i~at6®lr~s ~~ Fraday, ~alr~h 2, 2Q12. R~tulrn appl~~ati~n ~A: Gty of Dublin, City Cler[c's Office 1(~© Civic Plaza, Dublin, CA 94565, Attn: Patricia Parks i`L "` ~'~'13 j~ ~~~ ~~(I~A1V SERIf[CES TASK E~RCE APP~1C,~~'(~11! a~~ ~ ~'~ sz - ~,~, ~ FU FE NAME:- T G:'~GL-!''I ~ ~ ~~e /-f i,C Ut f.~ ADDRESS: TELEPHONE {baytime}: EMA{L~ADDRESS: i=k_PLA1~E1~! Y YOU WORLD L[KE TO SERVE ~~~~~~ 1=P~ 2 3.2012 ~h~f ®~r i~€f~L~N~N ~ i~?AllAG1;~'~ ~~~~~ ~iTY iN WHICi-I YOU L{Vi~ r _ (Evening}~~ THIS TASK FC3RCi=;. . .. ~~~~ ~-~.~ r f(~R.PUS Llc sERVieE oR C]VIC A`C/TivITY: ~ ~ /~ `~ "cJ ~ rc-c- ~ - ci'L/ ~ .~5.~,,r~ • _ ~~~~~C/ ~l 7 /~ ~ / j (~ /~ AREYOU ABLE TO COMMlTT'TO FOUR OR MORE MONTHLY MEETINGS ^'YE5 ^ NO PREFERRED DAYS} OF THE WEEK: / ARE YOU ABLE TO ATTEND MEETINGS DURING BUSINESS HOURS: C~'ES p NO PREFERRED TIMES: ~ Q~ ~~ j ~ ~ .~ DO YOU WISH TO SERVE OIU TE-€E :CASK FORCE ]N THE CAPACETY AS R: (check one or more) ^ Faith Based Organization - name of church ^ Community Based Organization or dub - name of organization or club ' Q Dublin Resident, and are farniiiar v~rith human services? ©"YES ^ NO ^ Nora Dublin Resident, and are familiar v~+ith human services? ^ YES ^ NO What City OTHER INFORMATION OR COMMENTS; SIGNATURE: ,l/~"~/ =~1/,~ ~1 ~~~/' . ~ DATE: :a2 -2~ /,~-r . L ~ - ~ ~~~d[~n~ ~~Ir appli~a~e~l~~ is Friday, ~~rc~ ~, ~~~~e ~~~ur~ ~pp~~~a~~®~ ~®: City of Dubin, City Clerk's Office x.00 Civic Plaza, Dublin, CA 94568, Attn: Patricia Parks ~~~~~~~~ ~~ ~~~ HUMAN S~RVICE~ TASK P~RCE APPLICAl"ION ~~~ ~ ~.20fZ ~~~ ~~ ~~~~I~ ADDRESS: _ _C[TY IN WHICH YOU LIVE TELEPHONE {baytime), _ {Evening}: , EMAIL ADDRESS: EXPLAIN WHY YOU WOULD L[KE TO SERVE ON THIS TASK l=ORCE PRIOR PUBLIC SERVICE OR CIVIC ACTIVITY: C~ c f~ ~ ~ ~ ~~ ARE YOU ABLE TO COMM[TT TO FOUR OR MORE MONTHLY MEET[IGS YES ^ NO PREFERRED DAY{5} OF THE WEEK: ~[.C.F~`i~~' j~r~r_~~~,4~ - ARE YOU AISLE TO ATTEIVD MEETINGS DURING BUSINESS HOURS: YES ^ NO PREFERREDTIMES:~--~ ,e~. ~ _ I' .._ .. ,... DO YOU WISH TO SERVE ON THE TASK FORCE [IV THE CAPACITY AS`A: {cheek one or mare) ~-Faith Based Organization - name of chart ) ~ ~ ~2 ~ -~~~~~~~ ~ ~c1~ ^ Community Based Organization or club -name of organization or club. ^ Dublin Resident, and are fami[iar with human services? ,~7 YES ^ lV0 ^ [Von I?ublin Resident, and are familiar with human services? ^ YES ^ 1~0 What City OTHER INFORMATION OR COMMI=N S; / /~'~. t/~ tsvU Y(c~r~ 51GNATURE: ~~_rC.t ~ ~ DATE: ~ ~O /~ ®ead~6ne f®lt` applicati®ns is Friday, iViarch 2, 212. Retl~rl~ appl~~a~i®n ~®: City of bublin, Gity Clerk's Office 100 Civic Plaza, Dublin, CA 94568, Attn: Patricia Parks i ~~~~~® ~~~~~ ~~R~f~C~S T1~5~~ ~~~~E ~.~~L~~~TiE~~ ~'~B ~ x.2012 ~~~ ~A~~G~R~~ ~t?ta~etm FLiLL ~~I~E: ~~ ~ ~'~._ l ADDRESS: TELEPFfOf~E (Daytime} EMAIL ADD)~E55: CITY tN tfidFttCt-f YD[,! LIVE tE'vening}: _ EXF'l~lfV 1~l~tY YDI~ VIlOULE3 Ltf<E TO SERVE DN Tf-ftS TASK FC1f~Cf=: ~~ r ~u~ ~~~ i r~ ~ ~~~ s r~r~d/ QI~iiD~i ~ V OL~Ir .3LF1l~Il.L ~R C.t'S f~ ~L ~ ~~~-1 Tt. '~ ~~ ARE YDU ABLE TD Ct]6~Ptt~tTl` TO FDLtR OR M®RE tVtONTHLY MEEftP~tGS ~ YES ^ tad t'REFERRt=t] bAY[5} QF TFtE MEEK: .