Committee and Position
Personal Information
Addresses
NOTE: Preferred address will appear on public rosters
Phones
NOTE: Preferred phone numbers will appear on public rosters
References
General Information
Are you currently an officer or member of a policy-making board of a nonprofit organization founded by the County of Fresno?
County Non-Profit Organizations
Spouse County Non-Profit Organizations
Reason For Applying
Why do you want to become a member of a County Board, Commission, or Committee?
Qualifications
Please list your qualifications applicable for appointment
Interests Or Activities
Are there any interests or activities that you wish to bring to the attention of the Board of Supervisors?
Previous Appointments
List past or present County appointments, as well as any other public service appointments or elected positions held (please list dates served)
Experience
What experience or special knowledge can you bring to your area(s) of interest?
Community Organizations
List community organizations to which you belong
Convictions And Penalties
Have you ever been convicted of a felony? If yes, give dates(s), location(s) and penalties. (Convictions are evaluated for each position and are not necessarily disqualifying.)
Affiliations
List any affiliation you or your spouse has with public service agencies
Additional Information
This space is provided for any additional information you may have about yourself or the position being sought
Supplemental Information
The Fresno County Behavioral Health Board must comply with Welfare and Institutions Code, Section 5604(a) which requires:
Membership to reflect the ethnic diversity of the client population in the county as a whole, or to the
extent feasible.
Membership of the Board must be 50% consumers or the parents, spouses, siblings, or adult children of
consumers who are receiving or have received mental health services. At least 20% of the total
membership shall be consumers and at least 20% shall be a parent, spouse, sibling, or adult child of a
consumer.
For the sixteen-member Fresno County Behavioral Health Board, the correct composition requires:
Four (4) of the sixteen (16) to be consumers and four (4) of the sixteen (16) to be family of consumers.
The remaining eight (8) shall be comprised of one (1) member of the County's Board of Supervisors and
seven (7) members from the general public including individuals with experience and knowledge of the
mental health system and/or alcohol and other substance use disorder problems.
The Fresno County Board of Supervisors seeks to fulfill these requirements by actively recruiting members
of a diverse range of ethnic and cultural backgrounds, and to identify and guide consumers within our own
system of care who express an interest in serving.
The following questions are helpful in determining eligibility for appointment.
Agreements
