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9 <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: Krista Last Name: Caraway <br /> Address: 109 Cabernet Drive <br /> City: Chapel Hill County: Orange <br /> State: NC ZIP: 27516 <br /> Phone: 9105546681 Email: kristazeltcaraway@gmail.com <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 /> I decline to answer <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 /> 20 years as a special educator in public education in NC, ARC, UNC Autism Researcher and Educational <br /> Coach, ASNC board of directors for Orange and Chatham Counties, Special Olympics of Orange County <br /> Coach <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 /> Housing, Community organizing, Education, Maternal/child health, Children/youth services, Transitional age <br /> youth, Addictions, Community/public health, Early learning, Local government, Public policy/advocacy, Mental <br /> health services, Wellness promotion/prevention, Health equity/disparities, Law enforcement/corrections, Faith <br /> communities, Domestic violence <br /> Page 1 of 2 • <br /> rev. 20190926 cardinalinnovations.arg <br />