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Michael Gillman Application PackageID MIAMI BEACH NAME: Gillman Michael Last Name First Name HOME ADDRESS: 5415 Collins Avenue, Apt 303 Miami Beach Apt No. Home No./Street City PHONE: 305-864-6314 Home Work Business Name: Address: Street Position: City CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM Middle Initial Florida 33140 State Zip Code mrmichaelgillman@gmail.com Email Address State Zip Code Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six months; or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six (6) months Yes • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: No • Are you a registered voter in Miami Beach: Yes • (Please circle one): I am now a resident of: Middle Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I have taught Sociology. Went to John Jay College in New York for Criminal Justice and my father was a Detective in New York • Are you presently a registered lobbyist with the City of Miami Beach? No Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (3) choices will be observed by the Citv Clerk's Office. (Regular Boards of City) Choice 1: Police/Citizens Relations Committee Choice 2: Health Facilities Authority Board Choice 3: * Board members are required to file Form 1 — "Statement of Financial Interest" with the State. If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review Board, Historic Preservation Board or Planning Board, attach a copy of your currently -effectively license, and furnish the following information: Type of Professional License License Issuance Date License Number License Expiration Date Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board: No Years of Service: 2. Present participation in Youth Center activities by your children No if yes, please list the names of your children, their ages, and which programs. List below: . Have you ever been convicted of a felony: No If yes, please explain in detail: . Do you currently have a violation(s) of City of Miami Beach codes: No If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: No If yes, please explain in detail: • Are you currently serving on any City Boards or Committees: No If yes, which board? • What organizations in the City of Miami Beach do you currently hold membership in? • I am now employed by the city of Miami Beach: No Which department? • List all properties owned or have an interest in, which are located within the City of Miami Beach: Gender: Male The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is being asked to comply with federal equal opportunity reporting requirements. Race/Ethnic Categories What is your race? Mark one or more races to indicate what you consider yourself to be. White Other Description: Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino. No Physically Challenged: No NOTE: If appointed, you will be required to follow certain laws which apply to city board/committee members. These laws include, but are not limited to, the following: o Prohibition from directly or indirectly lobbying city personnel (Miami Beach City Code section 2-459). o Prohibition from contracting with the city (Miami -Dade County Code section 2-11.1). o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami Beach Code section 2-26). o Requirement to disclose certain financial interests and gifts (Miami -Dade County Code section 2-11.1). (re: CMB Community Development Advisory Committee): prohibition, during tenure and for one year after leaving office, from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom you have business or immediate family ties (CFR 570.611). Upon request, copies of these laws may be obtained from the City Clerk. "I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, Article VII — of the City Code "Standards of Conduct for City Officers, Employees and Agency Members." I Michael Gillman agreed to the following terms on Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Michael Gillman, principle of ASTA Healthcare came into the industry in the summer of 1985. Prior to that time, he was employed by the New York City Department of Education in the capacity of a Guidance Counselor as well as John Joy College of Criminal Justice, Queensborough Community College and Touro College as a Lecturer, Associate Professor and Department Head in the discipline of Sociology/Anthropology. Dr. Gillman received his PhD in Sociology from St. John's University in New York. His Bachelor of Arts and Master of Arts were completed at the City of New York University -Brooklyn College. Upon arriving in Chicago, he was the Vice President of Operations for a chain of Nursing Homes managed by First Healthcare Associates. In 1996 he embarked on his own leasing three facilities. Over the years he acquired an additional four (4) facilities. The facilities are managed by ASTA Healthcare Company which is a family owned and operated company. Resume -Michael Gillman Education 1976- Ph.D- St Johns University-Sociology/Anthropology 1972- MA- Brooklyn College -Sociology 1966- BA- Brooklyn College-Sociology/Anthropology PostGraduate Studies A. New School of Social Research -study in gerontology and public health B. St Johns and Adelphi Universities -study in individual and group counseling Academic Experience 1976-1985 Touro College New York, NY Professor of Sociology/Anthropology Department Deputy Chairman from 1978 to1985 • Personnel and Budget Committee • Engaged Faculty Members 1980-1985 Licensed Guidance Counselor for the City of New York • Counseled high school students with severe emotional and adjustment problems. There were only two high schools in the city of New York (counting the 5 boroughs) that had the facilities to work with these teenagers whose mental impairment lead to anti -social behavior. 1980-1985 (summers) • Conducted psychological, educational tests to determine if the placement of student in Special Education classes were appropriate. 1970-1980 John J. College of Criminal Justice New York, NY R Assistant Professor and Lecturer of Sociology Among the job responsibilities was to teach academy level • Police officers. The group included the first female and Hispanic Police officers in the city of New York. 1970-1980 Queensborough Community College Queens, NY Assistant Professor and lecturer of Sociology /Anthropology