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Home My WebLink AboutJ2 apps Alcohol Board Date CITY OF BOZEMAN, MONTANA APPLICATION FOR COMMUNITY ALCOHOL COALITION Name Physical Address__a a,')5 G - LA rv,c R. Mailing Address (if different from physical address) E-mail Address 6(a C,,�� w�o.2� c�r�y_. ��-L-L _._. Home Phone $�S C _ Work Phone q_cl-1a), Length of time residing in Bozeman area (e 4f lz Occupation �i L l L.1�i r-- F Employer_!Y1 +J?.. Have you ever served on a City or County board? .m_�j al If yes, where, what and how long? Check the position(s)for which you would qualify- 0 Bar or Tavern Owner/Manager ❑Restaurant Owner/Manager ❑Alcohol Distributor ❑ Tavern Industry Association ❑ Off-site Retail Sales ❑Hotel/Motel management(with alcohol on-site) ❑ Bozeman Police Department ❑ Gallatin County Sheriff's Office ❑ Montana Highway Patrol MSU Police ❑ Prevention Specialist ❑MSU-Bozeman student with interest in health prevention ❑MSU-Bozeman faculty/staff ❑ BHS student ❑ School District No. 7 Representative, not involved in prevention issues but involved in policy-making ❑ Emergency Room Physician ❑ Local Business Person not in hospitality industry ❑ Neighborhood Association Representative [Interested citizen What are your relevant qualifications, interests and experiences? i Lu is �• vy� nJ^1 ,2.��a.�b Ic, JT _ r -T e 2 a ,q F L,J-.L- "A a _i:�,1L C.a-7�,rJ cti ] "4, A G ..^a_—C� �: I•_`�_` i ti.. „tf �CLI-A 6. U<SACC-_� T 1T Mq fa+..� ,2 i H, iI yiL 6� ra � � P) LCAT, J Ll LjyJ References (Individual or Organization) LL) (L rJc 5-;L4i�,2 �� eJ ��c J;u�� ..� Phone_..-.. `d`/r( - -��- 3(� 2- (1 H it i S 7 1 rA j /Lj lbi�s 7,C/L Phone 3. ____... Phone The above information is true and correct to the best of my knowledge and I recognize that the information contained above is a matter of public record. < (Signature) • 0 Check if you want this application to be considered for openings during the year. Please return this application to the Clerk of the Commission, City Hall, 411 East Main Street 08/03 CITY OF BOZEMAN,MONTANA APPLICATION FOR BOARDS AND COMMISSIONS Date: Jun 9,2000 Name: Donna V.LaRue Physical Address: 2275 East Cameron Bride Road,Bozeman,M'I'59718 Mailing Address (if different): E-mail Address: dlarue ,montana.edu Homc Phone: Work Phone: -4 a Q_g q g_ Cry I o Length of time residing in Bozeman area: 45 years Occupation: Assistant Police Chief Employer: Montana State University Police Dept. Have you ever served on a City or County board? Yes Are you currently serving on a Board? Yes If yes,where,what board,and how long? Community Alcohol Coalition- current member Gmmunjl �I cd ho( C4 /,`j,,a Please select the position for which you would qualify. MSU Police What are your relevant qualifications,interests and experiences? Law enforcement officer for 18 years,experience interacting with college students,knowledge of students interests and their experiences with alcohol. References (Individual or Organization): Courtney Stryker,Dean of Students([!))MSU Phone: Nj _ q Q.t-f- Robert Putzke,Chief of Police @ MSU Phone: 4 7(a - ci L4_ Phone: Please subrmt electronically or print cmnpleted form and return to: Deputy City Clerk PO Box 1230 Signature: y Bozeman,Montana 59771-1230 ,,_`J Q CITY OF 130 Z IMAN, NIONTANA APPLICATION FOR 13OARDS AND COMMISSIONS Date: Name: lenria Caplette. Physical Address: 415 Last.Aspern, Bozeman Mailing Address (if different): F,-mail.Address: jcnnac(a,)irrrt.net Flome Phone: (406) 586-5286 Work Phone: (406) 585-1492 Length of time residing in l3ozeman area: 30 years (.)ccupatic>n: DUI"Task Force, free la.ncc writer, marketing 0 F rriployer: Gallatin County, self Have you ever served on a City or County board? Yes Are you currently serving on a Board? Yes If yes,where, what board, and how lung? Community