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19 <br /> Membership Application for Community Advisory Council <br /> The Community Advisory Council is chartered to keep the Regional Health Council informed about member <br /> and family experiences and community health needs. This group is also intended to allow members and <br /> community stakeholders to take an active role in improving their lives and community. <br /> First Name: Lara Last Name: Kehle <br /> Address: 101 Cloister Ct. Ste. D <br /> City: Chapel Hill County: Orange <br /> State: North Carolina ZIP: 27514 <br /> Phone: 9193589270 Email: LKehle@kidscope.chtop.org <br /> How would you like us to contact you? Please check all that apply: <br /> Email, Text Message <br /> Age Range: <br /> 35-44 <br /> 1 self-identify as: <br /> Female <br /> describe my race or ethnicity as: <br /> White <br /> Race: Other, if applicable: <br /> Which spoken language to you prefer? <br /> English <br /> Do you require an interpreter? <br /> No <br /> Do you require any accommodations (handicap accessibility, space for service animal, etc.)? <br /> Do you want written material in your spoken language? <br /> Yes <br /> Work Experience: <br /> Currently, the director of KidSCope leading an agency with two developmental day centers in Orange and <br /> Chatham Counties, parent education programs (Incredible Years), early childhood mental health consultation <br /> and therapy, consultation, training and support to pediatric offices and clinics (ABCD program) Founder of <br /> Chatham Action on Resilience (CARS), and co-chair of numerous committees and coalitions Ten years in <br /> Chatham County as an Early Childhood Mental Health Consultant, parent educator, and professional <br /> development trainer with KidSCope Previously, school psychologist and mental health disabilities coordinator <br /> in Pasco County, Florida, and Baltimore, Maryland <br /> Education (for demographic purposes. No formal education required to participate): <br /> Master's Degree <br /> I am passionate about or have knowledge of(please check ALL that apply): <br /> Community organizing, Education, Maternal/child health, Children/youth services, Early learning <br /> Page 1 of 2 • <br /> rev. 20190926 cardinalinnovations.org <br />