State Council on Developmental Disabilities Outreach Application

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This “outreach application” is intended to identify individuals interested in serving on the State Council on Developmental Disabilities or on one of the Council’s Regional Advisory Committees. The Council is always accepting applications. Please note that there may or may not be a vacancy that fits for you. Your application will be reviewed as vacancies occur.

The Governor makes appointments to the Council. The Council reviews and makes recommendations to the Governor. If the Council recommends that you be a Council Member, you will need to fill out an additional on-line application with the Governor’s Office.

The Council appoints directly to the Regional Advisory Committees.

First Name *

Last Name *

Street Address *

City *

Zip Code *

County of Residence *

Email *

Phone *

Race

Check all that apply (The Council is required by law to reflect the geographic and ethnic/racial diversity of California)

African- American

American Indian/Native Alaskan

Asian

Hispanic or Latino

Native Hawaiian/Other Pacific Islander

White

Other:

I am a:

Check all that apply

person with a developmental disability

parent, family member, legal guardian or conservator of a person with a developmental disability

representative of the general public

Are you currently employed by, or a member of the governing board of an organization providing services to persons with developmental disabilities? *

Yes

Are you a member of a nongovernmental agency that does not receive regional center funding? *

Yes

Check if you want to serve on the State Council

All appointments to the State Council are made by Governor Newsom. You should expect your Council activities, which include attending Council meetings every other month in Sacramento, to take 10 to 15 hours a month of your time. Your accommodation, meal and travel expenses are reimbursed and you receive a stipend of $100 per Council meeting.

Yes, I want to apply to serve on the State Council

Check if you want to serve on a Regional Advisory Committee

Members of the Council’s 13 regional advisory committees are appointed by the State Council. Regional advisory committees advise the state council and its regional office on local issues and identify and provide input regarding local systemic needs within its community. Your time commitment may be from 2 to 6 hours a month. Reimbursement for accommodation, meals, and travel is made to you, but no stipend is provided for attendance at meetings.

Yes, I want to apply to serve on the Regional Advisory Committee

How did your interest in, or knowledge of, the developmental disability field and service system develop? *

What are your areas of interest in the developmental disability field and service system? *

Please explain why you wish to serve on the State Council on Developmental Disabilities, or on one of its Regional Advisory Committees. *

What strengths would you bring to the State Council and/or Regional Advisory Committee? *

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