UCAP Advisory Board Application
Name *
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Home or Business Address *
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City *
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State *
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ZIP *
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Email *
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Preferred Phone Number *
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Primary Occupation
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Website
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Your Experience
What specialties, constituencies, or communities could you represent? *
For example, therapy, recovery, prevention, technical, social, religious, particular life stage, etc.
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Describe any professional, business, nonprofit, service, or other relevant organizations you have been involved with. *
Please include your role in the organization.
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Please describe any experience, education, or areas of expertise which relate to serving on the Council. *
Please include relevant accomplishments, publications, or awards.
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Why would you like to join the Advisory Council? *
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Availability
Advisory council meetings will take place four times per year for 1 ½ hours at lunchtime on a weekday. Meetings will be in the Salt Lake area. Would you be able attend each of the 4 meetings? *
Between meetings, would you be interested in collaborating on projects to get the word out in Utah? *
Would you be interested in helping at the next UCAP conference? *
Please add any other comments you have about becoming a contributing member of the Advisory Council.
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