Alcohol Coalition Please select the position for which you would qualify. Interested Citizen What are your relevant qualifications,interests and experiences? Member of the Criminal Justicc Advisory Council;Prevention Writer for Alcohol and Drug Services; Marketing for the Gallatin Responsive Intervention Partnership and F11 Photographic Supplies; owner of a downtown retail business for 18 years. References (Individual or Organization): Jenny Haubenrciscr hors@d nontana.cdLl Phonc: (000)000-OOf1f1 Shaun Phoenix Phone: (406) 580-0562 Dorothy Bradley dObradley(a)mt.gov Phonc: Please submit electronically or print completed form and return to: Deputy City Clcrk PO Box 1230 Signature: Bozeman,Montana 59771-1230 CITY OF BOZFMAN,MONTANA APPLICATION FOR BOARDS AND COMMISSIONS Date: dun 23,2o0C Name: Sheena M. Rice Physical Address: 22 West Main,Apt. 11 Bozeman, MT 59715 Mailing Address (if different): F-mail Address: sheenarice(DRmail.com I Iomc Phone: '(Q,",' -11�0 -17]7 Work Phone: Length of time residing in Bozeman area: Three Years Occupation: Student Employer: Have you ever served on a City or County board? No Are you currently serving on a Board? No If yes, where, what board, and how long? Community .Alcohol Coalition Pleasc select the position for which you would qualify. MSU-Bozeman Student with interest in health prevention What are your relevant qualifications, interests and experiences? I am entering my Senior year at Montana State University, and working towards degrees in Philosophy and Political Science. lam also a part of the Honors Program on campus. "Throughout my tenure at MSU I have been actively involved in Students for Choice,Amnesty International, the Mentoring Gifted Children program, and Mortar Board. I have volunteered in the past in the public schools as well as Head Start. Currently I am the President of the MSU College Democrats, and have been active in the local community politics as well. Upon graduation from MSU I plan to attend law school,with a focus on international law, particularly on human rights and health issues. References (Individual or Organization): Kaaren Jacobson Phone: 11106 S%s Franke Wilmer Phone: 1/0 E S-Z-2 "i 3�1 Jane.Jehnski Phone: 1/0 C - 5 S Please submit electronically or print completed form and return to: Deputy City Clerk PO Box 1230 Signature: --3> Bozeman,Mont;:ma 19771-1230 CITY OF BOZEMAN, MONTANA .APPLICATION FOR BOARDS AND COMMISSIONS Date: Name: Stacie.Taylor Phvsical Address: 1318 W. Story St. Mailing Address (if different): same. E-mail Address: hr(aJmnw-inc.com Home Phone: (406) 579 8612 Work Phonc: (406) 587-0092 Length of time residing in Bozeman area: since 1997 Occupation: I-luman Resource Director Lrnployer: MNW, Inc (MacKenz.ie Diver Pizza) Have you ever served on a City or County board? No Are you currently serving on a Board? No If yes,where,what board,and how long? Community Alcohol Coalition Please select the position for which you would qualify. Bar or Tavern Owner/Manager What are your relevant qualifications, interests and experiences? Previous restaurant server, cocktail server, and manager at multiple establishments. Relevant present work experience dealing with alcohol service policy, training, and practice. HR person for multiple restaurants that serve alcohol (13 locations across Montana and approx. 600 employees). Currently a teacher of the free. community Responsible Beverage Service class for servers, bartenders, sales people,and managers to educate on responsibly seeing alcohol to customers, risks and responsibilities involved. References (Individual or Organization): Sean Becker Phone: (406) 581-7571 Stacy wesen Phone: (400) 587-7786 Phone: Please submit electronically or print completed form and return to: Deputy city Clerk PQ Box 1230 Signature: Bozeman,Montana 59771-1230