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21 <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: Kathryn Last Name: Kennedy <br /> Address: 3105 Mel Oaks Trail <br /> City: Chapel Hill County: Orange <br /> State: United States ZIP: 27516 <br /> Phone: 9196191523 Email: katepaisleykennedy@gmail.com <br /> How would you like us to contact you? Please check all that apply: <br /> Email <br /> Age Range: <br /> 45-54 <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 /> No <br /> Do you want written material in your spoken language? <br /> Yes <br /> Work Experience: <br /> I am currently the Chapel Hill Carrboro City School District Lead AVID, Twice Exceptional and Gifted Education <br /> Specialist. I have also worked as a Family Support Network parent advocate as well as working at UNC <br /> Department of Psychiatry as the Parent Education and Family Support Advocate in the ASPIRE autism study. I <br /> also supported families with other severe mental health diagnosis. <br /> Education (for demographic purposes. No formal education required to participate): <br /> Bachelor's Degree <br /> I am passionate about or have knowledge of(please check ALL that apply): <br /> Education, Children/youth services, Transitional age youth, Early learning, Mental health services, Wellness <br /> promotion/prevention, Disability services, Health equity/disparities, Domestic violence, Communities of color <br /> Page 1 of 2 • <br /> rev. 20190926 cardinalinnovations.org <br />