Clinton Collaborative Council Agreement

Council Involvement Agreement

The Clinton Collaborative Council is a countywide group of stakeholders who work together through the Strategic Prevention Framework (SPF) process to address substance misuse issues.

I agree to become a member of the Clinton Collaborative Council. I agree to learn about programs and projects within the Clinton Collaborative Council and participate in supporting and/or working on projects and programs as appropriate. I acknowledge the contributions and expectations of all members and organizations of the Council. I also agree to communicate if I become unavailable.

Question Title

* 1. Contact Information

Name *

Agency

City/Town

Email Address *

Phone Number

Question Title

* 2. What sector do you represent?

Youth (Under 18)/Student

Parent/Caregiver

Business Professional

Media

Educator

Youth-Serving Representative

Law Enforcement Professional

Religious/Fraternal Representative

Civic/ Volunteer Representative

Healthcare Professionals

Elected Official

Substance Use Professional

Young Adult/College Student

Senior Citizen

Veteran

Person with relevant lived experience

Concerned Citizen

Other (please specify)

Clinton Collaborative Council Agreement

Council Involvement Agreement

Question Title

* 1. Contact Information

Question Title

* 2. What sector do you represent?

Question Title

* 3. Thank you for your membership to the Clinton Collaborative Council. Please feel free to make any additional comments below.