~~ ._ ASE You ABLE TO ~rt`t=t~t~ ~EE~f~!~s ~u~ttti~ susf~i=ss t ~Dt~~s: ~ DES fl t~© PREFERREDTtfViES: o~ft~i~G_s ®r~ ~~~'~`~ ~fl~Rrs , DD YDE1 ~ftSE~t TD SERVE DfV Tf~E 'ASK FORCE tPd TFfE CAPACITY AS A: tcf'teck one ar morel ~1 Faith Based E?rgantzation -name of church ~ Cczrs~cr~c~nity Based Organize#ion or club- name oforganiaation or club ,~~~aGt~~ ~'~+~~ ~ ~ rev ~'~~/~~J1~/ D C~€~f~fin Resielent, and ere tas~ifiar ~tth hcrrnan services? ©YE5 ^ d~Q ^ tdon Dublin I;esident, and are familiar v~sith human services? ^ 1't=S ©ND t~tlftat CtEy QTHER tNFORtl~ATfDN DR COtiltMl=NTS: SIGNATURE: DATE: ~~~ ~°/ / 2- ,,-, . ,.. ®~ City of Q~ahtin, City Cfert; s Dfifice 1D©Civic Plaza, Dublin, CA 9568, Attn: Patricia Parks ~~~~~~~ ~~.~o~brr~~~ HUMAN SERVICES ~ASI< FORCE APPLICATION ~ p _ ~~ CFTY' :~~AE~A~E~`~: CFF~C~ ~~~ ~~ - l~ `.(~..~--~~ FULL NAME: '~J ®~ t~ _ ~ ~ ~~~~ I ADDRESS: TELEPHONE (Daytime:. EMAIL ADDRESS: CITY iN WHICH YOU LIVE {Evening}: EXPLAIN WHY YOU WOULD LIKE ~'O SERVE ON THiS T ~~~, ARE You ABLE To PREFERRED DAYS} OF THE WEEK: © Faith Based Drganization -Dame ofi church ^ Community Based Organization or club -name of organiz_a/tion ar club _ ^ Dublin Resident, and are familiar with human services? ®YES ^ NO ^ Non Dublin Resident, and are fiamiliar with human services? ^ YE5 ^ NO What City OTHER INFORMATION OR COMMENTS: SIGNATURE: ~- DATE: ~ ~~ ®eadl~ne ~®~ ~ppl~ca~i®n~ is ~r~day, arch ~, ~®12. ~e~u~~ ~ppli~~ti®I~ ~®: City of Dublin, City Clerk's Office J.UO Civic Plaza, Dublin, CA 94568, Attn: Patricia Parks MiTTTO FOUR ARE YOU ABLE TO ATTEND MEETfNGS DURING~BU5iNE5S HOURS: Ll YES ^ NO PREFERRED TIMES: ~(~~ e 11r~ S DO YOU W15H TO SERVE ON THE TASK FORCE iN THE CAPACITY AS A: (check one or mare) CITY OF DUBLIN BUDGET CHANGE FORM FISCAL YEAR 2011/2012 CHANGE FORM # New Appropriations (City Council Approval Required) From Un-Appropriated Reserves From New Revenues Budget Transfers: X From Budgeted Contingent Reserve (Approval Reqd) Within Same Department Activity Between Departments (City Council Approval Reqd) Other: DECREASE BUDGET ACCOUNT AMOUNT INCREASE BUDGET ACCOUNT AMOUNT Name: EXPENDITURE :General Name: EXPENDITURE: General Fund -Budgeted Contingent Fund -Social Services Department Reserve ($15,000) -Contract Services General $ 15,000 GL Account #: 1001.1901.81101 GL Account #: 1001.5501.64001 REASON FOR BUDGET CHANGE ENTRY: Included on the City Council agenda for March 20, 2012, is the appointment of a Human Services Task Force. As presented the coordination and administrative support to the Task Force will require contract services which were not included in the adopted Fiscal Year 2011/2012 City Budget. In order to fund these services, a Transfer is proposed from the Budgeted Contingent Reserve to the Social Services Activity. Transfers from the contingent reserve of this type require City Council approval. As Presented at the City Council Meeting on: Date: 3/20/2012 #################(Finance Use Only)################### Posted By: Date: City Council Minutes Excerpt Attached Reviewed By: G:IBudget Changesl4_2011_12126_3_20_12_Human_Svcs_Task_Force.doc ATTACHMENT 3