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<br />( <br />\\J~ <br />~~'\ j <br />\1 <br /> <br />C...m <br />...........-. <br />umumu <br /> <br />Application for Appointment to <br /> <br />Citizen Advisory Boards and Commissions <br /> <br />Wfnllll1~ <br /> <br />Trll <br /> <br />1_ <br /> <br />Name of Board, CommissionJ or Committee <br />Please print or ~vpe <br />Name Kenneth John Ncubeck <br /> <br />Human Rights Commission <br /> <br />Home Address 4915 W Hillside Drive, Eugene 97405 <br /> <br />Home Telephone <br /> <br />302-0183 <br /> <br />Daytime TdephOIH.~ 302-0183 <br /> <br />Do you reside within the city limits? X Yes <br /> <br />DNo <br /> <br />If yes, how long? 2 years <br /> <br />City Council Ward Ward 2. <br /> <br />Neighborhood Organization Southea<>t Neighbors <br /> <br />Occupation/Place of Employment Retired Professor of Sociology, University of Connecticut <br /> <br />Business Address N/ A <br />Fax number (if applicable)_ <br /> <br />Bmail (if applicable) kneubeck@corncast.net <br /> <br />How did you kam of this vacancy? <br />Vveb page <br /> <br />U Newspaper <br /> <br />o Word of Mouth <br /> <br />o Mail <br /> <br />u <br /> <br />Other source: Karen Hyatt, Human Rights Commission Stan' <br /> <br />NOTE- Information consisting C!f home addresses and phone numbers may be exempt from disclosure <br />per ORS 192.502(3). <br /> <br />OPTIONAllNFORMA TION <br /> <br />The Eugene Ci~y Council supports diversity and seeks to appoint persons who represent the diversit.yof <br />the communi~y, Byproviding the iliformaiioll belmf.', you can help the City Council to know ~lthe <br />appointments match the diversi(v (~f the community, Applicants are considered without regard to race, <br />sex, color, national origin, age, religion, marital SiatllS, medical condition, or disabili(v_ In some <br />instances, however, appointment to certain boanl.../commissirms may be ba>;ed upon the need to fill <br />specific positions on the board/commission. <br /> <br />X Male Of<'emaie <br /> <br />o 18 and under <br /> <br />o 19-25 <br /> <br />026-35 <br /> <br />a 36-45 <br /> <br />a 46-55 <br /> <br />X 56..65 <br /> <br />066+ <br /> <br />o African American <br /> <br />U American Indian! Alaskan Naji\"e <br /> <br />o Asian/Pacific: Islander <br /> <br />o Hispamc <br /> <br />Q Middle [~stem <br /> <br />X White/European American <br /> <br />U Mnltimda! <br /> <br />C: l)()('!f~,n':l KEN UKALg.! TEMP 2005 BLCapplicolijond,.c <br />