Board and Council Interest Form

2. How you identify
It's important to have many types of people on our Boards and Councils. Knowing how you identify helps us make sure there are different voices at the table.

Please pick the identity you would speak for if nominated for a Board. Select all that apply. *This question is required.

• I am a person with a disability or who uses OPWDD services.
• I am a family member or caregiver of a person with a disability.
• I work for a provider agency.
• I am a direct support professional.
• I am a care manager or care coordination organization staff.
• I work for a community-based organization.
• I work for a county or local government.
• Other Please enter an 'other' value for this selection. * This question is required.
• I prefer not to answer.

6. How you want to be contacted *This question is required.

• Phone
• Email

7. Group you are most interested in joining *This question is required.

• Autism Spectrum Disorders Advisory Board (ASD Board)
• ASD Board Self-Advocacy Subcommittee
• Developmental Disabilities Advisory Council (DDAC)
• DDAC Committee
• Board of Visitors
• Any of the Above
• Don’t Know
• Other Please enter an 'other' value for this selection.

8. DDAC Committee you are most interested in
You can pick up to 2 committees.
The DDAC webpage has short descriptions of each committee.

• Children’s Committee
• Employment and Meaningful Activities Committee
• Family Support Services (FSS) Committee
• Health and Wellness Committee
• Regulatory Committee
• Residential Committee
• Self-Direction Committee
• Systems, Quality, Data and Service Delivery (“Systems”) Committee