Community Advisory Council Application
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Please provide a brief statement of interest, including any experience, skills or expertise that will allow you to be an asset to the council, board or committee:
Please check all boxes that apply to your current and past professional experience or areas of expertise that indicate a perspective you will bring to the committee:
Denver Resident
Person Accepting Services
RMHS Contractor/Provider
Media
Legal
Finance/CPA
Operations & Regulations
Government Official
Family Member
Community Partner (eg., Denver Public Schools,mental health center)
Do you have any experience serving on any other boards, councils, or committees in the last five years? If so, please list the organization(s).
What experiences do you feel have best prepared you to be a member of this committee?
What perspective would you bring to the Community Advisory Council about unmet needs in the I/DD community?
Can you give an example of how you have successfully collaborated with others when your viewpoints weren’t necessarily aligned?
Do you have the time to attend a 2-3 hour meeting every month?
Submit
Should be Empty: