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27 <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: Allison Last Name: Zirkel <br /> Address: 217 S Hillsborough Ave <br /> City: Hillsborough County: Orange <br /> State: NC ZIP: 27278 <br /> Phone: 919-245-2304 Email: azirkel@orangecountync.gov <br /> How would you like us to contact you? Please check all that apply: <br /> Email <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 /> No <br /> Do you want written material in your spoken language? <br /> Yes <br /> Work Experience: <br /> Community-based mental health - provision of state funded services (IIH, CST, outpatient therapy) Currently <br /> work for the Orange County Criminal Justice Resource Dep't. I provide mental health and substance use <br /> assessment and referral, along with some brief counseling and crisis management, to the county jail <br /> population. I also collaborate with other agencies in the community including the Partnership to End <br /> Homelessness, IFC, CEF, Freedom House, and UNC. I facilitate the "Familiar Faces" Task Force to try and <br /> identify needs and service gaps relevant to community members with the highest utilization of emergency, <br /> crisis, and law enforcement services. <br /> Education (for demographic purposes. No formal education required to participate): <br /> Master's Degree <br /> am passionate about or have knowledge of(please check ALL that apply): <br /> Housing, Community organizing, Transitional age youth, Addictions, Local government, Mental <br /> Page 1 of 2 • <br /> rev. 20190926 cardinalinnovations.org <br />