Tulare County CAPC Membership Application

Council Membership Qualifications

 

Have a direct interest in and commitment to, the improvement of child abuse prevention and intervention services in the community.

Demonstrate a knowledge of child abuse prevention and intervention services in the County and an interest in, and commitment to, the improvement of those services.

Interested agencies or individuals shall attend three (3) Council meetings within a five (5) month period prior to applying for membership.

A Council Member may not represent organizations/agencies of a controversial nature and/or that do not have child abuse prevention as a primary mission of said organization, e.g. the National Rifle Association, political organizations, fiduciary organization etc.

Council Membership Responsibilities

Attend Council meetings with no more than three (3) unexcused absences per calendar year.

Council Members shall notify the Council Executive Director and/or Council Secretary when they are unable to attend a council meeting and/or send a representative.

Participate actively on at least one (1) committee.

Council Members shall obtain approval from the CAPC prior to using the CAPC logo or referencing the CAPC in any way in relation to a specific project event or activity.

Whenever possible, Council Members shall serve as a conduit for information to and from the Council and the constituency they represent.

Participate and share responsibility for the leadership of the Council and its committees.

Evaluate annually the performance of the Council in achieving its goals.

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Please check one.

Dues

Dues are payable annually, by August 31, or a subsequent deadline date as set forth by the Executive Committee each year.

*For individual members for whom dues present a hardship, dues may be waived by the Executive Committee, upon written request by the member.

**For large organizations, the dues level is based only on the budget of the program(s) being represented to CAPC.

Make checks payable to: Tulare County CAPC

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Personal Information

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Prefered Contact Method
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Emergency Contact Information

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Organization/Agency Membership

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To represent (please indicate only one category):
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Check all funding sources that your organization receives:
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Committees/Acknowledgement

CAPC Members are expected to serve on at least one committee.

On which of the following committee(s) are you willing to serve (please select all that apply):
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CAPC Membership Responsibilities Acknowledgement:

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Please retype your name to certify your CAPC membership application.
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Please check one

Make checks payable to:

Tulare County Child Abuse Prevention Council
PO Box 1062
Visalia, CA 93279

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Tulare County CAPC Membership Application

Council Membership Qualifications

 

Have a direct interest in and commitment to, the improvement of child abuse prevention and intervention services in the community.

Demonstrate a knowledge of child abuse prevention and intervention services in the County and an interest in, and commitment to, the improvement of those services.

Interested agencies or individuals shall attend three (3) Council meetings within a five (5) month period prior to applying for membership.

A Council Member may not represent organizations/agencies of a controversial nature and/or that do not have child abuse prevention as a primary mission of said organization, e.g. the National Rifle Association, political organizations, fiduciary organization etc.

Council Membership Responsibilities

Attend Council meetings with no more than three (3) unexcused absences per calendar year.

Council Members shall notify the Council Executive Director and/or Council Secretary when they are unable to attend a council meeting and/or send a representative.

Participate actively on at least one (1) committee.

Council Members shall obtain approval from the CAPC prior to using the CAPC logo or referencing the CAPC in any way in relation to a specific project event or activity.

Whenever possible, Council Members shall serve as a conduit for information to and from the Council and the constituency they represent.

Participate and share responsibility for the leadership of the Council and its committees.

Evaluate annually the performance of the Council in achieving its goals.

Application Status:
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Dues

Dues are payable annually, by August 31, or a subsequent deadline date as set forth by the Executive Committee each year.

*For individual members for whom dues present a hardship, dues may be waived by the Executive Committee, upon written request by the member.

**For large organizations, the dues level is based only on the budget of the program(s) being represented to CAPC.

Make checks payable to: Tulare County CAPC

Affiliation/Dues
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Personal Information

Name
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Job Title
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Organization
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Home Address
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Work Address
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Personal Email
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Work Email
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Home Phone
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Work Phone
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Cell Phone
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Fax
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Prefered Contact Method
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Membership on other Boards/Commissions (Please list all):

Emergency Contact Information

Name
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Home Phone
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Cell Phone
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Organization/Agency Membership

In applying for an organizational membership, I have authority, as granted by (provide name and title below):
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To represent (please indicate only one category):
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Check all funding sources that your organization receives:
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Committees/Acknowledgement

CAPC Members are expected to serve on at least one committee.

On which of the following committee(s) are you willing to serve (please select all that apply):
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CAPC Membership Responsibilities Acknowledgement:

As a Member of this Council, I understand that I may not have more than three (3) unexcused absences per calendar year to maintain membership and I agree to participate by representing myself or my agency in the Council's activities and decisions as stated in the Council By-Laws: "A Council Member must show involvement in and support from the organizations, agencies, and constituencies they represent and be willing to be a liaison between them and the Council."
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Name
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Payment Options
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Make checks payable to:

Tulare County Child Abuse Prevention Council
PO Box 1062
Visalia, CA 93279
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